 Hello everybody. Now this particular session we are going to discuss about three tutorials. Again you just watched junk food and you also watched you know why families give junk food to children. This particular tutorial that we are going to show three tutorials, they are not only important for adults but they are also important for children because as you know the CNNS report has just come out couple of years ago and it has shown you know 34% children between 5 to 9 years of age have high triglyceride level. It has also shown that same age group about 9% children have prediabetes. This shows that children are not eating right food, you know probably having formulas, ultra process formulas and they are also having complementary foods which are not very healthy. So you will learn a lot from this next two sessions. I have shown about insulin importance of insulin, complications of insulin resistance. So what happens when you eat food which is very high in carbohydrate, carbohydrate you know, basically refined starch, rice, too much of roti, bread, you know, metha and of course other things like sugar, honey, you know, cereals which are you know kelog and oats. A lot of those, you know, those cereals specifically, you know, they have high fructose concentrate. These are very unhealthy sugars, okay. So here in this session we have shown what happens when you have food which is extremely high in carbohydrate and lacking in important other nutrients like protein and good fats. And what it does, it causes insulin to rise because the effect of insulin is to push that glucose into the cells, okay. And what happens when that cells are overfilled with glucose, it will prevent insulin action to push that glucose because we all know that high glucose level in the blood is not healthy, okay. So here what we can do is to, you know, what body does, it raises the insulin level to push that glucose more into the cell. And this stage is called insulin resistance, okay. Sugar level is still normal in the blood because it's pushing that sugar in the cells but at the cost of high insulin, okay. Many of us are insulin resistant, we don't know because we don't check fasting insulin level. We only check blood glucose and, you know, it takes almost 10 years to 12 years, you know, to get this glucose high because for 10 years insulin was working very hard to push that glucose in the cells, okay. So we have almost good number of years to prevent prediabetes and diabetes but we need to know the fasting insulin level. So that's what we have shown in this session. I'm sure you'll enjoy this three tutorials. Do watch them carefully and do share it with your friends and family. Thank you. Welcome to this spoken tutorial on the importance of insulin. In this tutorial we will learn about secretion of insulin from the pancreas, role of insulin in the body. Insulin is an important hormone. Hormones are secreted directly in the blood. They are carried to various tissues and organs where they exert their functions. Insulin is secreted by the pancreas. Pancreas is an organ located behind the stomach. The pancreas is made up of glands which secretes various enzymes and hormones. Now we will focus on insulin's release and the factors which affect it. There are several factors which stimulate the release of insulin. The most important factor is the level of glucose in the blood. Remember that glucose level increases on eating food. Presence of food in the intestine causes a release of various gut hormones. This also affects the release of insulin. Food contains three main macronutrients. Carbohydrates, protein and fats. Insulin's response to different foods varies. Carbohydrate-rich foods raise blood glucose levels quickly. As a result, large amounts of insulin are secreted. Examples of carbohydrate-rich foods are bread, chapati, potatoes and fruits. Sweets, grains and even vegetables are some other examples. Sugar, jaggery and honey are also included. The release of insulin in response to protein-rich foods is slightly low. Examples of protein-rich foods are eggs, meat, fish. Fat has the least effect on stimulating the release of insulin. Fat-rich foods include ghee, oil, butter, etc. Insulin is released in two phases. It is either in the basal rate or in the peak rate. Insulin is released continuously in small amounts even when no food is consumed. This is the basal rate. When food is consumed, insulin is released in high amounts. This is known as the peak rate. After learning about insulin's secretion, let us understand its role in the body. Insulin promotes the uptake of glucose into the cells. This is the most well-known role of insulin. Insulin acts like a key to open the cells. The cells then take up glucose from the blood. This glucose is used by the cells mainly for producing energy. When we eat food, we are in a fed state. The body uses glucose as a fuel to provide energy. Let us see what happens if we consume extra glucose. In the liver, the excess glucose gets converted to glycogen and triglycerides. Glycogen is the concentrated form of glucose. It gets stored in the liver and the muscles. Triglycerides are the stored fats in our body. These stores can be used later when we are not consuming food. Not consuming food is the non-fed state. A fresh supply of glucose is not available during this state. This is when the body uses glycogen and fat as a fuel to supply energy. The body breaks down glycogen into glucose. This is required for our brain which needs glucose as a fuel. Other non-carbohydrate sources are also converted to glucose. For example, amino acids, lactate, glycerol. This conversion occurs mainly in the liver and kidneys. However, the conversion is inhibited by insulin. Among the various roles of insulin, the most crucial is managing energy. In the fed state, insulin promotes the storage of energy. It does this by promoting conversion