References

Bertsch RA, Merchant MA. Study of the use of lipid panels as a marker of insulin resistance to determine cardiovascular risk. Perm J. 2015; 19:(4)4-10 https://doi.org/10.7812/TPP/14-237

Bikman B. Why we get sick.Dallas, Texas: BenBella Books; 2020

Demasi M. COVID-19 and metabolic syndrome: could diet be the key?. BMJ Evid Based Med. 2021; 26:(1)1-2 https://doi.org/10.1136/bmjebm-2020-111451

Gallagher EJ, LeRoith D. Hyperinsulinaemia in cancer. Nat Rev Cancer. 2020; 20:629-644 https://doi.org/10.1038/s41568-020-0295-5

Murdoch C, Unwin D, Cavan D Adapting diabetes medication for low carbohydrate management of type 2 diabetes: a practical guide. Br J Gen Pract. 2019; 69:360-361 https://doi.org/10.3399/bjgp19X704525

Noakes TD, Sboros M. Lore of nutrition: Challenging Conventional Dietary Beliefs.South Africa: Penguin Books; 2017

Reaven G. All obese individuals are not created equal: insulin resistance is the major determinant of cardiovascular disease in overweight/obese individuals. Diabetes Vasc Dis Res. 2005; 2:105-12 https://doi.org/10.3132/dvdr.2005.017

Reaven G. Insulin resistance and coronary heart disease in non-diabetic individuals. Arterioscler Thromb. 2012; 32:(8)1754-1759 https://doi.org/10.1161/ATVBAHA.111.241885

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Eat well or die slowly: your guide to metabolic health. 2020. http://www.wellnesseq.net

Meeting the challenge of insulin resistance in general practice

02 February 2022
4 min read
Volume 33 · Issue 2

Abstract

As evidence around the role of insulin resistance in many long term conditions continues to grow, George Winter looks at what we know so far

‘Insulin resistance is the major determinant of cardiovascular disease in overweight/obese individuals’ (Reaven, 2005); ‘if more physicians understood that insulin resistance is a huge risk factor for ischemic heart disease, we could potentially do more to motivate our patients’ (Bertsch and Merchant, 2015); and Noakes and Sboros (2017) cite Reaven (2012) that ‘the six conditions most likely caused by high-carbohydrate diets in those with insulin resistance are obesity; arterial disease, both local (heart attack or stroke) and disseminated (type-2 diabetes); hypertension; non-alcoholic fatty liver disease (NAFLD); cancer; and dementia (Alzheimer's disease, also known as type-3 diabetes).’

Yet ‘insulin resistance is the epidemic you may have never heard of’ (Bikman, 2020: 3).

Insulin resistance is a reduced response to the hormone insulin (Bikman, 2020: 6), with insulin resistance a key component of metabolic syndrome (Gallagher and LeRoith, 2020). In metabolic syndrome the patient must have two of either hypertension, dyslipidaemia, central obesity, or low concentrations of urinary protein; and second, the patients must have insulin resistance (Bikman, 2020: p81).

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