Insulin resistance can be seen as an early warning sign of diabetes mellitus. The resistance represents a massive disruption of the entire carbohydrate metabolism. The result is a constantly increased blood sugar level, which is followed by a strong release of insulin.

In the long run, this can lead to diabetes mellitus.

The cells of the body become unwilling to give orders and no longer react properly.

If there is insulin resistance, there is no insulin deficiency.

However, since insulin cannot act on body cells, due to the resistance, the body tries to finally smuggle the sugar into the cells by producing more and more insulin.

There is a lot of insulin, so there is an excess of insulin.

Symptoms:

• Feeling restless

• Symptoms of hypoglycaemia: dizziness, sweating, rapid heartbeat, paleness, cravings, tremors, dilated pupils

• unnatural weight gain

• Menstrual cycle disorders with an unfulfilled desire to have children

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Why is nutritional therapy important?

Nutritional therapy supports you in reducing insulin resistance and restoring a normal metabolic situation, in which insulin can function normally again. Insulin also plays for that  Adipose tissue plays a central role and ensures that our dietary fat is stored after eating. Because of the excess of insulin, it takes a lot longer for all of the insulin to break down and disappear from the blood. The balance between fat build-up and breakdown can now shift significantly towards fat storage. An excess of insulin can therefore be a driving force behind pathological overweight ( obesity ).

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Nutritional therapy supports you in reducing your symptoms overall and thereby positively influencing your health. An energy-adjusted wholesome diet under the supervision of a certified nutritionist can lead to your long-term success. The diet is adapted to your current weight and a jointly defined goal for weight gain / or loss.

The aim is to supply all of the fatty acids, micronutrients (vitamins and minerals) that are important to you, energy and protein in the measure that your body is optimally supplied with. For this purpose, foods that promote inflammation are specifically avoided and plenty of anti-inflammatory foods are consumed.

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Diagnosing insulin resistance - options:

Blood sugar, sober

An increased blood sugar level is usually the result of a lack of insulin or a reduced effect of insulin (insulin resistance). In rare cases, there is an overproduction of blood sugar-increasing hormones.

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HbA1c value

Since the HbA1c value allows an assessment of the blood sugar level over a longer period of time, this measurement value has established itself as a quality criterion for blood sugar control and thus for diabetes therapy. In the case of easily controllable diabetics, an HbA1c of around 7% (53 mmol / mol) is generally aimed for. According to a new position paper of the international diabetes societies, lower therapy goals of 6 to 6.5% (42-48 mmol / mol) should only be aimed for in diabetics with a short medical history, high life expectancy and without cardiovascular diseases. Moreover, these are only justified if the risk of hypoglycaemia is rather low. In the case of patients with a shortened life expectancy, with a history of multiple cases of severe hypoglycaemia, progressive complications and secondary diseases, and in the case of unreasonably high therapeutic costs, less strict target values should be applied. Here an HbA1c of 7.5 to 8% (58-64 mmol / mol) is quite satisfactory [ Inz 2012 ]. Excessive blood sugar control should be avoided, especially in patients who would need several drugs in high doses to achieve the target values and who therefore run the risk of severe interactions or side effects (especially with impaired kidney function).

Oral glucose tolerance test (OGTT)

If the blood sugar level is still elevated after 2 hours to 7.8 to 11 mmol / l (140-199 mg / dl), there is impaired glucose tolerance or pre-diabetes. Even if no medical diabetes therapy is necessary at this point, the preliminary stage should not be underestimated. At this point in time, the risk of later cardiovascular events such as myocardial infarction, stroke or heart failure is already increased and the first vascular changes can be detected [ DeF 2011 ]. If possible, non-pharmaceutical therapeutic measures should be taken at this point to improve glucose tolerance.

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Proinsulin

Proinsulin is the storage form of the insulin hormone as it is in the beta cells. Only when needed do proteases split the hormone precursor into active insulin and C-peptide. Increased serum levels of intact proinsulin clearly correlates with an increased risk of developing arteriosclerosis (CHD). In addition, increased levels of proinsulin and its non-specific breakdown products in the plasma inhibit fibrinolysis (breakdown of blood clots). In the event of a heart attack, the dissolution of blood clots is hindered and the risk of a heart attack increases.

