UNDERSTANDING INSULIN RESISTANCE - When the body blocks insulin from doing its job - The bodies of many people with diabetes are fighting a quiet war against the essential hormone insulin. This conflict is called insulin resistance, and while it's a hallmark of prediabetes and type 2 diabetes, it can also affect those with type 1. Just why a person fails to respond properly to insulin is something of a mystery. In people who have neither diabetes nor insulin resistance, eating a typical meal will cause blood glucose levels to rise, triggering the pancreas to produce insulin. The hormone travels through the body and induces fat and muscle cells to absorb excess glucose from the blood for use as energy. As the cells take up glucose, blood glucose levels fall and flatten out to a normal range. Insulin also signals the liver — the body's glucose repository — to hold on to its glucose stores for later use. However, people with insulin resistance, also known as impaired insulin sensitivity, have built up a tolerance to insulin, making the hormone less effective. As a result, more insulin is needed to persuade fat and muscle cells to take up glucose and the liver to continue to store it. In response to the body's insulin resistance, the pancreas deploys greater amounts of the hormone to keep cells energized and blood glucose levels under control. (This is why people with type 2 diabetes tend to have elevated levels of circulating insulin.) The ability of the pancreas to increase insulin production means that insulin resistance alone won't have any symptoms at first. Over time, though, insulin resistance tends to get worse, and the pancreatic beta cells that make insulin can wear out.

..............................................................................................................................................................

Understanding Insulin Resistance

When the body blocks insulin from doing its job

By Erika Gebel, PhD

The bodies of many people with diabetes are fighting a quiet war against the essential hormone insulin.

This conflict is called insulin resistance, and while it's a hallmark of prediabetes and type 2 diabetes, it can also affect those with type 1.

Just why a person fails to respond properly to insulin is something of a mystery.

But there are ways to make the body more receptive to insulin, which can help prevent or ameliorate diabetes.

Building Up Resistance

In people who have neither diabetes nor insulin resistance, eating a typical meal will cause blood glucose levels to rise, triggering the pancreas to produce insulin.

The hormone travels through the body and induces fat and muscle cells to absorb excess glucose from the blood for use as energy.

As the cells take up glucose, blood glucose levels fall and flatten out to a normal range.

Insulin also signals the liver — the body's glucose repository — to hold on to its glucose stores for later use.

However, people with insulin resistance, also known as impaired insulin sensitivity, have built up a tolerance to insulin, making the hormone less effective.

As a result, more insulin is needed to persuade fat and muscle cells to take up glucose and the liver to continue to store it.

In response to the body's insulin resistance, the pancreas deploys greater amounts of the hormone to keep cells energized and blood glucose levels under control. (This is why people with type 2 diabetes tend to have elevated levels of circulating insulin.)

The ability of the pancreas to increase insulin production means that insulin resistance alone won't have any symptoms at first.

Over time, though, insulin resistance tends to get worse, and the pancreatic beta cells that make insulin can wear out.

Eventually, the pancreas no longer produces enough insulin to overcome the cells' resistance. The result is higher blood glucose levels (prediabetes) and, ultimately, type 2 diabetes.

Insulin has other roles in the body besides regulating glucose metabolism, and the health effects of insulin resistance are thought to go beyond diabetes.

For example, some research has shown that insulin resistance, independent of diabetes, is associated with heart disease.

Behind the Battle

Scientists are beginning to get a better understanding of how insulin resistance develops.

For starters, several genes have been identified that make a person more or less likely to develop the condition.

It's also known that older people are more prone to insulin resistance.

Lifestyle can play a role, too; being sedentary, overweight, or obese increases the risk for insulin resistance.

Why? It's not clear, but some researchers theorize that extra fat tissue may cause inflammation, physiological stress, or other changes in the cells that contribute to insulin resistance.

There may even be some undiscovered factor produced by fat tissue, perhaps a hormone, that signals the body to become insulin resistant.

Doctors don't usually test for insulin resistance as a part of standard care.

In clinical research, however, scientists may look specifically at measures of insulin resistance, often in an effort to study potential treatments for insulin resistance or type 2 diabetes.

They typically administer a large amount of insulin to a subject while at the same time delivering glucose to the blood to keep levels from dipping too low.

The less glucose needed to maintain normal blood glucose levels, the greater the insulin resistance.

Insulin resistance comes in degrees, with important health implications for people with diabetes.

The more insulin resistant a person with type 2 is, the harder it will be to manage the disease because more medication is needed to get enough insulin in the body to achieve target blood glucose levels.

Insulin resistance isn't a cause of type 1 diabetes, but people with type 1 who are insulin resistant will need higher insulin doses to keep their blood glucose under control than those who are more sensitive to insulin.

