Understanding Insulin Resistance – By Dr Harold Gunatillake
“Commemorating Sri Lankans worldwide. Compiled and presented by Dr. Harold Gunatillake.” Dear audience, I’d like to express my gratitude for your regular viewership of my channel. The consistent growth in the number of subscribers is genuinely commendable.
Today’s discussion centres on a compelling subject that will engage you and our esteemed medical colleagues. Specifically, our focus will be on diabetes and the need to revolutionise its management, shedding light on the current practices.
First, why not consider renaming type 2 diabetes as ‘Insulin Resistance Disease’? This terminology
would aptly reflect the essence of the condition. Unfortunately, we cannot proceed because there are other clinical conditions in which insulin resistance is causative.
Insulin resistance is a clinical condition shared by many diseases besides type 2 diabetes (T2DM), such as obesity, polycystic ovary syndrome (PCOS) and nonalcoholic fatty liver disease (NAFLD). In all these diseases, insulin resistance can be reversed to recover from type 2 diabetes, obesity, fatty liver disease and may be Polycystic disease in the ovaries.
Most women with PCOS are metabolically resistant to insulin, either owing to genetic propensity or obesity, and it may be challenging to reverse the insulin resistance, unlike in other diseases like type 2 diabetes, obesity and fatty liver disease. Let’s now discuss type 2 diabetes, the most common disease among people, including Sri Lankans worldwide.
It’s a common misconception that taking medications like metformin, diamicron, and later insulin therapy can cure type 2 diabetes, but this is not the case.
If you label it as insulin resistance disease, steps can be taken to reverse the insulin resistance and make insulin more sensitive, ultimately reversing the process.
Most people believe that simply seeing a doctor and taking anti-diabetic medication will control their disease. However, this is not the case, and many people with diabetes are not aware of it.
It is a factual assertion that administering antidiabetic medication for type 2 diabetes enables the regulation of blood glucose levels. Consequently, individuals often experience a sense of contentment when their trimonthly HbA1C tests yield results within the normal range, specifically below 7, affirming the efficacy of their management regimen.
Consider the following analogy: a person holds an asbestos sheet over a fire, mistakenly believing
there is no fire beneath the sheet. In this scenario, diabetes represents the fire, while medication
symbolises the sheet. I sincerely hope this analogy effectively conveys my intended message to the
audience.
Healthcare providers frequently prescribe antidiabetic medication without fully conveying the nature of the disease and the importance of addressing insulin resistance. In cases where blood sugar levels remain elevated despite medication, additional medications may be introduced to manage the levels, potentially exacerbating insulin resistance.
Dear audience, I aim to present this information without casting aspersions on medical practitioners. Regrettably, this is the prevailing approach to diabetic management.
To manage elevated blood sugar levels, it may be necessary to consider doubling the prescribed medication. However, while this approach may offer control over blood glucose levels; it does not
address the underlying inflammatory processes contributing to the full spectrum of complications
associated with diabetes.
Moreover, this intervention may only defer the onset of complications rather than prevent them altogether. The elevated prevalence of diabetic complications, notably cardiovascular events, stroke, and peripheral artery disease, frequently necessitates amputations. Presently, the most severe complication observed in well-managed diabetics manifests as infections and ulcerations of the lower extremities, culminating in septicaemia, coma, and fatality.
This happened to my dear wife. It is currently perceived that the essential approach to managing insulin resistance and its related complications does not primarily involve the use of antidiabetic medication for reversal. Instead, the emphasis is on managing insulin resistance with minimal or no medication to enhance sensitivity, presenting itself as a viable solution. Furthermore, a method exists to achieve this objective.
Allow me to recount my experience of overcoming insulin resistance, a condition for which I relied on substantial doses of insulin twice daily for more than a decade. The insulin medication resulted in weight gain, causing me to become overweight.
Five years ago, I transitioned to a plant-based diet comprising 3-5 tablespoons of red rice and a plate predominantly filled with home-cooked vegetables. I initiated an interval walking regimen within my home’s confines, achieving an average of 30,000 steps daily. Indoor walking provided considerable motivation and bolstered my
confidence to expand my physical activity. I could conveniently take breaks, hydrate, and attend to personal needs amidst these sessions, further intensifying my commitment to indoor walking. I must confess that I enjoyed two cans of chilled beer daily on my routine indoor walks.
Beer serves as a substantial source of nutritional value. A standard 12-ounce serving of beer boasts a rich array of B vitamins and essential minerals, including potassium, magnesium, and phosphorus, comparable to wine. Notably, beer surpasses wine in selenium and silicon content. Moreover, grain and yeast in beer ensure a notable protein content. Barley, the predominant grain used in beer production, contributes significantly to its protein composition, while other grains such as corn, wheat, oats, and quinoa further enhance the beer’s plant-based protein profile.
Beer has no sugar, and people with diabetes can enjoy it. Some beers may have about 2 grams of sugar. Alcoholic beer is likely safe for most adults when used in moderation (two 12-ounce glasses daily). But drinking more than this is possibly unsafe. Drinking higher amounts of alcoholic beer can cause blackouts, drowsiness, low blood sugar, vomiting, and other serious problems.
Dear viewers, I have provided important information, especially for those with diabetes, about current practices.
Therefore, I advise you to follow my lead and enjoy two cans of chilled beer daily during indoor intermittent walks.
Take care and goodbye for now.
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