5 ways to control your blood sugar, reverse insulin resistance, and reduce your heart disease risk | Prof Rob Semple

**SPEAKER_1** (0:00)
Welcome to ZOE Science & Nutrition, where world-leading scientists explain how their research can improve your health.
The smell of freshly baked bread hits you. You start salivating. You have a slice. Let's be honest, it's delicious and you have two slices. Within minutes, your body turns the bread into glucose, and your blood sugar starts to spike.
Sensing this, your body releases just enough insulin to lower your blood sugar back to normal. Too much blood sugar spells serious trouble, but too little and your body shuts down.

**Rob Semple** (0:40)
Permanently.

**SPEAKER_1** (0:41)
So, what happens if this magic hormone that controls your blood sugar can no longer get your cells to listen? What if this delicate balancing act is upended? Insulin is a metabolic peacekeeper, keeping blood sugar on a tight leash. Not too much, not too little. And if it fails, metabolic war can break out, significantly increasing your risk of chronic conditions like heart disease, type 2 diabetes, even dementia. Insulin resistance affects around one in three of us, and yet most of us have no idea we're living with it. So how can something so serious remain hidden for so long? Insulin resistance has become one of the defining health issues of the modern world, yet it's surrounded by confusion and misinformation. Social media tells us insulin is something to fear, but is that really true?
Joining me is Professor Rob Semple from the University of Edinburgh, one of the world's leading experts on insulin resistance. Together, we'll explore why this condition develops, learn how to spot warning signs, and most importantly, discover what we can all do to reduce our risk now and in the future.
Rob, will I live if my body stops making insulin?

**Rob Semple** (1:56)
No.

**SPEAKER_1** (1:58)
Has there been a huge rise in the number of people with insulin resistance?

**Rob Semple** (2:01)
Yes.

**SPEAKER_1** (2:03)
When insulin is working well, can it reduce blood sugar spikes?

**Rob Semple** (2:07)
Yes.

**SPEAKER_1** (2:09)
If you develop insulin resistance, is there anything you can do to reverse it?

**Rob Semple** (2:14)
Yes.

**SPEAKER_1** (2:15)
Can someone have insulin resistance even if their blood sugar level looks normal?

**Rob Semple** (2:20)
Yes.

**SPEAKER_1** (2:21)
If you develop insulin resistance, is diabetes inevitable?

**Rob Semple** (2:25)
No.

**SPEAKER_1** (2:27)
What's one thing that most people get wrong about insulin resistance?

**Rob Semple** (2:32)
Incident is a rapidly changing complex hormone that can go wrong in many different ways. Trying to package it all into one thing called incident resistance is often misleading.

**SPEAKER_1** (2:43)
Insulin resistance is a term I've heard quite often, often when people are talking about blood sugar control.
But whenever I have it explained to me, I am quickly overwhelmed by the complexity and honestly, I just give up. I'm hoping you can explain this to me through this podcast in a way that I can understand what it means. Actually, before we talk about insulin resistance, could you just talk about what is insulin and what does it do?

**Rob Semple** (3:12)
Exactly. This is where we have to start. Insulin is, I would argue, the most important hormone in the world. Certainly, there's no more important hormone. A hormone is a chemical messenger, which comes from one bit of the body and sends signals to the rest of the body.
That's the start. Now, insulin solves an absolutely crucial problem that is essential to life. The problem is that many of our key organs need energy and nutrients constantly, our hearts, brain, kidneys, etc. And yet, we don't eat constantly. We eat once every so often. Increasingly often, I acknowledge, but through much of human history, we've had long periods of fasting or even starvation, and then episodic binges of food.
So insulin solves the problem of smoothing out that energy supplier to organs. So every time we eat, nutrients are taken up from the gut and insulin is made. An insulin completely remodels the body's metabolism. When we fast, when we don't eat, we need to be trickling out energy from our energy stores, mostly in fat tissue, but also in the liver. But as soon as we eat, we need to recognize that we've eaten and then replenish those fat stores. So we reverse everything to store energy in the fat stores and also allow the tissues to grow in the times of plenty. An insulin is that thread which connects what we're doing with our diet and our body's metabolism.
And we know it's absolutely essential because of the horrible consequences of not having any insulin at all. I think we're all familiar with type 1 diabetes when the body makes no insulin. Still an important problem. But it's transformationally different now to how it was just over 100 years ago before we had insulin to deliver. In those days, if you were diagnosed as having no insulin, as having type 1 diabetes, it was essentially a death sentence and led to wasting away and death often of teenage children over the course of two years. And I think it's very easy for us to be more blasé about. Incident these days, but it was equivalent to being diagnosed with an advanced cancer. And with a starvation diet, you could buy a few extra months, but that was more or less all you could do.