A 2023 study by the Lancet has stated that more than a 100 million Indians are diabetic and this will increase to 44 per cent by 2027. While insulin resistance is commonly associated with prediabetes and type 2 diabetes, it's important to note that it can also impact individuals with type 1 diabetes.

Individuals with insulin resistance, their cells, particularly those in fat and muscle tissue, become less responsive to the effects of insulin. Consequently, the body requires higher levels of insulin to achieve the same glucose uptake by these cells and to maintain proper blood sugar control. This increased demand on the pancreas to produce more insulin can lead to higher levels of insulin circulating in the bloodstream.

 

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The Link Between Insulin and PCOS

According to a 2020 study issued by BMC Medicine, PCOS is a lifelong condition that can significantly impact insulin resistance and disrupt hormone regulation. The prevalence rate of PCOS is high among Indian women. Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting between 8 and 13 per cent of women of reproductive age and 6–18 per cent of adolescent girls depending on the diagnostic criteria used and the population studied.

Common PCOS symptoms 

• Irregular and heavy menstrual periods 
• The presence of small ovarian follicles or cysts 
• Elevated levels of the male hormone androgen (which may lead to acne) 
• Unexplained and persistent weight gain due to impaired blood sugar metabolism
• Excessive body hair known as hirsutism
• Hyperpigmentation
• The development of skin tags
• Difficulties with fertility or becoming pregnant

Insulin resistance indeed plays a pivotal role in the development of Polycystic Ovary Syndrome (PCOS), affecting both individuals with obesity and those who are lean. Insulin resistance is a prevalent feature in PCOS. It is observed in approximately 70-95 per cent of individuals with obesity-related PCOS and in a significant proportion (30-75 per cent) of those with lean PCOS.

Insulin resistance can impair ovulation, leading to irregular or absent menstrual periods in individuals with PCOS. This ovulatory dysfunction is a key characteristic of the condition.

Elevated insulin levels can stimulate the ovaries to produce excess testosterone, a male hormone. This can lead to hirsutism (excessive body hair) and acne commonly seen in PCOS.

 

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Managing PCOS 

Making dietary and lifestyle adjustments is a crucial component of the holistic approach to managing PCOS, complementing your regular medications. By reducing the consumption of inflammatory foods and embracing a healthy lifestyle that includes adequate rest, physical activity, and proper hydration, you can effectively prevent the worsening of your symptoms.

• Eat an anti-inflammatory diet: Mumbai-based dietician and naturopathy practitioner Charmaine D'Souza suggests that anti-inflammatory foods like berries, turmeric, fatty fish, green vegetables, tomatoes etc are great choices to manage PCOS. Herbs like fenugreek or methi sprouts, shatavari and ashwagandha are also very beneficial. 
• Choose foods that have a low glycemic index: PCOS often disrupts insulin resistance, leading to insulin spikes. Opting for foods with a low glycemic index, which cause slower and more controlled increases in blood sugar, can help prevent these spikes. Some excellent low-glycemic foods include fresh fruits and vegetables, legumes, nuts, dairy products, and dark chocolate (with more than 70 percent cocoa).
• Make healthy swaps: Nidhi Singh, the founder and director of PCOS Club India, a PCOS-specific wellness platform nudges to choose healthy diet alternatives to control PCOS. Swap out regular tacos for whole-grain, high-protein taco shells or replace white rice with quinoa. Instead of traditional wheat rotis, consider options like ragi or jowar rotis, or incorporate emmer wheat or millets into your diet. Substitute chips with a mix of nuts, seeds, and fruits for a healthier snacking option. 
• Diet to minimise androgens (male hormones): Mumbai-based celebrity nutritionist, Shweta Shah recommends a certain diet that can help suppress the excessive male hormones (androgens). She suggests green leafy veggies, flax seeds, coconut, and pumpkin seeds. Also, try pomegranate decoction, which includes boiling tulsi, ginger, peepli, and pomegranate juice. 

 

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Insulin And Diabetes

Prolonged insulin resistance can ultimately lead to the development of type 2 diabetes, as the body's insulin production becomes insufficient to control blood sugar levels effectively.
In cases of insulin resistance, it's common to observe elevated insulin levels in the blood even when blood sugar levels appear to be within the normal range. This occurs because the body's cells are not responding efficiently to insulin's signal, prompting the pancreas to produce more insulin in an attempt to compensate. 

• In type 1 diabetes, the body's immune system mistakenly attacks and destroys insulin-producing cells in the pancreas, requiring individuals to rely on external insulin injections or pumps for survival. 
• Type 2 diabetes occurs when the body's cells do not use insulin effectively, leading to elevated blood sugar levels. It is often associated with lifestyle factors like obesity and physical inactivity. 
• Prediabetes is a condition in which blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. It signifies an increased risk of developing type 2 diabetes in the future.

 

Nutritional Tips For Insulin Resistance

Managing insulin resistance often involves strategies to improve insulin sensitivity, such as dietary changes, exercise, and sometimes medication, to help cells respond more effectively to insulin and maintain healthy blood sugar levels. Managing insulin levels through diet is essential for individuals with insulin resistance, prediabetes, and type 2 diabetes. 

Here are some diet tips:

• Choose complex carbohydrates: Opt for complex carbohydrates like whole grains (e.g., brown rice, quinoa, whole wheat bread), legumes (e.g., beans, lentils), and non-starchy vegetables. These foods have a lower glycemic index and can help stabilise blood sugar levels.
• Control portion sizes: Be mindful of portion sizes to avoid overeating. Using smaller plates and paying attention to portion control can help prevent large spikes in blood sugar.
• Include fibre-rich foods: Fibre slows down the digestion and absorption of carbohydrates, helping to control blood sugar. Incorporate fruits, vegetables, whole grains, and legumes into your meals.
• Prioritise lean proteins: Choose lean sources of protein, such as poultry, fish, tofu, and legumes. Protein can help regulate blood sugar and increase satiety.
• Healthy fats: Include sources of healthy fats in your diet, like avocados, nuts, seeds, and olive oil. These fats can help improve insulin sensitivity.
• Limit added sugars: Minimise the consumption of foods and drinks with added sugars, as they can cause rapid spikes in blood sugar. Read labels to identify hidden sugars.
• Regularise meal timing: Aim for regular meal times and spacing meals throughout the day. Avoid skipping meals, as this can lead to erratic blood sugar levels.
• Consume carbohydrate in moderation: While carbohydrates are an essential part of a balanced diet, it's important to monitor your carbohydrate intake. A registered dietitian can help you create a personalised carbohydrate plan.
• Monitor blood sugar: Regularly monitor your blood sugar levels as advised by your healthcare provider. This can help you understand how different foods affect your body.
• Limit processed foods: Processed foods often contain unhealthy fats and added sugars. Minimise your intake of processed and fast foods.

Remember that dietary needs can vary among individuals, so it's important to consult with a healthcare provider or dietitian to create a diet plan that aligns with your specific health goals and requirements.

 

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Regular health checks are essential for everyone, but they are particularly important for individuals who are at risk of or already have insulin resistance. Taking regular health checks can help detect insulin resistance at an early stage when it is easier to manage and treat. With the UR.Life HRA, we help you to invest in your well-being through seamless interventions and targeted medical treatments. Our holistic wellness approach caters to all aspects of your well-being. We ensure that you can bring your whole self to work.