When Your Body Stops Listening to Insulin

 Before The Sugar Rises

Your Blood sugar may be normal - but is your sugar?  

In the past week, three newly detected diabetics walking into the clinic:

·       Rakesh, a 39-yer-old corporate consultant with a leading MNC who has been on thyroid medication since the past 9 years. Despite his 30-minute morning walks, his abdominal circumference is increasing

·       Nikhil, a 28-year-old busy IT professional with a sedentary lifestyle and poor sleep schedule. Lean but with central obesity (abdominal fat)

·       Megha, a 38-year-old overweight, Call Centre employee with irregular sleep and meal timings and a completely sedentary lifestyle, Add to that, stress; both in her personal and professional life

Actually this diabetes begins much before it is detected. At times, people ignore the warning signs and symptoms (knowingly or unknowingly), while some have no major symptoms. The metabolic changes preceding it may start years earlier. One of the earliest and most important changes is Insulin Resistance. 

So what exactly is Insulin Resistance? This topic deserves a lot more attention than it has because of the increasingly sedentary lifestyles and changing dietary habits. And it is not just a problem of obese people or those with high sugar levels. It can develop even when body weight is normal and blood glucose appears normal even while the body requires progressively more insulin to maintain that normal level. Over time, this stress can lead to prediabetes, fatty liver disease and cardiovascular complications.

This awareness is particularly of importance in India where metabolic disease is increasingly prevalent and can occur even in those with comparatively low BMI.

  Let us first understand what is Insulin and Insulin Resistance

Insulin is a hormone that helps to remove glucose (sugar) from the bloodstream and move it into the cells to be used for energy.

 Why do blood sugar levels rise?

Sometimes, the insulin is no longer effective at transporting glucose into the cells. The body becomes resistant to insulin, particularly the way it functions to keep blood sugar levels within normal range. This is Insulin Resistance. Glucose (sugar) builds up in the bloodstream and causes blood sugar levels to rise. The pancreas then produces more insulin in an effort to reduce glucose, but most of it is ineffective. So the patient may have both high blood sugar and high Insulin levels. Insulin resistance often appears along with or as a component of other metabolic problems, such as diabetes, high blood pressure, high cholesterol, heart disease, and polycystic ovarian syndrome. It often develops long before any of these diseases appear.

 

 Causes of Insulin Resistance

The exact cause of insulin resistance is not known. However, researchers have identified Genes that may increase the likelihood of developing Insulin Resistance and type 2 Diabetes.

·       Ethnicity

·       Lifestyle and

·       Certain medications could also be responsible

·       Smoking

·       High-fat diet

                     Risk Factors of Insulin Resistance

·       Family History of type 2 diabetes

·       History of Gestational Diabetes

·       Polycystic Ovarian Syndrome (PCOS)

·       Obesity (especially abdominal obesity) with a BMI of 30 or more

·       Waist-to-hip ratio or waist circumference in the high-risk range (Central Obesity)

 

 Insulin Resistance Symptoms

There are usually no symptoms. However, severe insulin resistance can cause acanthosis nigricans, which is seen as velvety dark patches of skin, usually around folds, such as the neck, armpits, elbows, knees, knuckles, and groin area. If blood sugar levels are high, the symptoms may be similar to those for type 2 diabetes.

  Clues that Suggest Insulin Resistance

·       Polycystic Ovarian Syndrome (PCOS)

·       Waist-to-hip ratio or Waist Circumference in the high-risk range

·       Elevated Triglycerides

·       Low HDL

·       High Blood Pressure

·       Fatty liver

·       Polycystic Ovarian Syndrome (PCOS)

·       Acanthosis Nigricans

·       Family History of type 2 Diabetes

·        Smoking

·       Aging because we accumulate excess fat around our middle, become less active and lose muscle mass as we age

 Metabolic Syndrome

Insulin Resistance causes blood sugar levels to rise and increases the risk for developing Prediabetes or type 2 Diabetes. When a patient has insulin resistance and three or more of the problems listed below, they are considered to have Metabolic Syndrome (formerly called Syndrome X). Metabolic syndrome is the name given to the combination of risk factors that increases risk for cardiovascular disease and diabetes.

