Prediabetes is an increasingly common health condition affecting more than 97 million people in the United States. That is more than one in three adults. As the name suggests, prediabetes precedes diabetes, a condition in which the body cannot keep blood sugars in a healthy range without medical intervention. Prediabetes is a state where it is more difficult to keep blood sugars in a healthy range. Blood sugar values, or glucose levels, may still be in a normal range but the body is working harder to maintain this range. While diabetes may be reversible in some cases, prediabetes is reversible in most cases.
However, many people with prediabetes are not aware that they have it. Fortunately, screening has become more routine. Because it is such a treatable condition, the sooner the condition is diagnosed, the better the outcome. Prediabetes is also called “insulin resistance”. Insulin resistance is a description of what is happening metabolically to the cells in prediabetes.
What is insulin resistance, anyway?
When we eat, the food travels from our mouth where simple digestion starts, to our stomach where the digestive process picks up steam, and finally to our small intestines where the bulk of digestion happens. The “fuel” from food is absorbed into the bloodstream in the small intestines.
Insulin is the hormone that allows us to use all of this fuel. Insulin “unlocks” a receptor that allows glucose, the fuel, to get in and power a cell. When the cells in the body need fuel, they respond quickly to insulin, opening the receptor to allow it inl. When cells don’t need fuel, they respond to insulin more slowly.
Insulin resistance can develop in a number of ways. One example is eating that in a way allowing large amounts of glucose in the system all at once, causing cells to take up lots of glucose all at the same time. This results in a quick drop in blood glucose levels. When blood glucose drops too quickly, the body signals a need for more fuel immediately - no matter when you ate last. Eating foods high in readily-available fuel, like sugar/glucose, gets blood sugars up quickly. In response the body secretes insulin and the cells try to respond by taking up as much fuel as they can. This causes blood glucose levels to drop quickly which cues the need for more fuel/glucose and the cycle repeats.
When this cycle happens too often and for long periods of time, cells struggle to take up glucose even though insulin is there to open the receptors. Cells are, essentially, “full”. But since there is a lot of fuel floating around the body, insulin is continually secreted. It’s like banging on a locked door with a louder and louder “knock” to get the door to open. At first, the body can manage this and blood glucose levels will appear “normal”, it’s just taking more insulin to make that happen. This is insulin resistance. When cells are slower to respond to insulin, they are “resistant”. Over time, this cycle gets worse, blood glucose will start to creep upward, and you have prediabetes.
How to eat to improve insulin sensitivity:
There are several ways diet can help your cells be more responsive to insulin. The goal of a diet for prediabetes is to reduce how much insulin is needed after eating, reduce how often you secrete insulin, and increase feeling well-fueled and energized between meals.
Remember, it isn’t until food reaches the intestines that blood glucose levels rise, so one way to keep blood glucose levels low is to slow down how quickly food is digested and fuel is absorbed.
Adding protein and fiber rich foods to a meal is like making a “time release” capsule out of your food.
Reducing the amount of readily-available fuel in a meal can also reduce blood glucose levels. Since certain types of carbs (carbohydrates) are digested and absorbed very quickly, adjusting the types of carbs in the diet, and the quantity, can reduce the insulin you secrete.
Consume moderate quantities of simple carbs and starches at each meal. It’s not “no carbs”, it’s “some carbs”.
Going for hours and hours between meals might seem like a great way to reduce insulin, afterall, we only secrete insulin after eating a meal, right? Not exactly! Going for long periods of time without eating (more than 4 hours in most cases) results in an increase in the stress hormone cortisol. Cortisol makes insulin resistance worse, and makes it more difficult for cells to respond to insulin.
Eat every 3-4 hours during the day, to keep cells out of “stress-mode”. This is especially important when first addressing insulin resistance.
I have frequently seen that following these simple changes results in improving insulin sensitivity. It may also result in an increase in physical energy, an increase in mental clarity and a reduction in sugar cravings. I’ll dive into these results in more detail in an upcoming article.
Stay tuned!
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