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What is Insulin? Insulin is a fat storing blood sugar regulating master hormone that is involved in multiple body functions beyond its metabolic role. A few examples include triglyceride and fat synthesis, electrolyte balance of sodium and potassium, feeding behaviors and cognitive and emotional brain function.

What is Insulin Resistance? Insulin resistance (IR), also known as syndrome X or metabolic syndrome, is a cluster of symptoms (weight gain, cravings and increased appetite, skin tags, gum disease, low energy) and health risk factors (abnormal blood sugar, high triglycerides and cholesterol, polycystic ovarian syndrome, high blood pressure) all resulting from abnormal insulin function. To be insulin resistant means that your body can't properly respond to the insulin it makes. Over tie, this leads to chronically high blood sugar levels. What is important to know is that just like diabetes, with IR there may be no symptoms at all. Insulin resistance is an early-stage in Type 2 diabetes but not everyone with IR will develop diabetes. Fifty percent of those with essential hypertension are insulin resistant. ( 1).

How Many People Are Affected by Insulin Resistance? IR is more common than you may think. In the United States, an estimated 60 to 70 million individuals are affected by insulin resistance. That’s 1 out of 4 people. More than 40% of individuals older than 50 years may be at risk for insulin resistance; however, it can affect anyone at any age ( 2) especially overweight children and adolescents regardless of race. You can connect with this link to see a table of the prevalence of insulin resistance by country.

Causes of Insulin Resistance There are several factors that may play a role in developing insulin resistance: Genetics and family history of diabetes, pre-diabetes

Ethnic origin (African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American)

Age

Impaired hormonal regulation

Pregnancy, including a baby delivered at 9 pounds or more

Weight gain and obesity

Medications such as steroids

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Am I at Risk of Developing Insulin Resistance? Insulin resistance or prediabetes is characterized by a high insulin level. N.M. Kaplan names insulin resistance as one of 4 risk cardiovascular risk factors of the "deadly quartet" along with hypertension, hypertriglyceridemia, and low, high-density lipoprotein cholesterol (HDL). ( 3) Along with these risks, IR is associated with: fatty liver possibly leading to cirrhosis and less commonly liver cancer ( 4);

4); high blood sugar (>100mg/dl); high blood pressure—140/90 mmHg or above; HDL cholesterol level below 35 mg/dL or a triglyceride level above 250 mg/dL;

acanthosis nigricans, a skin condition characterized by areas of dark, velvety discoloration in body folds and creases such as the back of the neck, armpits and groin ( 5);

5); male pattern baldness, in women too (6);

carbohydrate addiction and insatiable hunger ( 7);

7); polycystic ovarian syndrome ( 8);

8); skin tags and acne ( 9);

9); gout as a result of easily converting fructose to uric acid ( 10);

10); gum disease ( 11);

11); and/or swollen fingers and ankles with sodium/potassium imbalance ( 12).

Diagnosing Insulin Resistance The general signs of insulin resistance may make it difficult to pinpoint but it can be diagnosed clinically by taking a fasting insulin level (over 25 ml/U/L) or blood insulin and glucose levels obtained during 120 min of a standard (75 g glucose) Oral Glucose Tolerance Test (OGTT). The table below lists normal insulin levels (13). However, many functional medical doctors believe that a fasting insulin level of less than 5 mI/U/L is optimal (14). Insulin Level Insulin Level (SI Units)

SI unit: conversional units x 6.945 Fasting < 25 mlU/L < 174 pmol/L 30 min after glucose uptake 30-230 mIU/L 208-1597 pmol/L 1 hr after glucose uptake 18-276 mIU/L 125-1917 pmol/L 2 hr after glucose uptake 16-166 mIU/L 111-1153 pmol/L The #1 Keto Diet App Free Download 1,500+ delicious keto recipes Trialed & tested for best results Optimized for nutrition Never feel hungry Planner & tracker Track all macros including net carbs Scan products Create your own meals Advanced tracking Track ketones, blood glucose & lipids Stay hydrated with water tracking Track your mood & energy levels Macro calculator Calculate your ideal fat, protein & carb intake Set any goal: weight loss, maintenance or weight gain Your macros update based on your progress Progress Monitor your macros, water intake, mood & energy Body weight, body fat and body measurements Ketones, blood glucose & lipids Evidence-based content Expert articles to help you make informed choices Guides & free diet plans New daily content And so much more...! Complete Keto Diet guide Integrated shopping basket Restaurants & guide to eating out Free Download App Store Google Play App Store Also available on Google Play Google Play Also available on App Store

How Does the Ketogenic Diet Improve Insulin Resistance? Since 100% of the carbohydrates you consume will trigger insulin release, cutting carbs to a ketogenic level of 25-50 grams a day will help lower insulin levels. Green leafy low-glycemic vegetables are healthy low calorie sources of carbohydrates. The safety and efficacy of a ketogenic diet is well established in helping to reduce cholesterol and heart disease risk and blood sugar and insulin fluctuations ( 14, 15) while a low fat diet may increase these health risks. In one randomized study, 13 overweight women followed a low fat diet for 4 weeks and then a ketogenic diet for 4 weeks. "Compared to a low-fat weight loss diet, a ketogenic diet did not lower LDL-C but did prevent the decline in HDL-C and resulted in improved insulin sensitivity in overweight and obese, but otherwise healthy women." ( 16) In other studies, a ketogenic diet helped raise good HDL cholesterol levels in men ( 17). This is true for children too. For 12 weeks, 10 pre-adolescent children with GLUT-1 deficiency syndrome (a rare genetic disorder involving neurological dysfunction) consumed a ketogenic diet. Insulin levels were significantly lower without medications or adverse effects on inflammation or abdominal fat ( 18). Ketogenic diets are not just for adults. A family can eat healthy while feasting on delicious ketogenic meals to support good health, weight loss and insulin control. These studies support the role of a high-fat ketogenic diet benefitting heart disease risk factors and insulin levels, without causing weight gain or inflammation in both adults and children. Research has shown many health benefits for ketogenic diets.

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Valerie Goldstein, MS, RD, CDE Author and Health & Blood Sugar Expert Valerie is a Dr. Atkins trained registered dietitian and certified diabetes educator. She is acknowledged in his books, "Dr. Atkins New Diet Revolution" and "Atkins for Life". Valerie always says, "The ketogenic diet provides the most nutrient bang for the calorie buck" and so she uses this nutritional approach and personalizes it for all her medical, weight loss and athletic clients throughout the country. More posts by Valerie Goldstein, MS, RD, CDE Valerie Goldstein, MS, RD, CDE Expert Article This article was written by Valerie Goldstein, MS, RD, CDE who is a qualified expert. At KetoDiet we work with a team of health professionals to ensure accurate and up-to-date information. You can find out more on the About us page. Evidence Based Evidence-Based articles are based on medical research, and scientific evidence. Our expert authors focus on hard evidence alone and include relevant research references from trusted sources to support their articles. We always aim to deliver relevant, trustworthy and up-to-date information based on trusted evidence and proven research.