·       Waist circumference of 40 inches or more for men and 35 inches or more for women

·       Triglyceride level 150 mg/dL or higher

·       HDL or ‘good’ cholesterol less than 40 mg/dL for men and less than 50 mg/dL for women

·       Blood pressure of 130/85 or higher

·       Fasting Glucose of 100 mg/dL or higher

 

Insulin Resistance Treatment

There are no FDA-approved medications for Insulin Resistance. The American Diabetes Association recommends the drug Metformin for people who are at very high risk or who have had impaired results for both the fasting glucose and glucose tolerance tests. Insulin resistance and pre-diabetes may be reversed or avoided with lifestyle changes, and these are usually tried first.

·       Moderate physical activity, at least 30 minutes a day for 5 to 7 days per week. Physical activity makes muscle cells more sensitive to insulin.

·       A 5 to 7% weight loss can prevent or delay diabetes by almost 60%. Studies have shown people over the age of 60 could lower their risks by 70% with same amount of weight loss.

·       Eating natural foods high in fiber helps to decrease risk.

 

Hyperinsulinemia (Elevated Insulin levels) leads to:

•  Sodium Retention – this can lead to high BP and hence increased risk of heart disease
• Elevated levels of LDL and Triglyceride – low levels of HDL – increasing risk of heart disease and stroke further increasing risk of heart disease and stroke
• More blood clotting. Can trigger release of compounds in blood that make it clot more readily.
• In women, it leads to increased levels of testosterone – can prompt growth of excess facial and body hair and ovarian cysts that increases chances of uterine cancer and fertility problems
• Weight gain. Insulin stimulates appetite and encourages fat storage.  Excess body fat causes insulin resistance
• Affects memory, learning
• Breathing related sleep disorder or snoring linked to insulin resistance

Note: You can have significant Insulin Resistance but normal fasting glucose and HbA1C. Conversely, a high fasting insulin doesn’t necessarily indicate diabetes

 

Wakeup! Prospective Fathers

   Pre-Pregnancy Diet for Prospective

 Fathers

Maternal diet during preconception affects the baby’s health is well established. But there is evidence that the father’s diet also plays a crucial role in health and disease in the baby’s adult life. So the sperm is not just the baby’s sex determinant, it carries non-genetic signals that may influence embryonic growth, body composition and long-term health outcomes.

 

Risk Factors for Cardio-metabolic Diseases

Greater the consumption of ultra-processed foods like packaged and ready-to-eat snacks, by the fathers, the higher the birth weight and greater accumulation of fat in the baby’s thighs and love handles. High birth weight and elevated body fat early in life are risk factors for cardio-metabolic diseases in adulthood.

 

Sperm Quality

Consuming ultra-processed foods negatively impacts sperm formation. These foods can create a pro-inflammatory environment in the body, affecting sperm quality and altering the expression of genes that will be passed on to the baby.

Gene activity can be activated or deactivated depending on the father’s dietary habits. One of the genes mentioned in the study is IGF-II which is responsible for fetal growth and is inherited exclusively from the father. Old research studies have shown that a father’s dietary habits can biochemically modify this gene in the sperm. But so far, the evidence is stronger in animal studies than in humans.

 

Poor nutrition  may reduce:

·        Sperm count

·        Motility

·        Morphology

·        DNA integrity. Nutrient deficiencies and obesity increase oxidative stress, leading to sperm DNA damage

 Pre-pregnancy diet for men

A pre-pregnancy diet for men should focus on boosting sperm quality, count and motility by emphasizing antioxidants, healthy fats and key minerals like Zinc. Key foods to include are walnuts, leafy greens and citrus fruits.

 

Essential Nutrients and Foods

·        Zinc – Pumpkin seeds, eggs and nuts to support testosterone levels and sperm production

·        Antioxidants (Vitamins C and E) - Citrus fruits, berries, tomatoes, almonds and sunflower seeds to protect sperm cells from oxidative damage

·        Omega-3 Fatty acids – walnuts, chia seeds. flax seeds, fish

·        Folate (Vitamin B9) – Spinach and dark leafy greens to promote healthy sperms 

Other key nutrients are Selenium and Vitamin D

 

Practical recommendations for prospective fathers

·        Eat a balanced diet rich in fruits, vegetables, whole grains, legumes, nuts and fish

·        Maintain a healthy body weight

·        Increase physical activity

·        Ensure adequate intake of folate, zinc, selenium, vitamins C, D, E and Omega-3 fatty acids through diet or supplements

·        Avoid smoking, excessive alcohol and recreational drugs

 These lifestyle changes have to be made at least 3 months before conception because it takes approximately 75 to 90 days for sperm development.   

