by Dr. Laura Korman, DC, DACBN 

 
The World Health Organization (WHO) ranks chronic illness as the greatest threat to human health and states that 71% of all global deaths are due to these chronic, non-communicable diseases. The main point I want to address here is that the common denominator contributing to these potential life-robbing conditions is chronic inflammation.   

Acute inflammation, which is short-lived and vital for healing wounds and helping us recover from infections or exposure to toxic compounds, is a healthy and important process. On the other hand, chronic inflammation is continual warfare in our bodies and detrimental to our well-being and quality of life. Acute inflammation is quite simple to identify with traditional blood testing, but chronic inflammation is more subtle and involves running tests outside of the “typical” annual blood panels. 

There are six or seven inflammatory blood markers I routinely order for my patients to help identify underlying causes of chronic inflammation. I believe the most underutilized and significant test of inflammation is a fasting insulin level. Insulin is a hormone produced by the pancreas that rises after eating in direct response to the rise in blood sugar caused from the type of meal or snack consumed.  

The ability of food to raise blood sugar levels is given a value referred to as the glycemic index. This number falls between zero and 100, with a higher value equating to the greater ability of a food to raise serum blood sugar levels two hours after consumption. Insulin's job is to keep blood sugar levels in a narrow range and to allow for either the production of energy to meet immediate energy needs or for energy to be stored (in the form of belly fat) for future energy needs. In other words, insulin is a fat storing hormone.  

If you overconsume more high-glycemic (sugary) foods than the body needs for energy, insulin will direct the body to store that extra fat. This is how excess sugar and carbohydrates make you put on unwanted weight around the midline. The higher your insulin levels, the more fat you are storing. Some high-glycemic foods include soda, sweetened teas, sweet coffees drinks, juices, candy and processed foods with sugar—even flour, rice or potatoes. The frequent consumption of these foods forces the body to overproduce insulin on a continual basis, leading to metabolic syndrome or insulin resistance, also known as prediabetes. 

It is a conservative estimate that 40% of  Americans have early diabetes, and 90% of them are unaware of it. This is a serious disease, but unfortunately, it’s undiagnosed or overlooked until the diagnosis of  Type-2 diabetes occurs. According to the Cleveland Clinic, up to 50% of patients with prediabetes will develop Type-2 diabetes within five to 10 years. Being diagnosed with prediabetes is rather ambiguous because most doctors are trained to rely upon using only one fasting blood glucose level to make the diagnosis.  

A morning glucose level can swing either above 100 mg/dl (considered the upper range of normal) and back under 100 mg/dl (considered normal) for years due to a variety of daily lifestyle factors. As I described earlier, it is insulin's job to keep blood sugar in a healthy and rather narrow range (75mg/dl-95mg/dl ideally). Fasting insulin levels begin to elevate earlier then the fasting blood glucose level which makes this a more predictable indicator of early diabetes or metabolic syndrome than a fasting blood sugar alone.  

Unfortunately it is rarely tested unless a patient has already been diagnosed with diabetes. Elevated insulin is not only an indicator of poor metabolic health, it is an inflammatory marker in and of itself. Elevated fasting insulin is known to be associated with obesity, Type-2 diabetes, heart disease, cancer, Alzheimer's and poor immune resistance to viral infections.  

The development of insulin resistance and Type-2 diabetes has not only been associated with long-term nutritional inadequacies and poor lifestyle choices, but also the persistent exposure to toxins found in our food, water and environment, as well as our household and personal care products. Unmanaged stress and chronic sleep deprivation are known to contribute to the development of prediabetes and diabetes.   

The positive news is that insulin resistance or metabolic syndrome can be prevented, and early intervention could reverse those that have already been diagnosed with Type-2 diabetes. Start by asking your doctor to run a fasting insulin test. This might not be covered by insurance as the test falls outside the regular annual blood panels. An optimal level will be below five, and insulin resistance or prediabetes will be evident with a fasting insulin above eight.  

If you need assistance to order or manage your insulin levels, please reach out to my office at 941-629-6700 or find another physician who specializes in functional medicine.