of excess glucose into fat. The breakdown and conversion of fat is suppressed. Thus, insulin prevents the loss of fat in the body. This way, a person will not be able to use or melt the stored fat in the body. In the non-fed state, lack of insulin promotes the utilization of fat. The stored fats are broken down to provide energy. There is another hormone that helps insulin to maintain the blood sugar level. It is the glucagon hormone secreted by the pancreas. Let us see how insulin along with glucagon maintains the blood glucose level. When blood sugar level rises, the pancreas releases insulin. Insulin takes up glucose from the blood into the cells. It then promotes the formation of glycogen and triglycerides in the liver. Blood glucose then returns to normal level. When blood sugar levels are low, the pancreas releases glucagon. Glucagon promotes the breakdown of glycogen into glucose in the liver. This releases glucose in the blood. As a result, blood sugar then returns to normal level. This is how insulin and glucagon complement each other. Insulin acts as an anabolic hormone as well, which means it promotes the growth of the cells and tissues. It also helps in bone development and formation. Another role of insulin is to manage the potassium levels in the body. Insulin promotes the entry of potassium into the cells. Potassium is an important mineral for the body. It is involved in muscle contractions, heart functions and fluid balance. These beneficial roles of insulin are seen when it is present in normal level. Fasting insulin in healthy individuals should be between 2 to 5 miu slash ml. Miu slash ml stands for milli-international units per millilitres. High levels of insulin in the blood creates a lot of health issues. This will be discussed in detail in another tutorial. Remember the reasons mentioned in this tutorial to maintain insulin level. Maintain the level within the normal range. It will help you to have a healthy body. This brings us to the end of the tutorial. Thank you for joining. Welcome to the spoken tutorial on introduction to insulin resistance. In this tutorial we will learn about the normal response of cells to insulin. The change in response to insulin when there is insulin resistance. The traditional definition of diabetes, root cause of diabetes. Let us begin. Our body needs energy for survival and growth. Glucose is a very convenient source of energy for humans. Multiple molecules of glucose form starch. Starch is a type of carbohydrate found in our food. Carbohydrate rich foods are abundantly available and are cheap. So we consume a lot of glucose which is a type of sugar through such foods. Harmful consequences of eating a lot of dietary sugar are widely known. Dangers of high and low levels of blood sugar are also well known. So our body should convert dietary glucose quickly into energy or body fat. This helps us to maintain a normal level of blood sugar. The pancreas maintains a fasting blood glucose level between 70 and 99 mg per dl. mg per dl stands for milligram per deciliter. This range is maintained by the insulin hormone produced by the pancreas. Insulin is explained in detail in another tutorial in the same series. Please visit our website for more details. Next let's discuss the traditional definition of diabetes. It is based on blood glucose levels. Fasting blood glucose levels are checked on two separate blood tests. 126 mg per dl or higher level is diagnosed as diabetes. However a higher blood glucose level is just a symptom of a disease. It is not the disease itself. It is an effect of something going wrong in the body. It is not the root cause of diabetes. It does not provide a better understanding of the disease and its treatment. Suppose your blood report shows high blood glucose levels. You consult a doctor. You describe your problem as high blood glucose levels. The doctor will give you a medicine to lower your blood glucose levels. This medicine treats the symptom and not the cause. Let us understand what is the root cause and define diabetes accordingly. Most of the food we consume is converted into glucose in the body. This glucose enters our bloodstream. Glucose from the blood has to enter the cells to be converted into energy. Cells have membranes that allow the entry and exit of molecules such as glucose. Entry of glucose into the cell requires help from insulin. Insulin sits on the insulin receptors present in the cell membranes. This starts a chain of events which results in glucose entering the cell. Glucose will not be able to enter the cells if there is no insulin. It will also not enter if the cells do not respond to the insulin signal well. If glucose does not enter the cells, the body will not get enough energy. The glucose will remain in the blood. This will raise the blood glucose levels which we see in the blood report. Hence the root cause of diabetes is glucose not being able to enter the cells. Now let's understand and define diabetes on the basis of this root cause. A person has diabetes if the mechanism of entry of glucose is impaired. It is not being carried out effectively and efficiently. In the traditional definition, insulin played no part at all. However, insulin is very important. Let's discuss the relationship between insulin and glucose concentration. Suppose your fasting blood glucose level is 70 mg per dl. Your fasting insulin level is 5 units. However for some reason it is not able to push glucose into the cells. This will increase your fasting blood glucose levels from 70 to 75. So 5 units of insulin are not enough to maintain glucose levels of 70. Therefore the pancreas will produce 6 units of insulin. This will push a little more glucose into the cells temporarily. Blood sugar levels will drop down to the normal level of 70. However the mechanism of glucose entry still has a problem. It will only keep getting worse from