As with type 2, people with type 1 may be genetically predisposed to become insulin resistant. 

Or they may develop resistance due to overweight. 

Some research indicates that insulin resistance is a factor in cardiovascular disease and other complications in people with type 1.

Counterattack

While it may not be possible to defeat insulin resistance entirely, there are ways to make the body cells more receptive to insulin.

Getting active is probably the best way; exercise can dramatically reduce insulin resistance, in both the short and long terms.

In addition to making the body more sensitive to insulin and building muscle that can absorb blood glucose, physical activity opens up an alternate gateway for glucose to enter muscle cells without insulin acting as an intermediary.

This reduces the cells' dependence on insulin for energy.

This mechanism doesn't reduce insulin resistance itself, but it can help people who are insulin resistant improve their blood glucose control.

Weight loss can also cut down on insulin resistance. 

No one diet has been proved to be the most effective.

Some evidence suggests, though, that eating foods that are low in fat and high in carbohydrates can worsen insulin resistance.

Research has also shown that people who undergo weight-loss surgery are likely to become significantly more sensitive to insulin.

No medications are specifically approved to treat insulin resistance.

Yet diabetes medications like metformin and thiazolidinediones, or TZDs, are insulin sensitizers that lower blood glucose, at least in part, by reducing insulin resistance.

While fighting an invisible foe may seem daunting, there are effective tactics to combat insulin resistance.

Losing weight, exercising more, or taking an insulin-sensitizing medication may get the body to bend once again to insulin's will, bringing about good blood glucose control and better health.

The Diabetes Forecast brand provides accurate, timely, and friendly information about all aspects of living with diabetes or prediabetes, including food, fitness, weight loss, medications, research, and well-being for the entire family. Hope and inspiration, including real-life stories and reader-submitted content are other key ingredients in the editorial mix. Diabetes Forecast content address the broad spectrum of people living with diabetes— from those newly diagnosed with diabetes to people who have been living with the condition for decades.
In 2013, Diabetes Forecast magazine was awarded the Best Publication Redesign Gold award from the American Society of Healthcare Publication Editors. Diabetes Forecast is also included in the National Diabetes Education Program’s Diabetes HealthSense website.

http://www.diabetesforecast.org/2011/jun/understanding-insulin-resistance.html

HIGH-FRUCTOSE CORN SYRUP - High fructose corn syrup (HFCS) is a sweetener derived from corn syrup, which is processed from corn. It’s used to sweeten processed foods and soft drinks — primarily in the United States. Similarly, to regular table sugar (sucrose), it’s composed of both fructose and glucose. It became a popular sweetener in the late 1970s when the price of regular sugar was high, while corn prices were low due to government subsidies. Though its use skyrocketed between 1975 and 1985, it has declined slightly due to the rising popularity of artificial sweeteners. High-fructose corn syrup is a sugar-based sweetener, used in processed foods and drinks in the United States. Like regular sugar, it consists of the simple sugars glucose and fructose. High fructose corn syrup is made from corn (maize), which is usually genetically modified (GMO). The corn is first milled to produce corn starch, which is then processed further to create corn syrup. Corn syrup consists mostly of glucose. To make it sweeter and more similar in taste to regular table sugar (sucrose), some of that glucose is converted to fructose using enzymes. Different types of high-fructose corn syrup (HFCS) provide varying proportions of fructose. HFCS 55 is similar to sucrose (regular table sugar), which is 50% fructose and 50% glucose. High-fructose corn syrup is produced from corn (maize) starch, which is further refined to produce syrup.

...............................................................................................................................................

High-Fructose Corn Syrup

Just Like Sugar, or Worse?

Joe Leech

For decades, high-fructose corn syrup has been used as a sweetener in processed foods.

Due to its fructose content, it has been heavily criticized for its potential negative health effects.

Many people claim that it’s even more harmful than other sugar-based sweeteners.

This article compares high-fructose corn syrup and regular sugar, reviewing whether one is worse than the other.

What Is High-Fructose Corn Syrup?

High fructose corn syrup (HFCS) is a sweetener derived from corn syrup, which is processed from corn.

It’s used to sweeten processed foods and soft drinks — primarily in the United States.

Similarly, to regular table sugar (sucrose), it’s composed of both fructose and glucose.

It became a popular sweetener in the late 1970s when the price of regular sugar was high, while corn prices were low due to government subsidies.

Though its use skyrocketed between 1975 and 1985, it has declined slightly due to the rising popularity of artificial sweeteners.

SUMMARY

High-fructose corn syrup is a sugar-based sweetener, used in processed foods and drinks in the United States. Like regular sugar, it consists of the simple sugars glucose and fructose.