 

Mounjaro, Ozempic, Wegovy - The Weight Loss Revolution

 From Diabetes Treatment to Weight Loss Revolution

India is undergoing a significant transformation in metabolic health particularly a sharp rise in cases of diabetes and obesity. This can be attributed mainly to modern lifestyles. On the flip side, today, social media strongly emphasizes good looks and healthy lifestyle. This increased the interest in weight-loss treatments. Fortunately, new treatments, awareness programs and medical advances are changing how these metabolic issues are dealt with.

Power Drugs

March 2025 marked the launch of the breakthrough drug Mounjaro (Generic name: Tirzepatide) in India. Mounjaro is a prescription medication used primarily to treat Type 2 Diabetes.

How Mounjaro Works

Mounjaro activates two important hormones in the body:

• GLP-1 (glucagon-like peptide-1)
• GIP (glucose-dependent insulinotropic polypeptide)

This dual-hormone action enhances blood sugar regulation and suppresses appetite, supporting weight loss. By September it had become one of India’s top-selling branded drugs because of the high demand for diabetes and obesity treatment. Since its approval by the U.S. Food and Drug Administration in 2022, Mounjaro has emerged as one of the most promising therapies for metabolic diseases.

Ozempic Launched

December 2025 saw the launch of Ozempic in India. It is available in 0.25 mg, 0.5 mg and 1mg doses. This prescription drug typically costing approx. Rs 8800 to 11175 per month. It is approved by the Central Drugs Standard Control Organization (CDSCO) for adults with type 2 Diabetes.

How Ozempic Works

Ozempic contains Semaglutide. Unlike Mounjaro, it mimics only GLP-1, which plays a key role in regulating blood sugar levels and appetite. By stimulating insulin production, slowing digestion, and reducing hunger, it often leads to substantial weight loss.

Originally developed for people with Type 2 Diabetes, Ozempic attracted global attention due to its unexpected effects - Significant weight loss. However, there is lot of controversy surrounding Ozempic because of its use for weight loss rather than diabetes treatment. In many countries, the drug has become popular among celebrities and social media influencers who are seeking rapid weight reduction.

Scene Stealer Wegovy

But it raises a question! Ozempic was launched internationally in December 2017 while Mounjaro had an international launch in May 2022. Then why was Ozempic launched in India after Mounjaro?

This was primarily to manage global supply shortage. The global demand for Ozempic was extremely high so they wanted to ensure a stable supply before entering a huge market like India. This way the patients would not start treatment and then have to deal with shortages.

Also, the manufacturers wanted to prioritize the introduction of their weight loss-specific drug Wegovy in India first rather than focusing initially on the diabetes-focused Ozempic.

Advantage Mounjaro

Thus, their competitor launched Mounjaro and took an early share of the market in India, To counter this, Ozempic entered the Indian market with a competitive lower-priced strategy. Typical monthly cost of Mounjaro is between 13,000 to 25,000 while that of Ozempic ranges from Rs 9000 to 20,000 and Wegovy is Rs 10000 to 17000 per month.

But there is a heavier price too!

Many people experience mild digestive side effects like Nausea, Diarrhea, Vomiting, Constipation, Stomach discomfort and Loss of appetite. Most of these symptoms improve as the body adjusts to the medication. Doctors usually start patients on lower doses and gradually increase them.

Rare but serious side effects

• ·        Pancreatitis
• ·         Gallbladder disease
• ·         Kidney problems
• ·         Severe allergic reactions

Hence for safe use, it should always be prescribed and monitored by a healthcare professional.

Figures from studies suggest the following average weight loss:

• Mounjaro - 15–22% body weight loss
• Wegovy - 12–15% body weight loss
• Ozempic - 8–12% body weight loss

However, the results vary depending on:

• Lifestyle
• Diet
• Physical activity
• Dosage

Celebrity Favourite

Some celebrities rumored to have used Ozempic or similar drugs include Elon Musk, Kim Kardashian and Oprah Winfrey, to name a few. Bollywood personality Karan Johar is being ridiculed for having an ‘Ozempic Face’. Many other international celebrities and Bollywood personalities have not officially confirmed using these medications specifically. The list of celebrity users coupled with the cost of the medications places it in the elite class of drugs. This raises questions about healthcare inequality.

