“I can’t lose weight”: what does insulin and glucose have to do with it

After the holidays, thoughts about how to throw off everything acquired by excessive rest come more and more often. Many try to go on diets, sign up for gyms, increase the amount of physical activity and reduce the number of calories absorbed.

In principle, this tactic in most cases brings results.

And yet not always. What if you can’t lose weight?

Sometimes the body’s insulin resistance is to blame. What is it and is there a way to fix the situation? MK dealt with this issue.

Are carbohydrates evil?

Those who actively follow trends in the world of diets and weight loss have probably noticed how from time to time one or another product or substance is declared a global evil and the root of all troubles with weight gain. These fads are similar to pestilence epidemics in the Middle Ages – when everyone massively starts to shy away from bananas and grapes, and then it turns out that they are harmful only to certain categories of patients.

In recent years, crusades have been periodically declared against carbohydrates and glucose. Low-carb or no-carb diets are gaining popularity more and more, each product is meticulously evaluated for the presence of these terrible substances, and all kinds of weight loss “gurus” talk about how bad it is to eat fruits, because they, oh horror, fructose! And this is a terrible carbohydrate. Although, in fact, carbohydrate restrictions are needed only for patients with certain diagnoses, and for a healthy body, receiving carbohydrates from food in an amount of at least 50% of the entire diet is simply vital.

“The thing is that for the implementation of any process, our body needs energy. It is necessary for the heart to beat, for the lungs to breathe, for the liver, kidneys, and spleen to work, and for the central processor to still be engaged in higher nervous activity, that is, to think. The main source of energy for our body is carbohydrates, from which glucose is produced. It enters cells, tissues and organs and gives them strength for daily existence. So there is nothing wrong with carbohydrates, and the whole point is how to handle them correctly, ”says Valery Savanovich, an expert on the laboratory diagnostics market.

The first important aspect is that it is better to feed the body with the so-called slow carbohydrates: these are cereals, legume dishes, whole grain and rye bread, durum wheat pasta. Carbohydrates from such products are processed slowly and provide long-term nutrition to the body. Vegetables, fruits, berries, greens are also useful: in addition to fructose, they contain fiber necessary for the functioning of the gastrointestinal tract, they are rich in vitamins and useful nutrients.

The second aspect is moderation. Even very healthy food can be eaten so much to harm yourself instead of good, which is why it is recommended not to exceed the norm of 50-55% of carbohydrates in the whole diet. But the third aspect is insulin and carbohydrate metabolism. And this is where the fun begins.

Why do we need insulin

Many have heard about insulin only in the context of diabetes, but we will talk about this a little later. Insulin is a protein-type hormone produced by the beta cells of the islets of Langerhans located in the pancreas. And they do this because insulin plays a leading role in the regulation of carbohydrate metabolism. That is, simply put, insulin commands the processing of carbohydrates and the absorption of glucose. If we simplify it a lot, then the scheme looks like this: first we eat something carbohydrate – for example, buckwheat porridge. The gastrointestinal tract digests it, turning carbohydrates into glucose. Insulin activates the enzymes that process it, increases the permeability of cell membranes for glucose and stimulates the formation of glycogen from glucose, which occurs in the liver and muscles. The result of this process is that the body received the energy necessary for work, and excess weight did not appear, since all carbohydrates went to a good cause. Problems begin when failures occur in this well-functioning mechanism.

Insulin resistance is a decrease in the sensitivity of cells to the effects of insulin. Because of this, insufficient glucose enters the cells and, accordingly, all tissues and organs, therefore, the body receives less energy. What is he doing? That’s right – it increases the production of insulin. The result is a fairly typical picture for a patient with insulin resistance: a strong craving for sweets, because. sugar is the source of the fastest carbohydrates; a sharp increase in appetite – up to the point that a person begins to eat every half an hour, a sharp increase in hunger – when it is impossible to do anything until you eat; a drop in the feeling of satiety – the very “black hole” in the stomach that many overweight people complain about; weight gain, even if the person is trying to control appetite and nutrition.

However, it is precisely with volitional control that difficulties arise. After all, the body increases the feeling of hunger for a reason – it really starves. Due to insulin resistance, he cannot get the right amount of energy for life processes. That’s why attempts to quickly, decisively pull yourself together and start eating less often fail, and the weight continues to grow, despite exercising in the gym.

Why carbohydrate metabolism breaks down

Insulin resistance is a very alarming signal that indicates that the patient has a sharply increased risk of developing diabetes. This is a serious endocrine disorder – according to WHO statistics, more than 4 million people die every year from complications of diabetes mellitus, which ranks 4th among the causes of death worldwide. In Russia, according to Rospotrebnadzor, the estimated number of patients with this diagnosis reaches 9 million people, which is 5.7% of the total population. In this regard, Russia is keeping pace with the rest of the world – 422 million diabetics, that is, just over 6% of the world’s population.

There are several main causes of insulin resistance. First of all, it is hypodynamia – a lack of elementary physical activity. And what can we say about sports, if office everyday life often leaves 2-3 hours of free time per day. Another reason is long-term malnutrition. That is, with a predominance of fatty, fried, sweet foods in the diet; the use of fast carbohydrates and unhealthy fats together with healthy ones.

In addition, the formation of insulin resistance is facilitated by various lesions of the pancreas – pancreatic necrosis, pancreatitis, as well as some infections, injuries, and alcohol abuse. Heredity also plays an important role – the presence of close relatives with a diagnosis of diabetes mellitus.

An endocrinologist, if insulin resistance is suspected, prescribes a number of tests: for the concentration of glucose in the blood (the norm for adults is below 7.0 mmol / l), the level of glycated hemoglobin (the norm for adults is below 6.5%); insulin level (the norm for adults is 1.9-2.3 mIU / l).

Insulin resistance is calculated by the formula: the glucose index is multiplied by the insulin level and divided by 22.5. If the result exceeds 2.7, then this indicates insulin resistance, but it is too early to despair – it can and should be reduced without bringing the matter to diabetes.

There are expert assessments in recent years: according to laboratory diagnostics, in 1.3% of patients in 2021 and 1.4% in 2022 who donated blood for glucose, an excess of its level above 7 mmol / l was detected. Which indicates developing diabetes mellitus. “If we consider patients who donated glycated hemoglobin without glucose or with a glucose level above 7 mmol / l, then the results are as follows: the number of results equal to or greater than 6.5% was 3.4% in 2021 and 3.3% in 2022 -m. That is, the situation has been stable for 2 years,” continues Valery Savanovich.

And yet, in 2021, the number of patients with identified insulin resistance was 10.8% of all who applied for glucose and insulin tests, and in 2022 – already 12.8%. Why so, if there is no growth in glucose? Because two indicators are needed to calculate the insulin resistance index – glucose and insulin. If glucose is normal, there is often an increased level of insulin, and this indicates that the body is struggling with the onset of diabetes and needs help, ”our expert notes.

To reduce the level of insulin resistance, you must strictly follow the prescriptions of the endocrinologist. As a rule, they include taking medications in a certain dosage, on a schedule and for a duration that the doctor will prescribe. He will also prescribe a diet – and these are not the “diets” that the Internet is full of. This is a nutritional system that must be adhered to always, until the end of life. It excludes foods that are unsafe for patients with insulin resistance, that is, those very fast carbohydrates and harmful fats. And finally – this is an increase in physical activity – albeit not sports, but walks and exercises.