Production Process

High fructose corn syrup is made from corn (maize), which is usually genetically modified (GMO).

The corn is first milled to produce corn starch, which is then processed further to create corn syrup.

Corn syrup consists mostly of glucose. To make it sweeter and more similar in taste to regular table sugar (sucrose), some of that glucose is converted to fructose using enzymes.

Different types of high-fructose corn syrup (HFCS) provide varying proportions of fructose.

For example, while HFCS 90 — the most concentrated form — contains 90% fructose, the most commonly used type, HFCS 55, consists of 55% fructose and 42% glucose.

HFCS 55 is similar to sucrose (regular table sugar), which is 50% fructose and 50% glucose.

SUMMARY

High-fructose corn syrup is produced from corn (maize) starch, which is further refined to produce syrup. The most common type has a fructose-to-glucose ratio similar to table sugar.

High-Fructose Corn Syrup vs. Regular Sugar

There are only tiny differences between HFCS 55 — the most common type of high-fructose corn syrup — and regular sugar.

A major difference is that high-fructose corn syrup is liquid — containing 24% water — whereas table sugar is dry and granulated.

In terms of chemical structure, the fructose and glucose in high-fructose corn syrup are not bound together like in granulated table sugar (sucrose).

Instead, they float separately alongside each other.

These differences do not affect nutritional value or health properties.

In your digestive system, sugar is broken down into fructose and glucose — so corn syrup and sugar end up looking exactly the same.

Gram for gram, HFCS 55 has slightly higher levels of fructose than regular sugar. The difference is very small and not particularly relevant from a health perspective.

Of course, if you compared regular table sugar and HFCS 90, which has 90% fructose, regular sugar would be far more desirable, as excessive consumption of fructose can be very harmful.

However, HFCS 90 is rarely used — and then only in tiny amounts due to its extreme sweetness.

SUMMARY

High-fructose corn syrup and table sugar (sucrose) are almost identical. The main difference is that the fructose and glucose molecules are bound together in table sugar.

Effects on Health and Metabolism

The main reason why sugar-based sweeteners are unhealthy is because of the large amount of fructose they supply.

The liver is the only organ that can metabolize fructose in significant amounts. When your liver gets overloaded, it turns the fructose into fat.

Some of that fat can lodge in your liver, contributing to fatty liver.

High fructose consumption is also linked to insulin resistance, metabolic syndrome, obesity, and type 2 diabetes.

High-fructose corn syrup and regular sugar have a very similar blend of fructose and glucose — with a ratio of about 50:50.

Therefore, you would expect the health effects to be largely the same — which has been confirmed numerous times.

When comparing equal doses of high-fructose corn syrup and regular sugar, research shows that there's no difference in feelings of fullness, insulin response, leptin levels, or effects on body weight.

Thus, sugar and high-fructose corn syrup are exactly the same from a health perspective.

SUMMARY

Many studies show that sugar and high-fructose corn syrup have similar effects on health and metabolism. Both are harmful when consumed in excess.

Added Sugar Is Bad — Fruit Isn’t

Though excessive fructose from added sugar is unhealthy, you should not avoid eating fruit.

Fruit are whole foods, with plenty of fiber, nutrients, and antioxidants. It’s very difficult to overeat fructose if you're only getting it from whole fruit.

The negative health effects of fructose only apply to excessive added sugars, which are typical for a high-calorie, Western diet.

SUMMARY

Though fruit are among the richest natural sources of fructose, they’re associated with health benefits. Adverse health effects are only linked to an excessive intake of added sugar.

The Bottom Line

The most common form of high-fructose corn syrup, HFCS 55, is virtually identical to regular table sugar.

Evidence to suggest that one is worse than the other is currently lacking.

In other words, they’re both equally bad when consumed in excess.

Joe Leech is an Australian dietitian with a master's degree in nutrition and dietetics. He has published hundreds of evidence-based nutrition articles, both for Healthline and his website. Joe has also produced nutrition videos for Healthline's Youtube channel. He currently lives in Sweden and keeps fit by weight training regularly, eating mainly home-cooked meals and snowboarding in the winter.

Healthline covers all facets of physical and mental health openly and objectively because we’re here for the whole person — for your whole life. And because people come to us with unique challenges we listen closely and put empathy first across our organization. In everything from our personal perspectives to our commitment to inclusivity, you’ll see that we feel with you. 

We hope you tap into all of Healthline’s resources — from our health and wellness library and newsletters to our apps, podcasts, and communities.https://www.healthline.com/nutrition/high-fructose-corn-syrup-vs-sugar#production