Hello,
Because insulin resistance is often talked about, I had always thought my ‘problem’ with sugar had to be insulin resistance.
Following some bloodwork results and based on the info I’ve found on the internet, I’ve gathered that I’m probably not insulin resistant (not overweight, normal fasting blood glucose, low triglycerides , high HDL) but porbably addicted to sugar…
Does sugar addiction often eventually lead to insulin resistance or can you be strongly addicted to sugar all your life and never develop insulin resistance / diabetes?
Also, can sugar addiction be reverted / controlled (after months on keto for instance) or, like alcohol or tobacco, the substance should be avoided?
Many thanks!!
PaulL
(You've tried everything else; why not try bacon?)
#2
Insulin resistance is defined as a particular insulin response to a load of serum glucose (blood sugar). The late Dr. Joseph Kraft identified five basic patterns of insulin response to an oral glucose tolerance test, one of which was healthy, and the other four of which indicated insulin resistance. Dr. Kraft demonstrated that these patterns showed up sometimes twenty years in advance of a diagnosis of Type II diabetes, so he called this pre-diagnosis “diabetes in situ” or “occult diabetes.”
The addictive quality of table sugar, sucrose, comes from the fructose component (1 sucrose molecule = 1 glucose + 1 fructose). The fructose moiety does not affect the serum glucose reading and provokes no insulin response; instead it is metabolised in the liver by the same process that deals with ethanol (ethyl alcohol). It also has the same effect on the nucleus accumbens in the brain, which is the brain’s reward centre. As with ethanol and other addictive drugs, about 20% of the population appears vulnerable to fructose addiction. This is not necessarily the same people as the 20% of the population vulnerable to alcohol addiction or to any other drugs or addictive types of behaviour (the addictive populations do overlap, but it is possible to be vulnerable to one type of addiction but not to another).
Does sugar addiction lead to insulin-resistance? Well, that depends on how much sugar you consume. Insulin-resistance in various organs arises when the cell in question has absorbed as much glucose as it can handle and down-regulates its insulin receptors. The pancreas then secretes extra insulin to make sure cells do their duty and deal with more glucose. So it is the fructose component that causes addiction, and the glucose component that causes insulin-resistance. If you are a sugar addict who does not consume any sugar, then your addiction will not lead to insulin-resistance. If you are not a sugar addict, you can still develop insulin resistance by consuming a great deal of sugar.
It is also possible—and far more usual—to develop insulin-resistance by consuming too much carbohydrate. Carbohydrates are just glucose molecules linked in various ways, so when they are broken down into their constituent glucose molecules, those glucose molecules raise blood sugar and provoke an insulin response. Over time, if carb intake is chronically elevated, the person is likely to develop insulin-resistance. The glucose part of one’s sucrose intake only adds to the effect.
Just as it is possible to be an alcoholic but never develop cirrhosis of the liver by avoiding the consumption of alcohol, it is also possible to be a sugar addict and avoid developing insulin-resistance by avoiding the consumption of sugar—provided of course, that one’s carbohydrate intake in general is low enough, as well, since the over-consumption of non-sugar carbs is also capable of provoking insulin-resistance.
The definition of a substance addiction is a loss of control when the substance is ingested (behavioural addictions are another matter). For example, an alcoholic is someone incapable of stopping at only one drink. Most recovering alcoholics find it safest to avoid alcohol entirely, since it is not within their power to drink moderately. The equivalent situation applies in the case of sugar addiction, which means that sugar addicts need to avoid sugar, just as alcoholics need to avoid alcohol, cocaine addicts need to avoid cocaine, nicotine addicts need to avoid nicotine, gambling addicts need to avoid gambling, and so forth.
Many people also consider themselves carbohydrate addicts (I consider myself to be one), but whether that is truly an addiction in the scientific sense remains to be demonstrated. The key to addiction is the pattern of dopamine response in the nucleus accumbens.
I don’t consume that much sugar these days but, like you I’m addicted to carbs (mostly bread, some fruits…)
The funny thing is that it does not give me much pleasure at all, I guess that at the level of addiction, the pleasure goes away…
Dr. Jen Unwin wrote a book about this, and she says some people (including her) have to stop eating sugar totally. Some don’t.
PaulL
(You've tried everything else; why not try bacon?)
#5
That, alas, is true addiction. The reason has to do with down-regulation of the dopamine receptors in the nucleus accumbens. If you want to learn a bit more, go on YouTube and search for “Lustig hacking of the American mind.” It’s a lecture based on his book of the same name. Dr. Lustig is a paediatric endocrinologist who used to run a childhood obesity treatment clinic at UCSF.
Dr. Lustig is also famous for his lecture, “Sugar: The Bitter Truth,” also available on YouTube, which goes into the basics of sugar metabolism and its role in obesity. Well worth a watch, and every statement he makes is backed by citations to the scientific literature, so you can verify all his claims.
Oh yeah, I call that compulsion in my life, it’s the worst… Fortunately it’s usually just some lingering thing, I remember the not so distant times when I did enjoy that food immensely… And then I more or less quickly learn the joy stopped coming so it’s a bad deal to eat the stuff. But I can relate very much.
The compulsion usually comes later, first I need to eat more than minimal non-animal carbs… They mess with me. Until I am close to carnivore, I don’t get these compulsions (except regarding coffee, that’s my addiction carnivore couldn’t help with).
And of course one can be addicted to things while still more or less healthy…
I don’t believe I ever was addicted to sugar, by the way. It seems I was a lucky one. Not lucky enough I think but I appreciate everything
I am not sure these markers can say that you are not insulin resistant.
Not overweight: you can definitely be slim and insulin resistant. Equally, you can be fat and not insulin resistant.
Normal fasting blood glucose: this can be normal, but it takes a lot of insulin to get it there (the definition of insulin resistance).
Low triglycerides: I am not sure on this one… does this suggest insulin sensitivity? Possibly. I am not sure.
High HDL: you can have a high HDL and be insulin resistant.
The best test of insulin resistance is to get a fasting insulin level. Alas, this is not a common test that doctors request as they have been trained that the outcomes are too variable to easily interpret. But if your fasted insulin is high, you are insulin resistant.
The problem with relying on blood glucose markers to measure IR is that insulin can be very high, but BG can look under control because the high insulin is keeping the BG down. But it is the high insulin that is doing the damage.
This is why we live in an inflamed society: we are told to eat a lot of carbs by the authorities, we are sold processed carbs by Big Food, our doctors measure our blood glucose and see nothing wrong because they are not measuring insulin, insulin is very high driven by the carb load, and this goes unnoticed for decades until it is too late. Result: a diabetes epidemic.
Yep, this what my low carb docs recommend, to be more certain. Underlying, slowly developing insulin resistance can easily be overlooked or dismissed, until … uh-oh.
If I take the HOMA-IR test, is it better to do it while following a ‘normal’ diet (as I’m doing now) or is it ok to have it tested while on keto? Would there be a difference?
Also, is what you eat the day before the test important?
Thanks!
I get a higher score on HOMA-IR because I have a higher morning blood sugar level. I suggest doing both normal and after keto.
I think eating the day before is important. The extent of that is unknown, however. Until we have insulin meters, we can’t really tell how what we eat affects insulin or for how long.