Looking Ahead

To end on a positive note, the most significant development is the expiry of the semaglutide patent on March 20, 2026. This will lead to the emergence of generic Ozempic from domestic pharma giants. Over 50 Indian companies like Sun Pharma, Zydus Lifesciences, Dr. Reddy’s and Lupin have received approval to launch their own versions. New generics are expected to enter the market at Rs   3,500 to 5,000, making the treatment accessible to a much larger segment of the population.

Natural Alternatives to Weight Loss Medication

• ·   High-protein diet - Protein helps control appetite - Fiber slows digestion and helps you feel full
• 
  
  
  
  
• ·       Exercise

Strength training
Walking 8,000–10,000 steps daily
Cardio workouts

• ·       Good Sleep- Poor sleep can increase hunger hormones 

 Osteoporosis – The Silent Thief

We all know that calcium is required for strong bones. But so are other vitamins and minerals. Read on…

Bones form the framework of the body and help in movement. With age, they become weak and fragile increasing the chances of fracture with or without injury. While Diabetes is called a Silent Killer and a lot of awareness is generated about it, Osteoporosis is a Silent thief as it steals Calcium from your bones and makes bones porous.

Osteoporosis

Osteoporosis deserves great attention to avoid mobility issues. This will reduce the suffering of the elderly population especially females. Calcium is the foremost mineral that comes to mind while referring to bones. It helps to make bones dense.

About 99% of calcium is in your bones and teeth and 1% is in the blood (serum calcium). Serum calcium helps in muscle contraction, beating of heart and clotting of blood. When serum calcium falls, there is removal of calcium from the bones to maintain the levels.

Calcium Requirement

The daily requirement of calcium for women up to 50 years and men up to 70 years is 1000 mg/day while for women above 50 and men above 70 years is 1200 mg/day. Why the difference in calcium requirement?

The reason is osteoporosis affects women more than men. A study in Delhi estimated its prevalence in men as 24.6% as against 42.5% in men. Osteoporosis has affected 100 million women worldwide – approx. one-tenth of women at 60, one-fifth at 70, two-fifths at 80 and two-thirds at 90. This is because there is a rapid decline in bone mass density after menopause.

Exercise and Lifestyle

However, while it is more predominant in women, it can also affect children and adults with hormonal imbalances, thyroid or on crash diets. Along with a proper balanced diet, weight bearing exercises like jogging, walking, climbing up and down the stairs and resistance training helps in its prevention. Lifestyle modifications, avoiding alcohol and smoking also make a big difference.   

We lose calcium through sweat, urine and faeces in day to day life. It is important for the body to maintain its calcium levels for smooth functioning. Our body does not make calcium. Therefore it is important to obtain calcium through our diet. Otherwise one has to resort to supplements. 

Calcium Sources

We are all aware of milk and other dairy products as rich sources of calcium. But are they the only sources? Soya and its products, dark green leafy vegetables such as moringa and radish leaves, almonds, walnuts, sesame and garden cress seeds, fermented ragi products, sardines, Chinese cabbage and broccoli are some other sources.

Other Vitamins and Minerals

However, we cannot forget the importance of other vitamins and minerals that help the body to absorb and utilize calcium; the foremost being Vitamin D, the Sunshine vitamin.

The other important vitamins are B5, B6, B9, B12 and K2. The minerals phosphorus, magnesium, manganese, zinc, potassium, Boron and silica all have key roles in bone strengthening. 

(More in Part II..watch out for the sequel!)

Follow: https://www.whitechharcoal.com/uncategorized/love-your-bones/

 

Abdominal Problems No More!

Our abdomen is regarded as our second brain. It plays a crucial role in sustaining our health and well-being. Any medical problem has its root in the gut. Treating an ailment at the purely local level will not benefit you much. You have to give priority to the abdomen.

The upper brain (our first brain) and abdominal brain (our second brain) have to work in tandem; otherwise there will be chaos in the abdomen and misery in the head. Maintaining a healthy second brain and encouraging its interaction with the upper brain must be regarded as an invaluable weapon to fight medical disorders and a host of diseases. It also helps to fight unbalanced states of mind and slows the ageing process. This is the best way to promote and sustain good health.

A malfunctioning abdomen is responsible for many disorders like back pain, fatigue, insomnia or skin issues. An abdominal disorder that disrupts the absorption-elimination process influences the upper brain as well and may be the source of more serious complaints.

