How to Treat Insulin Resistance and Lose Weight

In the last blog, I discussed how sugar leads to weight gain, particularly through empty calories and insulin resistance.

But  the main issue with sugar leading to insulin resistance is that insulin resistance is the precursor to Type 2 Diabetes (DM2).

What is DM2? In a sense, it is not true diabetes, at least at the outset, because the pancreas can still secrete insulin.  DM2 is actually insulin resistance that has progressed to the point that the cells in the body become so resistant to insulin that the blood sugar level in the blood is elevated pretty much all the time.

And that is what diabetes is--chronically high levels of sugar in the blood stream. At some point in DM2, the pancreas may not be able to secrete insulin any longer and then these diabetics will have to go on insulin therapy.

Currently we have an epidemic of DM2 in the US.

How dangerous is DM2? Well it doesn't kill you---directly. It kills you indirectly by causing inflammation that can lead to heart disease. And the high level of sugar in the bloodstream can deposit in your feet causing numbness and tingling which makes it difficult to walk and promotes falling. It can deposit in your kidneys leading to kidney disease and kidney failure. It can deposit in your eyes and cause blindness. It can cause poor wound healing that can lead to ulcers and infections and amputations.  I'll stop here.

So what can be done about it?

First of all, sleep 7-9 hours per night. This is vital. If we get less than 6.5 hours of sleep (and this means actual sleep, not just time spent in bed) cortisol (our stress hormone) becomes elevated for up to 2-3 days afterward. Elevated cortisol causes, among other things, increased appetite and weight gain around the abdomen, BECAUSE it increases insulin resistance! Just what we are trying to avoid!

So how do we prioritize sleep? if it were easy to do, more people would be getting more sleep, so let's take a look at this.

 If you aren't getting enough sleep, ask yourself: What is preventing me from getting more sleep? Some of the reasons patients give me for not getting enough sleep include: a partner who snores; having  a baby/small children; getting sucked into social media/TV/the internet/ etc; their work schedule interferes with their sleep; it's the only time they have to themselves.

Let's look at these one by one.

Snoring is a health issue. It impairs the quality of sleep of the snorer( and those around him or her).  Snoring can be due to sleep apnea, which can be a component of high blood pressure.  And it leads to insulin resistance. Get a sleep study and use a c-pap machine, OR use Breathe Right nasal strips, Bongo Rx, or get a mouth piece from your dentist.

Okay, small children are definitely sleep interrupters! And they are a priority. Other than taking naps while they're napping (hint hint)there's not much you can do. But they do grow up---so in the meantime, do what you can.

Getting sucked into social media/TV/the internet/etc:  Set a bedtime.  One of my instructors at Bastyr University, David Musnick MD, said at a recent conference that everyone should have a bedtime, and that he is surprised at how many adults do not have a bedtime. I'm not surprised, but he has a very good point! Set a bedtime that allows you 8 hours or more in bed. That gives you something to aim for. If you don't have a bedtime, then it's easy to watch one more show, read one more post or chapter in your book, do one more task, etc. And then you go to bed too late and have to get up too early.  And then you don't feel well. And without enough sleep we are more inclined to make poor decisions like having that piece of cake before bed, or skipping exercise because we are too tired.

Okay, it's also easy to ignore a bedtime. But at least you've thought it out and you have a goal. Maybe set a bedtime 15-30 minutes earlier than the usual time you go to bed and gradually increase it until you have 8 hours in bed.

Work schedules can be a tricky one, especially working a swing or graveyard shift instead of a day shift. Many shift workers tend to break up their sleep. If you have to, you have to. But if you can, try to allow for 8 hours in bed in a dark room. Wear earplugs or use a white noise machine to block noise. If your work schedule varies, try melatonin 1.5-3mg 30-60 minutes before bed. If it's just starting work earlier than you like, do your best to set an earlier bedtime and try to stick to a similar schedule on your day off so you have a more consistent sleep schedule which will  ensure better sleep.

Now we get to the big one! Not having enough time to do the things we want to do or to have time to ourselves. There is no easy answer to this one. We all have demands on our time that interfere with things we want to do. In my experience,  this is especially true of women who are wives and mothers. Many of my clients who are wives and mothers say it's only after the kids (and maybe the husband) are in bed, that they feel they can do things for themselves.

 One suggestion is to put the kids to bed earlier. My parents were on to this one! My siblings and I were in bed by 7:30 until we were 8 years old (then we were allowed to stay up until 8!).  Seriously, young children do need a lot of sleep.  Start adjusting their bedtimes to allow you more adult time in the evening. If your kids are older, set a time for them to be in their rooms doing quiet things until their bedtime. You can always check to make sure lights are out at the appropriate time.

Other options include delegating afternoon/evening chores, making dinner in the morning in a crock-pot to have dinner ready in the evening,  having older children prepare/help prepare dinner, or, just doing less (what a concept!). Life is not just about chores! Do things you enjoy--with your family AND for yourself. Like they say in the preflight video: If the oxygen masks drop, put one on yourself first, before you help someone else. If you don't have time to give to yourself, you can't really give to others. Just don't rob yourself of sleep to do it.