ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Insulin Resistance: Treatment & How it Affects Weight Loss | Mass General Brigham

Insulin resistance describes an abnormal process in the body that goes along with lots of medical conditions that are very common,

like type 2 diabetes, obesity, and atherosclerotic cardiovascular disease.

Insulin is a hormone produced by the pancreas

that helps your body break down the energy we eat and nutrients into substances it can use, like glucose, which is the medical word for sugar, and fats.

In states of insulin resistance, the body is not responding normally to levels of insulin that are being produced.

And as a result, we see lots of abnormalities.

The most common one we see is slightly elevated glucose.

Glucose won't always be elevated, but if the body isn't making enough insulin to keep up with insulin resistance,

then it certainly can be very elevated and lead to type 2 diabetes.

Lots and lots of different things can cause insulin resistance.

But when we commonly talk about insulin resistance occurring, it's usually because people are carrying extra weight, and that extra weight ends up getting stored in places it shouldn't be,

like liver and other tissues.

And that extra fat sitting in the liver then interferes with the body's ability to respond appropriately to insulin.

So there are lots of common conditions that go along with insulin resistance.

One of the most common is fatty liver, but there are other conditions such as polycystic ovarian syndrome, type 2 diabetes.

Fatty liver is a very common condition that you could be diagnosed with by a doctor, and that is described when people are really carrying extra fat in the liver.

When you take a big step back, the liver is really the factory that processes our energy.

And carrying extra fat in the liver interferes with a lot of a body's normal ability to function.

The good news is that when we overeat, the fat goes straight to the liver, but also when When we diet, the first place we lose weight is from the liver.

A common syndrome accompanied by insulin resistance without high blood sugars or diabetes is polycystic ovarian syndrome.

Polycystic ovarian syndrome is a syndrome characterized by irregular menstrual cycles.

People with PCOS often have very high insulin levels.

That said, the high insulin levels in PCOS probably to some degree drive the irregular menstrual cycles

and even to some degree drive the excess androgen or male hormone levels.

People often say insulin resistance causes type 2 diabetes.

And I want to point out

that that's not true unless the pancreas is not making enough insulin to keep up with the body's demand.

So there are many, many people who have insulin resistance, who are overweight with fatty liver, who don't have type 2 diabetes because their pancreas just produces more

and more and more insulin and keeps up to a large degree with the body's demand.

That's not a good situation because those high levels of insulin probably drive other abnormal body processes.

So even those people would benefit from weight loss.

But you really need insulin deficiency in combination with insulin resistance to lead to type 2 diabetes.

A lot of what determines insulin resistance is where excess weight is stored.

Some people tend to gain weight in their upper body and be sort of more apple-shaped.

Other people tend to store their excess weight in their hips or in their lower body and tend to be more pear-shaped.

It's actually the people who tend to store weight in what we call the apple distribution, the central weight, who tend to have much more problems with insulin resistance

because the excess weight is being stored in the liver and other abdominal organs, interfering with normal metabolic function.

So the best treatments for insulin resistance are also the best treatments for being overweight

or having obesity and also the best ways to just stay healthy overall.

Losing a modest amount of weight actually is very beneficial for insulin resistance

and the best way to achieve weight loss is through diet and exercise.

While many people give up on diet and exercise, in fact, relatively simple steps like eliminating sugary beverages,

including juices, having portion controlled meals that are balanced with a mixture of carbohydrates, protein, and fruits and vegetables,

particularly the healthy carbohydrates are very beneficial for insulin resistance.

And actually just exercising reduces insulin resistance, even in the absence of weight loss.

A lot of people feel it's very overwhelming to start an exercise program, but actually simple steps like walking 30 minutes over the course of the day,

even in three separate bouts of 10-minute exercise, things as simple as parking the car farther away, taking the stairs.

These things really make a difference over time and help reduce insulin resistance.

So people often wonder, should I take a medicine to treat insulin resistance?

Well, insulin resistance isn't really a disease in and of itself.

It's sort of the abnormal body process that goes along with many other conditions.

So if you have another condition that needs a medication, then by all means medications could be used to treat that condition.

The good news is that very simple steps, such as increasing exercise, healthier diet, and weight loss can dramatically improve insulin resistance

and reduce the risk of a lot of the health conditions that go along with it.

Thanks for joining me today.

I'm Dr. Deborah Wexler at Mass General Brigham.

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ฝึกพูดภาษาอังกฤษด้วยเทคนิค Shadowing จากวิดีโอ: Insulin Resistance: Treatment & How it Affects Weight Loss | Mass General Brigham

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