There are a lot of factors that affect our insulin sensitivity, from the food we eat to the medications we take, and controlling your insulin needs is key to effective diabetes management. Gary Scheiner, MS, CDE, recently explored the effects of fat on blood glucose, and he returned to our Twitter community to offer his thoughts on insulin sensitivity. Jewels Doskicz, who is a registered nurse, type 1 PWD, and mother to a type 1 PWD, hosted and shared what has helped her to manage her insulin needs.

Q. What is insulin sensitivity? How does it affect you?

Gary: It is a measure of how much blood sugar lowering takes place from a given amount of insulin.

Jewels: Insulin sensitivity determines how much insulin we need at any given time. It differs person to person and changes for individuals. Regular exercise and a clean diet keep my insulin needs quite low.

Other participants:
• It is how my body reacts to one unit of insulin. My needs are based off of that.

• It is how much insulin is needed to drop blood glucose a certain amount. It varies depending on a number of factors.

Q. How does physical activity impact your sensitivity?

Gary: A couple of major determinants of insulin sensitivity are body fat and level of physical activity.

Jewels: It depends on the effort. If I’m racing my bike I have blood glucose spikes and my insulin needs increase. A casual ride does the opposite.

Other participants:
• Exercise generally increases sensitivity—but not always. Not all exercise is created equal.

• Long cardio sessions will reduce insulin resistance. Shorter bouts? Not so much.

• Physical activity is key to maintaining insulin sensitivity. For me, at least, the more active I am the more insulin sensitive I am.

Q. Do other medications impact the effect insulin has on you? Explain.

Gary: They can, particularly steroid medications (inhalers, cortisone injections, prednisone). Metformin is good for those whose basal needs are extremely high because it keeps the liver from overproducing insulin.

Jewels: My RA medication greatly increases my insulin sensitivity.

Other participants:
• Steroids seriously impair insulin sensitivity. I avoid them like the plague.

• It is not so much medications but stress that increases my insulin resistance. I also experience the “dawn phenomenon.”

Q. What dietary supplements allegedly help with increasing insulin sensitivity?

Gary: Unless you live in a Third World country and your diet is seriously lacking, there is no evidence that supplements help insulin sensitivity. The most effective ways to improve insulin sensitivity remain exercise and loss of body fat.

Jewels: Supplements to improve insulin sensitivity may be those that decrease the inflammatory response such as fish oils and turmeric.

Other participants:
• Many people think that chromium, magnesium, and others have an effect, but this is likely only true if your diet is deficient.

• Alpha lipoic acid (ALA) has done so in the past, especially when taken on an empty stomach.

• Vitamin D seems to make me more insulin sensitive.

Q. What roles do body weight, weight loss, and body fat play in insulin sensitivity?

Gary: Fewer and smaller fat cells mean you have less insulin-opposing hormones.

Jewels: Insulin resistance can be a vicious and frustrating cycle. The wrong amount of insulin encourages weight gain.

Other participants:
• As I started being more active and my body shape changed, I started using less insulin.

• Even a small amount of weight loss can reduce insulin resistance in someone overweight. Strive for better, not perfect.

• I’ve lost 10 pounds in the last 2-3 weeks and I’ve noticed a significant drop in my insulin needs.

Q. What are the benefits of improving insulin sensitivity?

Gary: You reduce your costs for insulin, you have less body fat, and you lower your risk of heart disease. Also, pump reservoirs and pens last longer.

Jewels: There are associated cardiovascular benefits, cancer prevention, and longevity associated with improved insulin sensitivity.

Other participants:
• Better insulin sensitivity and less body fat seem to work together for optimal health.

• Cost savings! Insulin is really expensive.

• Less insulin used means less money burned and a less risk of hypoglycemia.

Thanks to Gary Scheiner and Jewels Doskicz for their insights. Thank you to all the participants as well for sharing your thoughts on insulin sensitivity. Gary and his team offer diabetes management consultations via phone and Internet to insulin users throughout the world. For more information, call (877) 735-3648 or e-mail gary@integrateddiabetes.com.

Twitter chats occur every Tuesday at 9:00 p.m. ET. Join the conversation next week when the topic will be practicing mindfulness with diabetes.