here on. Soon the 6 units of insulin won't be enough to keep the glucose level at 70. So the pancreas will keep secreting more units of insulin. This will manage to keep the glucose level at 70. It may increase to 80 but it will still be within acceptable limits. The cell is not sensitive to the presence of insulin. It is resisting the effect of insulin and not letting glucose enter the cells. This process is called insulin resistance. Pancreas response to insulin resistance is to produce more units of insulin. This is to keep glucose levels in the normal range. Since insulin resistance is not treated more and more insulin is produced. Soon even higher levels of insulin are not able to keep normal glucose levels. Eventually the blood glucose levels will be higher than 100 units. This is diagnosed as pre-diabetes. Then it progresses further and the blood glucose levels rise beyond 125. This is diagnosed as type 2 diabetes. This is not good. Now the person has both high glucose levels and high insulin levels. Insulin is produced by the beta cells of the pancreas. Higher insulin production at all times increases their workload. Say the body is making 15 units instead of 5. To do this beta cells are working 3 times harder than normal. Beta cells cannot sustain this workload for long. They will die eventually. Also high levels of insulin have many other harmful effects on the body. The effects are discussed in another tutorial in the same series. However it takes many years for the body to be diagnosed with type 2 diabetes. At any point in those years we can focus on improving insulin sensitivity. Lastly let's discuss the main difference between type 1 and type 2 diabetes. In type 1 diabetes the body does not produce insulin at all. Without insulin glucose does not enter the cells. The body does not get enough energy. Insulin is injected externally. That is why this type of diabetes is called insulin dependent diabetes. Whereas in type 2 diabetes there is never a deficit in the production of insulin. The body produces enough or excess insulin due to insulin resistance. The body is not able to use the insulin produced by the beta cells properly. Injecting external insulin becomes necessary when overworked beta cells die. That is when type 2 diabetes gets converted to type 1 diabetes. We must therefore correct insulin resistance. It is the root cause of type 2 diabetes. A higher glucose level is just a symptom of diabetes. Lifestyle changes are important to correct insulin resistance. How to improve insulin sensitivity is explained in another tutorial. This brings us to the end of this tutorial. Thank you for joining. Welcome to this spoken tutorial on effects of high levels of insulin in the body. In this tutorial we will learn about why having too much insulin is bad. Harmful effects of excessive insulin in the body. In our previous tutorial we learnt about insulin and its role in the body. Insulin is a very important hormone. It helps in taking up the glucose from the blood into the cells. Frequently having processed foods and foods rich in carbohydrates is not good. It results in more glucose in our blood. Insulin's action is resisted by the cells if they do not need this glucose. Thus, refusing the entry of glucose into the cells. This mechanism is called insulin resistance. Insulin resistance leads to hyperinsulinemia. It is a condition in which the insulin levels in the blood are constantly high. The body does not respond to insulin adequately or use it efficiently. The cells become less sensitive to the presence of insulin. Let us now look at the various effects of insulin resistance. Some effects have a direct relationship with insulin. High levels of insulin can cause one or more of these ill effects. One of the effects is type 2 diabetes. Let us see how it develops. In the early stages of insulin resistance blood sugar remains normal. Insulin levels rise when cells are not able to take up glucose efficiently. Once insulin levels rise more amount of glucose is pushed into the cells. As a result the blood glucose levels are maintained at normal levels. If insulin level is not checked in the blood this phase may be missed. As blood sugar levels would still be normal. After many years insulin resistance becomes severe. Even the increased levels of insulin is not able to do its work. It is not able to push enough glucose into the cells. That is when the blood sugar levels rise and type 2 diabetes gets detected. Another major problem associated with high insulin levels is obesity. Insulin is a hunger hormone. Excess of unused insulin sends signals to the brain. These signals are sent to supply glucose to the body. As a result hunger is stimulated. Even if a person has just eaten yet their body will crave for more food. This results in a continuous cycle of hunger and overeating. Let us understand this with an example. Suppose you are not hungry at the moment. Someone then offers you a small portion of carbohydrate rich food. For example biscuits, sweets etc. On eating it your blood sugar levels and then your insulin levels will rise. These high insulin levels will send a signal to the brain to eat more. That is why many of us are not able to restrict ourselves to small portions. The continuous cycle of insulin resistance and overeating goes on. This can result in obesity. There is another way through which high insulin levels can cause obesity. Due to high insulin levels the body is unable to break down fat for energy. The body goes into fat storage mode instead of fat utilization mode. Insulin can cause obesity by affecting the signals of leptin. Leptin is a hormone which gives signals to the brain that the stomach is full. High insulin levels can disrupt the leptin signals. This leads to food cravings and overeating. Detailed relation between insulin and obesity is explained in another tutorial. Being obese is