Health & Wellness: Insulin Sensitivity

Insulin resistance is directly related to many chronic health conditions. As the research continues to evolve, we see blood sugar regulation playing a large role in many diseases. Insulin resistance syndrome is used to describe a combination of conditions. However, the common factor in all of these is that the body does not properly utilize insulin to metabolize sugars. Some of these health conditions include obesity, type 2 diabetes, hypertension, excess inflammation, hypercholesterolemia, and heart disease.

For an individual who is experiencing insulin resistance, the body’s cells have a lack of ability to respond to the action of insulin. Insulin is a hormone that removes glucose from the body and places it into our cells. Type 2 diabetes in certain families has been linked to a genetic background but we are finding that environmental factors truly unmask the genes.

To test genotypes, we use DNA Health from DNA Life. This report shows us the genetic makeup an individual has as well as their risk factors for certain health conditions. A sample report is shown below:

Genes

PPARG 

This gene is lipid sensing, meaning it modulates energy metabolism, lipid storage, and inflammation. This protein is mainly found in fat cells. Studies show that it is involved with lipid metabolism and glucose and it has been identified as the nuclear receptor for insulin-sensitizing drugs.

The wild type, CC, has a moderate impact whereas the heterozygote CG and homozygote GG have beneficial impacts. When the G allele is brought in, we see benefits to individuals. The G allele is associated with reduced transcription activation and as a result, has been associated with lower fasting insulin levels. Additionally, it has also been associated with improved insulin sensitivity and reduced risk of insulin resistance in type 2 diabetes. For those who have the C allele, we see an increased risk for type 2 diabetes and impaired glucose tolerance.

For those who have a C allele, it is best to monitor this gene with nutrition and exercise. There is nothing that is more powerful to manage blood sugar that movement. For more information, please visit GeneCards, The Human Gene Database for PPARG. 

TCF7L2

This gene regulates blood sugar homeostasis. If you have this SNP there is influences with both insulin secretion and sensitivity. It is thought that TCF7L2 operates via impaired glucagon-like peptide secretion, which is stimulated more by fat than by carbohydrate ingestion. This is inflammatory and also stores toxins. If you have a decreased expression, you likely will have more particular fat storage.

Those who have the wild type, CC show no impact. Individuals with CT heterozygote show a low impact and individuals with TT homozygote show a moderate impact. Those who have the T allele are more susceptible to insulin resistance and diabetes. Furthermore, those with this allele tend to require more long term intervention to manage weight and prevent insulin resistance as well as diabetes.

Similar to above, exercise and nutrition are key. If you have a T allele, we see la ow fat, hypo-energetic diet to be the most beneficial when it comes to losing weight. However, all diets that will manage insulin resistance are recommended, such as intermittent fasting and low glycemic loads. For more information, please visit GeneCards, The Human Gene Database for TCF7L2. 

FTO

This gene is present at high levels in several metabolically active tissues. This includes the heart, kidneys, adipose, and is mostly expressed in the brain. Specifically, this gene is expressed in the hypothalamus which is responsible for arousal, appetite, temperature, autonomic function, and endocrine systems. It has been theorized that this gene plays a role in appetite regulation as well as energy expenditure, energy intake, and diminished satiety.

If you have the wild type, TT you have no impact. If you have the heterozygote TA, you have a low impact and the homozygote AA has a moderate impact. The A allele has been associated with higher BMI. This means that if you have the A allele, you need to get up and move more often. This allele is at an increased risk for insulin resistance and type 2 diabetes when the choleric load is high.

For these individuals, we must implement behavior modification. They do not always realize how much food they are eating. We need to get them to eat lower saturated fats, increase their lean meats, vegetables, and omegas along with exercise.  For more information, please visit GeneCards, The Human Gene Database for FLO.

GLUT2

GLUT2 is encoded by the SLC2A2 gene. It is a member of the glucose transport protein and is expressed in the pancreas, liver, small intestine, kidney, and brain. GLUT2 facilitates the first step in glucose-induced insulin secretion. Those who have the TT allele are more likely to have a sweet tooth. If the sensor is not properly working, individuals will have a tendency for more glucose-containing foods and develop poor eating behaviors, ultimately resulting in high caloric intake and triglycerides.

The CC wild type shows no impact. The CT heterozygote shows low impact and the homozygote TT shows a moderate impact. Individuals with a TT allele do best with a ketogenic diet. It is key to avoid all high sugar foods, especially those that have refined carbohydrates. For more information, please visit GeneCards, The Human Gene Database for GLUT2. 

Test Pairing

In order to better assess a patient who shows a high genetic impact for developing insulin resistance, we use other tests to solidify the numbers. The Kraft Prediabetes Profile from Meridian Valley Lab is one we use to assess fasting glucose as well as fasting insulin. A sample report is shown below:

Boston Heart Diagnostics is another company we use to measure an individual’s Hemoglobin A1c (HbA1c) and C-Peptides. We measure the C-Peptide level to see how much insulin the pancreas is producing.

Blood is essential and when there are markers in it and the numbers are thrown off, it begins to cause serious problems throughout the entire body. One condition that is becoming more prevalent in society is metabolic syndrome. Metabolic syndrome is a condition made up of a series of other health conditions. One being high glucose. Many chiropractors are well aware of metabolic syndrome and the heavy impact it puts on their patients. Chiropractors use manual techniques as well as natural supplements to decrease metabolic syndrome in their patients. This study below provides great insight:

An Overview of the Identification and Management of the Metabolic Syndrome in Chiropractic Practice

Insulin resistance is a huge issue that causes so many other problems throughout the body. We often do not realize that our body is undergoing insulin resistance until we have a diagnosis of type 2 diabetes. However, insulin resistance is something that builds up over time and if caught in time can be corrected or slowed down. If you get sleepy after eating lunch, chances are that is a blood sugar regulation issue. A higher dose of Vitamin D is great for stabilizing blood sugars and reducing the after lunch snooze.  Keep in mind that it is best to get blood work done first before taking supplements. -Kenna Vaughn, Senior Health Coach 

References:

Seaman, D. R., & Palombo, A. D. (2014). An overview of the identification and management of the metabolic syndrome in chiropractic practice. Journal of chiropractic medicine, 13(3), 210–219. doi.org/10.1016/j.jcm.2014.07.002

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