Do you feel hungry before meals and drowsy after meals? If this happens all the time, you may have insulin resistance in your body, which is considered prediabetes. Many people have pre-diabetes even if their blood sugar tests are normal. Be aware if you have the symptoms mentioned here.
Why Is There Insulin Resistance When Blood Sugar Level Is Normal?
According to the Centers for Disease Control and Prevention, approximately one-third of American adults had prediabetes.Pre-diabetic patients develop insulin resistance due to the decreased sensitivity of cells to insulin, so the body has to secrete a large amount of insulin to suppress blood sugar levels.
People with chronic insulin resistance are at high risk of developing diabetes later in life. Even if it does not develop into diabetes, when the insulin and blood sugar levels remain high for a long time, the continuous oxidative stress and inflammation in the body may cause various complications, such as hyperlipidemia, hypertension, cardiovascular diseases (e.g. myocardial infarction, angina pectoris, and stroke), hyperuricemia, sleep apnea, non-alcoholic fatty liver disease, polycystic ovary syndrome, dementia, and cancer.
However, what many people don’t realize is that blood test results may still show normal blood sugar levels when insulin resistance is already present in the body.
At present, prediabetes is mainly detected by blood tests:
Fasting blood sugar level: A normal fasting blood sugar level should be less than 100 mg/dL. A fasting blood sugar level between 100 mg/dL and 125 mg/dL is considered prediabetes;
Hemoglobin A1c (HbA1C) test: It reflects the average blood sugar index in the past 2 to 3 months. The normal value should be less than 5.6 percent. A level of 5.7 percent to 6.4 percent indicates prediabetes.
“There is a huge problem with such diagnostic criteria,” said Dr. Chun-Hsu Chen, director of the Dr. Chen Natural Health Center (DCNHC) in the United States. This is because diabetes means that both fasting and postprandial blood sugar levels are high, so the A1C level will also be relatively high. However, people with prediabetes are very likely to have significant blood sugar swings, but their average blood sugar levels are within the normal range. Relying solely on fasting blood sugar level or HbA1C can sometimes lead to misjudgment.
The HbA1C level reflects the average blood sugar level within three months, but it cannot reflect the changes in the usual blood sugar fluctuations. For example, A and B both had A1C levels of 5.7 percent. However, A’s fasting blood glucose and two-hour postprandial blood glucose are 95 mg/dL and 125 mg/dL respectively; while B’s fasting blood glucose and postprandial blood glucose are 90 mg/dL and 180 mg/dL. B clearly had blood sugar swings.
According to Dr. Chen, the difference between the two is that A is energetic during the day, sleeps well at night, and does not feel drowsy after eating; whereas B’s insulin will rise very high after a meal to suppress the blood sugar level, and the blood sugar level will drop significantly before the next meal. Also, B tends to be hungry and wants to have a snack before a meal. Fluctuations in blood sugar cause hunger before meals and drowsiness after meals.
Drowsiness After Meals and a Big Belly May Indicate Prediabetes
How do you know if you have insulin resistance? It can be detected through physiological responses, physical appearance, and blood tests.1.) Hungry before meals and drowsy after meals
Physiological responses such as hunger before meals and drowsiness after meals are closely related to blood sugar swings. Dr. Chen pointed out that such responses are very common in modern people, but it does not mean that they are normal.
2.) A big belly and “dirty” neck
People with insulin resistance typically have more visceral and abdominal fat. It can be seen from the appearance that the belly is big and the waist is thick, which is also known as “central obesity”.
If the waist-to-hip ratio can be obtained by dividing the waist circumference by the hip circumference. If the ratio is >0.9 for men or >0.8 for women, it means that there is too much fat in the waist and abdominal area, and it indicates the presence of insulin resistance.
In addition, you can also observe whether you have more muscle or fat on your body. You should be alert if you are gaining weight, and the body fat meter measurement shows that your body fat has increased and your muscles have decreased.
The third sign to look out for in terms of physical appearance is acanthosis nigricans. The typical symptom includes black patches appearing in the crease at the back of the neck—hence it is called the “Dirty Neck”.
Acanthosis nigricans is formed because excess insulin stimulates the proliferation of skin cells, resulting in melanin deposition and hyperkeratosis of the skin. In addition to the neck, it may also appear on the inner thighs, underarms, and the front of the elbows. However, not all patients with insulin resistance will develop acanthosis nigricans.
3.) Blood sugar and insulin tests
Blood test results that show the following values indicate insulin resistance:
Fasting insulin level > 5mIU/L
Difference between preprandial and postprandial blood sugar levels > 40 mg/dL
Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) ≥ 2
HOMA-IR is a formula that calculates the ratio of fasting blood glucose to fasting insulin. It indicates insulin resistance if the value is ≥2, but it is usually judged according to clinical symptoms.
According to Dr. Chen, blood sugar levels should be tested at four different times to detect whether there is insulin resistance: before meals (on an empty stomach), 30 minutes after meals, 1 hour after meals, and 2 hours after meals.
Under normal circumstances, the tests are taken 2 hours before meals and 2 hours after meals, which may not be able to objectively detect whether the patient has prediabetes. Assume that the patient’s preprandial and 2-hour postprandial blood sugar levels are 100 and 130, respectively. These numbers look good, but the patient’s blood sugar levels may actually rise to 150 and 180 half an hour and one hour after a meal, respectively.
