Why Insulin Sensitivity Is Key to Treating Chronic Disease

Insulin sensitivity is a health factor most often linked with diabetes, but it plays a much bigger role in your overall health than many people realize.

“When the body becomes resistant to insulin, it sets off a chain reaction that contributes to obesity and other chronic conditions,” says Nisha Kuruvadi, DO, an internal and obesity medicine physician in private practice in San Diego and a member of the Obesity Medicine Association. “Improving insulin sensitivity can transform metabolic health and lower the risk for disease.”

Insulin sensitivity refers to how well the body responds to insulin, a hormone that helps move glucose (sugar) from the blood into the cells where it can be used for energy.

“But insulin does more than regulate blood sugar; it also influences fat storage, muscle health, appetite control, and inflammation,” says Dr. Kuruvadi.

Insulin sensitivity is crucial for maintaining overall metabolic health, or the body’s ability to process and use energy appropriately. When your cells have an impaired response to insulin, known as insulin resistance, they require the pancreas to produce more of the hormone to achieve the same effects.

Insulin resistance is most well known as a cause of type 2 diabetes, but experts today recognize that it creates widespread issues throughout the body.

“When cells become insulin resistant, the body compensates by producing more insulin,” says Rita Rastogi Kalyani, MD, chief scientific and medical officer at the American Diabetes Association and professor of medicine at Johns Hopkins University School of Medicine in Baltimore.

Over time, this overload can cause or exacerbate several chronic diseases, including:

• Obesity “Insulin resistance and obesity often reinforce one another,” says Kuruvadi. Elevated insulin levels prompt the body to store more fat while preventing it from burning fat efficiently. It also drives hunger and cravings. “This makes people feel hungrier and more likely to choose foods that further raise blood sugar and insulin,” says Kuruvadi, which leads to weight gain over time, particularly around the midsection.
• High Blood Pressure People with high blood pressure have reduced insulin sensitivity compared with people with normal blood pressure. Experts suggest that because insulin causes sodium and water retention, an overproduction of the hormone due to reduced sensitivity increases blood volume and pressure on blood vessel walls, forcing the heart to work harder and elevating blood pressure.

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• High Cholesterol People with higher levels of LDL (“bad”) cholesterol tend to produce more insulin. The pancreas, where insulin is produced, has specialized proteins known as hormone receptors that respond to LDL cholesterol, so when you have more LDL cholesterol, your pancreas responds by making more insulin.

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   Too much LDL cholesterol also increases your risk of heart disease and stroke.

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• Diabetes Insulin resistance is a direct cause of type 2 diabetes. When the body is consistently exposed to high amounts of sugar in the blood, the pancreas has to continue pumping out larger amounts of insulin to move all the sugar out of the bloodstream and into the cells. Eventually, cells stop responding well to insulin, triggering the pancreas to release more insulin. Meanwhile, blood sugar levels remain elevated.

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• Liver Disease Insulin resistance helps cause the chronic liver diseases MASLD and MASH by provoking fat accumulation within the liver.

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• Cardiovascular Disease Aside from its effects on blood pressure and cholesterol, insulin resistance can also contribute to cardiovascular disease by causing inflammation and dysfunction within the blood vessels.

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Insulin resistance is “a vicious cycle where the body increases insulin levels to lower blood sugar, leading to weight gain, which, in turn, worsens insulin resistance,” says Marissa Toussaint, MD, MPH, a family physician in private practice in Brooklyn, New York, who specializes in weight loss and chronic disease management.

“Improving insulin sensitivity can transform metabolic health and lower the risk of disease,” says Kuruvadi. The following lifestyle strategies can help improve insulin sensitivity:

• Lose Weight Excess weight triggers and worsens insulin resistance. Modest weight loss (a 10 percent reduction in total body weight) can create lasting improvements in insulin sensitivity.

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• Eat a Nutritious Diet Prioritize whole foods, such as fruits, vegetables, whole grains, beans and legumes, nuts, and seeds, which are rich in fiber. High-fiber foods slow rises in blood sugar and reduce insulin demand, says Kuruvadi. Meanwhile, cut back or eliminate processed foods, sugary drinks, refined carbohydrates, and other foods that spike blood sugar. These foods and beverages encourage the body to produce more insulin.

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• Exercise Regularly “Exercise is one of the fastest ways to improve insulin sensitivity,” says Kuruvadi. Aerobic exercise, such as walking, jogging, cycling, and swimming, help muscles take in more sugar and become more responsive to insulin afterward.

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   Strength training can also significantly help improve insulin sensitivity.

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• Prioritize Sleep and Stress Management These are legitimate health issues that raise your chronic disease risks. “Lack of sleep and chronic stress raise insulin resistance by disrupting hormones that control hunger and metabolism,” says Kuruvadi. Make stress management and healthy sleep habits priorities.
• Seek Treatment for Sleep Apnea Dr. Toussaint says that interrupted sleep has also been linked to insulin resistance. Sleep apnea is a sleep disorder that causes breathing to stop during sleep. It tends to be more common in people who are overweight or have obesity. See your doctor for a diagnosis and treatment if you experience symptoms of sleep apnea, including loud snoring, excessive daytime sleepiness, and gasping for air during sleep.

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• Consider Medication Options “For some people, lifestyle changes aren’t enough on their own [to improve insulin sensitivity],” says Kuruvadi. Talk to your doctor to find out if you may benefit from medications that help reduce insulin resistance and support weight management, such as metformin or GLP-1 receptor agonists.

• Insulin sensitivity is a key factor in overall metabolic health. It reduces the risk of obesity, high blood pressure, high cholesterol, cardiovascular disease, type 2 diabetes, and metabolic dysfunction-associated steatotic liver disease (MASLD).
• The best ways to improve insulin sensitivity include exercising regularly, eating a healthy diet, prioritizing sleep and stress management, and losing excess weight.
• Treatment for obesity, type 2 diabetes, and sleep apnea can also help improve insulin sensitivity. Consult your healthcare provider to see whether medications are appropriate for you.