Insulin

What it is

Insulin is a vital hormone produced by your pancreas, a gland located behind your stomach. Think of it as a key that unlocks your body's cells, allowing glucose (sugar) from your bloodstream to enter and be used for energy. When you eat, particularly foods containing carbohydrates, your body breaks them down into glucose, which then enters your bloodstream. This rise in blood glucose signals your pancreas to release insulin. Insulin then helps to move this glucose out of the blood and into your muscles, fat, and liver cells. Any glucose not immediately needed for energy is stored in the liver and muscles as glycogen, or converted to fat for later use. Insulin also plays a role in telling your liver to stop producing more glucose when your blood sugar levels are already sufficient.

Why it matters

The balance of insulin and blood glucose is crucial for your health. When this system works well, your blood sugar levels are kept within a healthy range, providing your body with a steady supply of energy.

If your body doesn't produce enough insulin, or if your cells don't respond properly to the insulin that is produced (a condition known as insulin resistance), glucose can build up in your bloodstream. Persistently high blood glucose levels can lead to serious health problems over time, including damage to blood vessels, nerves, and organs. This is the hallmark of diabetes.

Measuring insulin levels in your blood can help doctors understand how your body is managing glucose. For example, if your blood glucose is high but your insulin levels are also high, it might suggest that your body is producing a lot of insulin to try and compensate for cells that aren't responding well to it. This is often seen in the early stages of type 2 diabetes or in conditions like metabolic syndrome. Conversely, very low insulin levels might indicate that the pancreas isn't producing enough insulin.

What can cause it to be high or low

High insulin levels can be associated with:

• Insulin resistance: This is a common reason for high insulin. Your cells become less sensitive to insulin's signal, so your pancreas has to produce more and more insulin to try and get glucose into the cells. This is often seen in people who are overweight or obese, have a sedentary lifestyle, or have certain genetic predispositions.
• Metabolic syndrome: This is a cluster of conditions including high blood pressure, high blood sugar, unhealthy cholesterol levels, and excess abdominal fat. Insulin resistance is a key feature of metabolic syndrome, leading to elevated insulin levels.
• Type 2 diabetes (early stages): In the initial phases of type 2 diabetes, the pancreas often works overtime to produce extra insulin to overcome resistance.
• Certain tumours of the pancreas: Very rarely, tumours called insulinomas can produce excessive amounts of insulin, leading to dangerously low blood sugar levels (hypoglycaemia).
• Polycystic ovary syndrome (PCOS): Many women with PCOS have insulin resistance, which can lead to higher insulin levels.

Low insulin levels can be associated with:

• Type 1 diabetes: In type 1 diabetes, the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. This results in little to no insulin production.
• Late-stage type 2 diabetes: Over many years, the pancreas can become exhausted from overworking to produce insulin, and its ability to produce insulin may significantly decrease.
• Pancreatic damage or disease: Conditions that damage the pancreas, such as pancreatitis (inflammation of the pancreas) or pancreatic cancer, can impair its ability to produce insulin.
• Certain genetic conditions: Some rare genetic disorders can affect insulin production.

Lifestyle factors that may help

Certain lifestyle choices can positively influence how your body uses insulin and manages blood sugar. These are often areas that your GP might discuss with you:

• Healthy eating patterns: Focusing on a balanced diet rich in whole grains, fruits, vegetables, and lean proteins, while limiting processed foods, sugary drinks, and excessive saturated fats, can help improve insulin sensitivity.
• Regular physical activity: Engaging in regular exercise, including both aerobic activities (like brisk walking, swimming, or cycling) and strength training, can make your cells more responsive to insulin and help manage weight.
• Weight management: Achieving and maintaining a healthy weight, particularly reducing excess abdominal fat, can significantly improve insulin sensitivity.
• Stress management: Chronic stress can affect hormone levels, including insulin. Finding effective ways to manage stress, such as mindfulness, yoga, or hobbies, may be beneficial.
• Adequate sleep: Poor sleep quality or insufficient sleep can negatively impact insulin sensitivity and blood sugar control. Aiming for consistent, restful sleep is important.

Questions to discuss with your GP

If you have concerns about your insulin levels or blood sugar control, here are some questions you might consider discussing with your GP:

• What do my insulin and blood glucose results mean in the context of my overall health?
• Could my current symptoms or medical history be related to insulin resistance or diabetes?
• What are the most effective lifestyle changes I can make to support healthy insulin function and blood sugar levels?
• Are there any further tests or monitoring that would be beneficial for me?
• What are the potential long-term implications of my current insulin levels?
• How often should my insulin and blood sugar levels be checked?