not the only indicator of insulin resistance. Even lean people can have insulin resistance. Instead of fat gain under the skin they gain it inside or around their organs. They may have extra fat in the liver which is known as fatty liver disease. Excess glucose gets converted to triglycerides and gets stored in the liver. High insulin levels inhibit the breakdown of fat. Over a period of time fat keeps getting accumulated in the liver. This burdens the capacity of the liver to handle fat. Eventually the person develops the condition called fatty liver disease. Elevated insulin levels also increase the risk of hypertension. It does so by stimulating sodium reabsorption in the kidney. This results in increased blood pressure. With high insulin levels there is a risk of developing heart diseases as well. This occurs through various mechanisms. First is the inflammation of the blood vessels. Second is the alteration of lipid profile. Next is the formation of plaques and blood clots. Plaques is a buildup of fatty substances on the blood vessels of the heart. Let us understand these steps in detail. Long time high blood sugar levels and high insulin levels cause inflammation. Lining of the blood vessels of the heart gets damaged. Formation of nitric oxide is also impaired in case of insulin resistance. Increased intake of fructose can increase uric acid in the body. Uric acid then reduces the availability of nitric oxide in the body. Nitric oxide causes relaxation of the blood vessels. If it is not formed adequately it will constrict the blood vessels. This restricts the blood flow and increases inflammation. It also raises the blood pressure. Secondly the lipid profile gets affected adversely due to high insulin levels. There is a rise in the levels of VLDL and LDL. These are lipoproteins which transport fat and cholesterol in the blood. At high insulin levels LDL formed is small and dense. They are dangerous for the blood vessels of the heart. On sighting inflammation in the blood vessel, lipoproteins come to seal it. VLDL and small dense LDL get attached to the walls of the blood vessels. As a result plaques are formed which narrow the blood vessels. Supply of blood, oxygen and nutrients gets affected. Some plaques may break down and result in formation of blood clots. This can result in heart attack or stroke. Many people still have misconceptions about the dietary cause of heart disease. They think it occurs because of the fat and cholesterol in the diet. The real culprit is the consumption of excessive carbohydrates. Foods made with a lot of refined sugars and vegetable oils are also responsible. They initiate inflammation in the body. Whereas good quality fat in the diet helps in reducing inflammation. Examples of good quality fat are coconut oil, ghee, butter, fish, nuts. High insulin levels also accelerate the aging of the cells. This reduces life expectancy. There is a risk of developing Alzheimer's in such individuals. Alzheimer's is a disease of the brain that affects memory and mental functions. We know that insulin is an anabolic hormone. It increases cell production and reduces cell death. But if insulin levels are high, it can promote the growth of cancerous cells. There is also a relation between high insulin levels and thyroid dysfunction. High insulin levels affect the conversion of T4 to T3. This results in hypothyroidism. Insulin resistance affects the insulin and glucagon relationship. Let us see the relation between insulin and glucagon in healthy individuals. When the blood sugar levels are high, the pancreas releases insulin. It helps the cells take up the glucose and reduce blood sugar levels. When the blood sugar levels are low, glucagon is released by the pancreas. It acts on the liver to break down glycogen to release glucose in the blood. Glucagon prevents the sugar levels from dropping too low. Thus, glucagon and insulin work in a complementary manner. They balance the blood sugar levels within desirable range in healthy people. This relationship is disturbed in people with insulin resistance. In such people, the pancreas doesn't stop releasing glucagon. This further releases more glucose from the glycogen, hence increasing the blood sugar levels. Apart from these, high insulin levels indirectly cause other health problems. For example, fatty liver, osteoporosis, stress, kidney failure. Pain and stiffness in the joints can also occur. Other effects include damage to blood vessels of the eyes and cataracts. It can also damage the nerves causing numbness and tingling in hands and feet. High insulin also contributes to polycystic ovarian syndrome known as PCOS. High insulin levels cause excessive production of male hormones. Abnormal hormone levels prevent follicles from growing properly. They are unable to mature and release eggs. As a result, these immature follicles get accumulated in the ovaries. This affects ovulation and fertility in women. The production of sex hormones is also affected by high insulin levels. There are some other symptoms of high insulin levels such as frequent or constant hunger, feeling tired, confusion, acidity, etc. Skin tags and pigmentation in the neck and armpit region is also a symptom. Impaired lung functions and increased respiratory infections are other examples. Hence, it is important to keep your insulin levels under control. Insulin levels can be checked before all these harmful effects are manifested. A blood test for fasting insulin should be done. Fasting insulin in healthy individuals should be between 2 to 5 miu slash ml. Miu slash ml stands for milli-international units per millilitres. Anything above 5 miu slash ml indicates increased levels of insulin in the body. This can lead to one or more health complications. Please consult your doctor before taking any tests and medications. This brings us to the end of the tutorial. Thank you for joining.