So how do we take care of the abdominal brain?

 Taste buds

Let’s start young. It is important to educate the taste buds of young children as early as possible. The fetus develops taste organs in the fourth month in the womb. Adult abdominal health is conditioned by childhood eating habits.

 Exercise

Moderate exercise involving an endurance sport stimulates the interaction between the two brains and benefits the entire body. Serious functional disorders have just vanished with regular exercise. The exercisers look and feel better thanks to the beneficial effects on the upper brain

 Detoxification

• Peach - assists in flushing out harmful toxins from the liver and kidneys
• Dragon fruit - High water content accelerates removal of toxins and waste products from the body  
• Black Rice - Cleanses the liver of harmful toxic build-up
• Kiwi - has a rich source of dietary fiber, which removes toxins from the colon and detoxify the body resulting in better and clearer skin

 

Home Remedies for Constipation

• Water - Drink at least 3 liters of water every day to keep your body hydrated and improve bowel movement
• Spinach - It is a mild laxative and is the best remedy for constipation; especially the raw juice. It corrects the most aggravated cases. Drink half a glass of spinach juice mixed with half a glass of water twice daily for two to three days. Tomato spinach juice is an effective bowel cleanser
• Prunes - Have 4 to 5 Prunes daily 
• Ghee - Take a teaspoon of ghee mixed in a glass of hot milk before going to bed. This is an age old Indian traditional remedy.
• Dates - Soak a few dates in milk. Crush it to make a paste. Mix with milk and take it for a week
• Oranges and Sweet lime – It helps in digestion as well
• Bananas - Rich in pectin, holds water and provides bulk to stools. Also helps to improve intestinal flora
• Apricots – It is a gentle laxative
• Papaya - Corrects digestive problems like indigestion, acidity and constipation
• Exercise - Regular exercise fights constipation

 

Beat The Bloat

• Water - Simplest remedy for treating a bloated stomach. Water flushes the gases and sodium out of your stomach and reduces the bloating. When you feel bloated, drink several glasses of water.
• Massage Away - Stomach bloating is generally gas build up in your belly. Massaging helps to expel these gases quickly. Lie down flat and rub your stomach in circular motions from right to left (clockwise)for about 15 minutes, or until you can feel the bloat is gone. You will find instant relief with this remedy!
• Take a Walk - One of the simple and effective bloated stomach remedies that help gas pass through your system effectively. Just walk around for 10 minutes or pace up and down the stairs until the gas is expelled.
• Fennel Seeds - Fastest remedy for bloating. Chew a small amount of these seeds and watch them do their wonder to your bloated stomach in barely minutes! Plus, fennel seeds double as a mouth freshener. You could also boil a spoonful of fennel seeds in a glass of boiling water and drink it, to achieve the same results quicker! 
• Lemon and Baking Soda - Squeeze a lemon into a glass and add some baking soda into it. You’ll see it fizz like a champagne bottle being opened. Continue adding baking soda until the fizz stops. Add a cup of water into it and stir until all the baking soda is dissolved (This is just a quick-fix thing)
• Ginger - Slowly chew a piece of ginger and swallow its juices or you could just drink a cup of ginger tea
• Lemon Water - It stimulates the production of acid in your stomach and breaks down food more effectively, reducing a bloated stomach. Just squeeze a lemon into a cup of lukewarm water, stir and drink away.

 

Some Foods to Nourish The Tummy

• Avocado
• Carrots
• Rice
• Squash
• Sweet potatoes
• Saunf
• Tofu
• Turnip
• Yam

 

Some Digestive Aids

Apple cider vinegar is a wonderful digestive aid. Add 1 to 2 tsp to little warm water and sip slowly before meals.

Garlic. A garlic flake swallowed with water on an empty stomach solves gastric problems

Radish promotes digestion

Coconut and Coconut Milk improves digestion.

Kokum improves the digestive system

 

Maintain Liver Health

• Eat food that supports the liver. Avoid junk and processed food
• Eliminate fizzy drinks as they interfere with digestion. Phosphates in them deplete the body of minerals
• Fresh dark grapes, blackberries, strawberries, blueberries and raspberries stimulate the liver
• Lecithin helps the liver. It is found in egg yolks and soya
• Sulphur-containing vegetables like broccoli, nuts, flax seeds, sunflower seeds, pumpkin seeds, cabbage, cauliflower, turnip roots are high in specific liver-building enzymes