Moreover, some people may not feel drowsy after meals or have a big belly, but they are insulin resistant. These people need to have their blood sugar and insulin levels tested.
Dr. Chen explained that most of these people suffer from overwork and stress. Although they have a normal body figure, or even look slim, they develop insulin resistance due to excessive secretion of adrenaline caused by chronic stress.
Studies have also found that stress, long hours of work, and sleep loss can all lead to insulin resistance and elevated blood sugar level.
A South Korean study tracked the work hours and insulin resistance in more than 25,000 healthy adult men. The results found that compared with those who worked 35 to 40 hours a week, those who worked 41 to 52 hours a week, and those who worked more than 52 hours a week had a 28 percent and 180 percent increased risk of developing insulin resistance, respectively.
Stress causes high blood sugar levels due to the body’s mechanism. When a person is in danger, the body will secrete adrenaline and break down glycogen to glucose, and at the same time secrete insulin to quickly transport glucose to muscle cells. Hence, when a person needs to flee in a dangerous situation, the above-mentioned series of reactions will allow the muscles to burst with strength and the person to run away quickly.
Sleep deprivation will also increase adrenaline. This is because the body needs to secrete adrenaline to support itself when there is not enough energy, and it will enter a state of adrenal fatigue after a certain period of time.
Therefore, people who are often overworked, work late, and/or are under high pressure always have excessive secretion of adrenal hormones and increased insulin. Over time, many of their cells will become less sensitive to insulin, that is, insulin resistance, which will eventually lead to diabetes. Dr. Chen described it as how misbehaving children become numb after being scolded by adults for a long time. “Our senses and cells adapt to many stimuli over time,” he said.
3 Ways to Reverse Insulin Resistance
It is possible for patients with prediabetes to reverse insulin resistance and avoid progression to diabetes. There are three ways that can be implemented in daily life:1.) Avoid “high-frequency eating” and “high-carbohydrate diet”
Constant eating and eating too much high-carbohydrate food will prompt the body to secrete insulin frequently, which will lead to increased insulin resistance in the long term.
Feeling drowsy after eating indicates that the proportion of starch in the meal is too high. It is recommended to reduce the proportion of starch and remove staple foods (such as flour-based food) and increase the amount of protein and vegetables. Ideally, we should feel full after eating without feeling drowsy. At the same time, the order of eating should be changed to protein and vegetables first, and starch last.
Dr. Chen said that you should take a nap if you really feel drowsy after eating. This is because trying to stay awake when tired stimulates the secretion of adrenaline.
If you feel hungry between meals, you can eat foods rich in protein and high-quality fats (eggs, soy milk, and cashew nuts), and avoid foods such as biscuits, cakes, and candies.
2.) Do some resistance training
The main factors that cause insulin resistance are related to the accumulation of energy (high-sugar & high-frequency diet) and the reduction of physical activity. Therefore, patients should engage in aerobic exercise or resistance training in addition to dietary adjustments. These exercises can increase the sensitivity of muscle cells to insulin and reverse insulin resistance.
Resistance training can increase the speed at which glucose enters the muscle cells, allowing blood sugar levels to stabilize quickly; and it can also improve cardiovascular health and muscle mass. Skeletal muscle is one of the most important tissues that determine blood sugar levels. It is responsible for storing and withdrawing about 85 percent of glucose from the blood and plays a crucial role in maintaining blood sugar level stability.
In addition, excess visceral fat can cause insulin resistance. A three-week experiment found that high-intensity resistance training was the most effective at shedding visceral fat.
However, Dr. Chen pointed out that the repetition maximum of resistance training must reach 8-12RM to achieve effective blood sugar level control. RM refers to the “maximum number of repetitions” that can be lifted using a certain “weight”.
Aerobic exercise can also increase insulin sensitivity. It is recommended to choose high-intensity sports, such as mountain climbing, speed walking, and swimming.
Both resistance training and aerobic exercise are critical to achieving the long-term goals of improving insulin resistance and controlling blood sugar levels. In one study, researchers in the United States assigned 262 sedentary Type 2 diabetic patients into four groups (nonexercise control group, resistance group, aerobic exercise group, and combined aerobic and resistance training group). After nine months of exercise, it was found that the group of patients who combined resistance training with aerobic exercise achieved the best blood sugar control result. The absolute mean change in HbA1c was reduced by 0.34 percent.
3.) Relieve stress from time to time and maintain a good sleep quality
People who often suffer from sleep deprivation and “dreaminess” due to lack of sleep, staying up late or constantly under pressure should relieve stress and try to maintain a good sleep quality.
Generally speaking, we should sleep at least 8 hours and go to bed before 11 pm. Dr. Chen pointed out that this is because 11.00 pm to 3.00 am is the crucial “4 golden hours”, and it is best to be in a deep sleep state during this period. If you miss the “4 golden hours”, you may not be able to make up for it even if you sleep afterward.
There are many different ways to relax. Mindfulness meditation, yoga, tai chi, breathing exercises, and qigong all help to relax the mind and body.
Dr. Chen recommends using a far-infrared electric heater to warm your feet for relaxation and sleep aid purposes. “This is the fastest way to relieve stress and fall asleep.” Place the far-infrared electric heater about 30 cm away from the foot of the bed, and adjust the temperature to a low setting; lie on the bed wrapped in a blanket and expose the soles of your feet to warm them. After about 5 minutes, the warmth will stimulate the parasympathetic nerves, leading to relaxation, yawning, and falling asleep.
