Semaglutide & GLP-1s
What Is Insulin?
Insulin is an important hormone produced by the beta cells in your pancreas.
Has many actions within the body involved in the metabolism of carbohydrates, lipids, fats, and proteins.
What Is Insulin Resistance?
Prevents the tissues in your body, particularly muscles and fat tissues, to respond appropriately to insulin, requiring more insulin to elicit the same response. This results in higher levels of insulin needed to continue to exert its physiological effects.
Signs & Symptoms
Abdominal Obesity
Elevated Cholesterol Levels
High Blood Pressure
Fatigue
Frequent Infections
Tingling Sensation in Hands/Feet
Sweet Cravings
Increased Hunger
Acanthosis Nigricans (Darkening of skin in the folds and creases of the body) or skin tags
Causes
Insulin resistance has a strong association with genetics, but also can be a result of lifestyle and is often associated with the following:
Infection or Severe Illness
Metabolic Syndrome
Obesity
Pregnancy
Steroid Use/Other Medications
Stress
There are other medical conditions associated with insulin resistance, including:
Type 2 Diabetes-Insulin resistance can occur long before diabetes develops and if left untreated, insulin resistance can present as type 2 diabetes.
Fatty Liver-Caused by the accumulation of fat in the liver resulting in uncontrolled lipids due to insulin resistance damaging the liver and can possibly lead to cirrhosis and possibly liver cancer.
Arteriosclerosis/Atherosclerosis-Process of thickening and hardening of the walls of medium-sized and larger arteries. Responsible for the following:
Coronary Artery Disease-Angina/Heart Attack
Peripheral Vascular Disease
Stroke
Skin Lesions-Increased number of acanthosis nigricans (skin tags) as well as darkening and thickening of the skin especially in fold areas of the neckline and axilla (where the arm connects to your shoulder).
Reproductive Abnormalities in Women-Difficulties with ovulation, conception, regularity, and cessation of menses and can result in Polycystic Ovary Syndrome (PCOS).
Hypergonadism-Causes a woman's ovaries to produce high levels of male hormones such as testosterone and other hormones creating symptoms like excess body hair and weight gain.
Growth Abnormalities-Creates high levels of circulating insulin affecting some mechanisms as the result of glucose metabolism impairment. Insulin's effects on growth through a mediator called insulin-like growth factor-1 (IGF-1) creating linear growth in height and coarsening of features.
Risk Factors For Insulin Resistance Obesity-Body Mass Index (BMI) more than 25
Waist Measurements
Men-More Than 40 Inches
Women-More Than 35 Inches
Over the age of 40
Ethnicity-Latino, African American, Native American, or Asian American
History of gestational diabetes
Close blood-related family members with type 2 diabetes, high blood pressure, or arteriosclerosis
High blood pressure, high triglycerides, low HDL cholesterol or arteriosclerosis
Polycystic Ovary Syndrome (PCOS)
Acanthosis Nigrans (skin tags)
Diagnosing Insulin Resistance
Provider will look at detailed patient history, physical examination, and request laboratory testing.
Test fasting glucose levels in conjunction with fasting insulin levels, Hemoglobin A1C.
Treatment for Insulin Resistance
Lifestyle Changes-
Reduce sugar intake, artificial sugars, and sugar alcohols.
Reduce carbohydrate intake to decrease insulin released by your pancreas.
Carbohydrates are absorbed into your body after they are broken down into sugar components.
Foods high in glycemic index are absorbed faster than others increasing blood glucose more rapidly causing the secretion of more insulin to control the level of glucose in the blood.
Intermittent Fasting/Time Restricted Eating
Allows the pancreas to rest and not release insulin.
Start with 12 hours of fasting and a 12-hour eating window. Then may increase to 16 hours of fasting and 8 hour eating window.
Medications-These medications and supplements help increase the body's sensitivity to insulin.
Semaglutide or Liraglutide - (glucagon-like peptide-1 or GLP-1)
Metformin - (prescription medication)
Berberine - (supplement)
Semaglutide & How It Can Help The hormone insulin is made naturally in the body by the pancreas and helps to control the levels of sugar (glucose) in your blood. When the body makes too much insulin or doesn't use it effectively, it can result in central weight gain, increased blood pressure, abnormal lipid levels, and eventual diabetes.
What Is Semaglutide?
Semaglutide is a glucagon-like peptide (GLP-1) analog approved for weight management and is also used for diabetes. It closely resembles the natural hormone glucagon-like peptide-1 (GLP-1) which is secreted in the gut and targets receptors throughout the body, including the brain. Researchers believe that patients with obesity secrete less GLP-1 in response to eating. When a person is eating, GLP-1 sends the brain the “I’m full” signal. Semaglutide also decreases the emptying time of the stomach which makes you feel fuller fasting causing little desire to go back for seconds or snack later. In addition to the benefit of weight loss, semaglutide also has cardiovascular benefits, and can improve fertility. Semaglutide helps reverse insulin resistance by making your cells more sensitive to insulin. By making cells more sensitive to insulin, it decreases the likelihood of developing type 2 diabetes. However, this medication is a great effective treatment for those already diagnosed with type 2 diabetes.
Side Effects & Symptoms
The most commonly reported side effects include:
Nausea (which can be managed by dosing)
Constipation/Diarrhea
Abdominal pain
Indigestion
Vomiting
Fatigue
Decreased appetite
Rare Side Effects Include:
Pancreatitis
Hypotension
Contraindicated In Pregnant & Breastfeeding Women How To Use Semaglutide
Semaglutide is administered by injection through a very small needle. Self-injections are given once weekly in the subcutaneous (fatty) tissue of the abdomen, thigh, or buttocks. Patients start on a very low dose, and slowly titrate the dose up as instructed by your provider. Semaglutide provides the best results when coupled with intermittent fasting and a diet rich in vegetables, fruits, and lean meats.
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