Insulin Resistance, Syndrome X, and Type 2 Diabetes:

NNFA Today, Volume 18, No.  6/ June 2004

Insulin Resistance, Syndrome X, and Type 2 Diabetes:  A 21st Century Epidemic By Michael T. Murray, N.D.

Resistance to the hormone insulin is an underlying factor contributing to the development of obesity, increased appetite, type 2 diabetes, and syndrome X.  Recent statistics on the spectrum of conditions linked to insulin resistance are staggering:  roughly 64 percent of American adults are obese or  overweight; one out of the three people in the United States are projected to develop type 2 diabetes in their lifetime; 17 million people in the United States with type 2 diabetes; 16 million have pre-diabetes (as also called “impaired glucose tolerance”); and 23 percent of adults meet the criteria for having syndrome X (insulin resistance, high blood cholesterol and triglyceride levels, high blood pressure, and an increased waist to hip ratio).

All of these conditions linked to insulin resistance can be viewed as different facets of the same disease having the same underlying dietary, lifestyle and genetic causes.  The human body was simply not designed to handle the amount of refined sugar, salt, saturated fats, and other harmful food compounds that many people in the United States and other “Western” countries consume, especially in those who live a sedentary lifestyle.  The result is that a metabolic syndrome emerges—elevated insulin levels, obesity, elevated blood cholesterol and triglycerides, and high blood pressure.  Syndrome X is the label that modern medicine has chosen to ascribe to a condition caused by poor dietary and lifestyle choices.

How Insulin Resistance Develops

It is well established that obesity leads to insulin insensitivity and vice versa.  When fat cells, particularly those around the abdomen, become full of fat they secrete a number of biological products (that is, resistin, tumor necrosis factor, free fatty acids) that dampen the effect of insulin, impair glucose utilization in skeletal muscle, and promote glucose production by the liver.  Also important is that as the number and size of fat cells increase it leads to a reduction in the secretion of compounds that promote insulin action including a novel protein produced by fat cells known as adiponectin.  Adiponectin is not only associated with improved insulin sensitivity, it also has anti-inflammatory activity, lowers triglycerides, and blocks the development of atherosclerosis (hardening of the arteries).  The net effect of all these actions by fat cells is that they severely stress blood sugar control mechanisms as well as lead to the development of the major complication   of diabetes – atherosclerosis.  Because of   all of these newly discovered hormones secreted by fat cells, many experts now consider the adipose tissue a member of the endocrine system.

Treatments for Insulin Resistance

Treating insulin resistance involves a comprehensive diet, lifestyle, and supplementation program designed to achieve ideal body weight.  However, the real key involves resetting the defective appetite control center that makes weight loss so difficult for many to achieve.  To combat the physiological bias to eat more than we require, we must accentuate the body’s processes that curb the appetite.  In addition to attempting to improve the adiponectin to resistan ratio, we must address the powerful signals originating from the gastrointestinal tract that stimulate or block the appetite.

In addition to nerve signals feeding back to the central nervous system, there is a growing list of gut-derived hormones and peptides such as neuropepetide Y and analogs, ghrelin, and cholecystokinin.  Just like the fat cells now being viewed as an extension of the endocrine system, there is also support for considering the gastrointestinal lining a component of the hormonal system as well.  There is promising research on at least some of these compounds.  For example, last September the New England Journal of Medicine reported peptide YY 3-36 (or PYY for short) dramatically reduced appetite in both obese and normal weight individuals.  In contrast, the stomach-derived hormone ghrelin increases appetite.  Ghrelin levels are highest when the stomach is empty and during calorie restriction.  Obese individuals tend to have elevated ghrelin levels, when they try to lose weight ghrelin levels increase even higher.  That makes weight loss extremely difficult.

Fiber Blend Shows Promise Against Syndrome X

The perfect drug or natural product to address the epidemic of insulin resistance must possess an ability to increase insulin sensitivity and to produce a targeted effect of reducing those factors which increase appetite while simultaneously increasing those factors that decrease appetite.  If those goals are achieved, effective weight loss should follow.  Recently, a unique blend of selected, highly viscous fibers has been suggested to provide the desired actions.  In patients with syndrome X, the results were truly phenomenal.

The study was a double-blind, crossover design, in participants with reduced insulin sensitivity and other signs of syndrome X.  Patients were assigned to receive a highly viscous fiber blend or placebo for three weeks.  In the treatment group, the area the curves for glucose and insulin were reduced by 23 percent and 40 percent, respectively.  These decreases translated into a 56 percent increase in the insulin sensitivity index.  In addition, body fat was reduced by 2.8 percent.  Previous studies have shown that at a dosage of one gram three times daily that the total cholesterol levels dropped by 15 percent to 20 percent.

Follow-up studies are now underway to more fully determine the appetite suppressing and weight loss promoting effects of this highly viscous soluble fiber blend.  Included in these studies will be a more complete analysis of the fiber blend in regulating various fat cell and GI-derived hormones as well as a pilot study in obese children.

With a greater understanding of human physiology and appetite regulation, there are emerging approaches to long term weight management that are producing effective answers.  While pharmaceutical companies continue to furiously race to discover the perfect pill to control hunger (most of the diet drugs discovered so far are ineffective and dangerous), the real answer may be a unique blend of selected, highly viscous soluble fibers that act synergistically to develop a higher level of viscosity and expansion.  Not only does it have positive effects on blood sugar levels and improving insulin sensitivity, but the soluble fiber blend also greatly reduces appetite.

Michael T. Murray, N.D., is widely regarded as one of the world’s leading authorities on natural medicine.  He is a graduate, faculty member, and serves on the Board of Trustees of Bastyr University in Seattle, Washington.  He is co-author of the best-selling “Encyclopedia of Natural Medicine” and author of over 20 books on natural health