C-peptide

(connecting peptide) is produced in the beta cells of the pancreas. When insulin is activated, it is split off from proinsulin and enters the blood with the insulin. In the case of impaired glucose tolerance, an increased increase in the C-peptide during the oral glucose tolerance test indicates insulin resistance.

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HOMA index.

To do this, the value of the fasting blood sugar level is multiplied by the value of the fasting insulin. Insulin resistance exists when the HOMA score is above 4.65.

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IRIS II score

Points system that allows the insulin resistance to be estimated on the basis of various parameters that are important in the metabolic syndrome. The respective points are assigned to the patient according to his values and then added up. If the patient reaches 70 points or more, the diagnosis of insulin resistance must be made.

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Source: https://fet-ev.eu/zuckerstoffwechsel-diagnostik/

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Classification of your weight - definition and classification of weight in relation to height.

Special percentile curves apply to children and adolescents; the BMI cannot simply be used here.

BMI and interpretation: BMI: body mass index. Formula: Body weight in kg : (body height in m) 2

Underweight: <18.5

Normal weight: 18.5 - 24.9

Overweight = pre-obesity: 25-29.9

Obesity grade I: 30 - 34.9

Obesity grade II: 35-39.9

Obesity grade III:> 40 = per magna

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Blood count:

It is advisable to have your Omega 3 index checked regularly.

This provides information about the supply of valuable omega 3 fatty acids (alpha-linolenic acid, eicosapentaenoic acid and docosahexaenoic acid), which can significantly counteract inflammatory processes in the body.

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Nutritional therapy

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• Reduce insulin resistance, normalize metabolism

• Body weight: Weight reduction is recommended if you are overweight / obese.

• In the case of insulin resistance and lipid metabolism disorders, also treat them with nutritional therapy

• Avoid micronutrient deficiencies and mineral deficiencies & possibly counteract them with nutrient preparations

• Prevent protein deficiency

• Which nutrients do I need in which ratio?

• Get enough fiber (> 30 g / day) through natural foods, possibly fiber substitution

• Sufficient fluid: total fluid per day: 30 - 35 ml per kg body weight and day. Attention, this is not just a drinking liquid. The liquid from food (approx. 500 - 800 ml) must still be subtracted from this, so that an amount of approx. 1.3 - 2 l of drinking liquid is created.

• add valuable anti-carcinogenic (anti-cancer) secondary plant substances

• anti-inflammatory diets for disease prevention

• A selection of foods tailored to your needs with cooking and technical information (for breakfast, snacks, lunch, dinner)

• Do you like to eat your warm meal in the evening? I am happy to cater to your individual situation and we will create a plan on how you can implement your wholesome diet into your everyday life.

• Overall fat selection, how should it be designed?

• which oils are good for me? What should I watch out for in relation to the anti-inflammatory diet?

• How much fat spread (butter / margarine / vegetable fat) can I use and which products are recommended?

• Get enough Omgea-3 fatty acids and essential fatty acids

• How can I boost and support my metabolism with natural foods?

• Coordinate sensible meal frequency for your individual case - meal allocation

• What do I have to look out for when choosing animal foods?

• How many animal foods (e.g. meat products, milk and dairy products, cheese, fish products, eggs) are recommended?

• Define the desired weight stabilization / normalization & the estimated period for this

• what should be considered with beverages and alcoholic beverages?

• How does exercise affect your body and thus also your diet?

• Avoid blood sugar fluctuations

• Sweetening foods - sweeteners, glucose, fructose, sugar and sugar substitutes, what can I use and in what quantities? How high is the respective sweetness of the different products?

• what should be considered when baking and cooking?

• what are cheap snacks / main meals

• Eating out - what should you watch out for?

• Vacation, boat trip or hospital stay, what should be considered?

• Flatulence, bloating, diarrhea, constipation, vomiting, heartburn, loss of appetite, pain related to eating, what can I do about it?

• Daily plans as an example for practical implementation in everyday life

• Enjoyment training

• Optimizing your eating situation

• long-term maintenance of a jointly defined weight

• Strengthen the stomach and intestines with natural foods

• Additional therapy options

• Dietetic products in support of nutritional therapy

• Food supplements - under certain circumstances, a supplement can be useful

• and other topics

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Any questions? I look forward to your call or email. To contact form

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Assistance:

• KISS self-help groups

• Self-help network

• DDG- German Diabetes Society

• German Diabetes Foundation

• German Diabetics Association V.

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