The role of skeletal muscle insulin resistance in the pathogenesis of the Metabolic Syndrome
Metabolic syndrome is unquestionably the health scourge of our time. However, unlike the Plague in Europe, we don’t seem quite aware yet that something is happening. Until the medical community wakes up and learns to identify and manage insulin resistance, this scourge will continue.
This study adds further understanding to MetS by looking at what happens to the muscles and liver in patients with insulin resistance fed a high carbohydrate diet. It also explains why patients with elevated triglycerides and lowered HDL do NOT have a cholesterol problem!! I can’t tell you how frustrating it is to have a patient with severe insulin resistance be told by their PCP to cut back on saturated fat!! So, normally, if someone ingests carbs, the level of glycogen storage in the muscles will increase.
However, in patients with insulin resistance, we don’t see this–instead we see a drastic reduction in glycogen synthesis. Worse yet, instead we see the liver increase its production of triglycerides and reduce production of HDL. Bad combo. This really does add some heavy understanding to my approach to patients with IR. There needs to be a consistent, strong focus on increasing muscle mass and glycogen storage. Dr. Alan Sears’ PACE program is a program that I personally recommend for this approach from an exercise standpoint.