Chronically high levels of insulin often precedes the onset of type 2 diabetes.
This article provides an overview of hyperinsulinemia, including the conditions related to it. Read on to learn possible causes and treatment options for hyperinsulinemia, including diet.
The word “diet” can have many meanings. In general, this article uses the term “diet” to refer to an eating lifestyle rather than a temporary change in how you eat.
Insulin levels are supposed to fluctuate. When your body needs insulin, your pancreas secretes it and it enters the liver. About half of the insulin stays in liver cells. The other half enters the bloodstream. After insulin does its job, your liver and other cells clear it out. Fluctuating levels of insulin are necessary to keep cells sensitive to it.
By definition, hyperinsulinemia is higher blood insulin than usual relative to blood glucose, and which does not cause hypoglycemia. Hyperinsulinemia means insulin is not fluctuating as usual in response to glucose levels.
Other terms for it include “dysregulated hyperinsulinemia” or “dysregulated insulin secretion and/or clearance.”
Hyperinsulinemia is a common clinical finding in people with obesity and certain metabolic disorders.
Environmental, dietary, and genetic factors may play a role in hyperinsulinemia, but the exact cause is not known.
The commonly accepted paradigm is that obesity and insulin resistance lead to hyperinsulinemia. However, recent evidence suggests the opposite: hyperinsulinemia leads to insulin resistance.
Insulin resistance is when cells become less responsive to insulin, which elevates blood glucose levels. In an attempt to clear excess glucose, your body continues to secrete and release insulin into circulation. Thus, insulin levels continue to rise.
Learn about insulin resistance here.
Rarely, a tumor on the pancreas causes hyperinsulinemia. These include insulinomas or nesidioblastosis.
Congenital hyperinsulinism is another rare cause of hyperinsulinemia. A genetic mutation present at birth causes excess insulin secretion. Congenital hyperinsulinism can be one cause of hypoglycemia in infants and children.
Hyperinsulinemia typically does not cause significant symptoms. However, the following health symptoms can indicate a problem with glucose and insulin metabolism:
- sugar cravings
- weight gain or difficulty losing weight
- fatigue
- difficulty focusing
- hypoglycemia, when due to insulinoma:
Treatment for hyperinsulinemia aims to address the underlying cause. Hyperinsulinemia goes hand in hand with insulin resistance. Your physician will develop a treatment plan that helps increase your body’s sensitivity to insulin.
This plan may include:
- Medications: Metformin is one type of medication that increases sensitivity to insulin. For congenital hyperinsulinemia, medications that block insulin secretion, such as diazoxide (Proglycem), are necessary.
- Dietary changes: A diet low in sugar and saturated fats can help with weight loss and metabolism.
- Exercise: This causes your muscles to take up glucose, which helps lower blood glucose. It also increases insulin sensitivity.
- Bariatric surgery: Also known as weight loss surgery, it can counteract hyperinsulinemia.
If you have an insulinoma or another tumor, surgery to remove it may help the hyperinsulinemia.
No matter the cause of hyperinsulinemia, discuss all your treatment options with your doctor to find the right plan for you.
Food and beverages that elicit a stronger spike in blood sugar increase the need for more insulin. As such, an eating plan low in sugar can help regulate glucose and insulin metabolism.
A 2019 research review supports an eating plan full of fiber-rich carbohydrates to treat insulin resistance, which often coincides with high insulin levels. This type of diet is rich in whole grains and nonstarchy vegetables. Examples include:
- salad greens
- carrots
- broccoli and cauliflower
- mushrooms
- okra
- green beans
Scientific evidence supports the Mediterranean diet for the prevention and treatment of metabolic syndrome, a condition linked to insulin resistance and hyperinsulinemia. The Mediterranean diet emphasizes lower carbohydrate intake and excludes processed food products.
There is also evidence that a carbohydrate-restricted diet, such as the ketogenic diet, may help prevent or reverse insulin resistance.
If you have hyperinsulinemia tied to insulin resistance, consider working with a registered dietitian to develop a safe and nutritious eating plan that takes into account your overall health and goals.
Read about diet strategies for insulin resistance here.
It is not common practice for doctors to measure insulin levels or screen for hyperinsulinemia. Your doctor may order a blood test to check your insulin levels if your medical history and other blood test results indicate potential problems with insulin.
Annual physicals usually include a lipid panel blood test to check your cholesterol level. One indicator of atypical insulin metabolism is high triglycerides or a high triglyceride to high density lipoprotein ratio.
Blood sugar tests can mask hyperinsulinemia because the excess insulin keeps blood sugar within a stable range.
Hyperinsulinemia may play a role in multiple conditions, although there is still debate on whether hyperinsulinemia is a cause or consequence of these conditions.
- Type 2 diabetes: Hyperinsulinemia contributes to the metabolic changes that lead to type 2 diabetes.
- Obesity: There is strong association between obesity and hyperinsulinemia. Insulin inhibits the breakdown of fat. It also promotes fat storage and expansion, increasing both the size and number of fat cells.
- Cancer: Insulin is an anabolic hormone that signals growth. There is a link between hyperinsulinemia and risk of cancer and cancer progression.
- Cardiovascular disease: Elevated insulin levels have an association with heart disease and may also contribute to high blood pressure. It also promotes blood vessel inflammation and other changes that contribute to atherosclerosis.
You may be able to prevent hyperinsulinemia through a nutritious diet and exercise plan. However, genetic factors and family history play a role, too.
Hyperinsulinemia is when there is too much insulin in the bloodstream. It often occurs with insulin resistance, which is when cells are no longer sensitive to insulin. The body compensates by producing more insulin, leading to hyperinsulinemia.
Insulin resistance and hyperinsulinemia can be present for many years before progressing to high blood sugar and diabetes. Problems with insulin metabolism can go undetected because there are no overt symptoms. A healthy lifestyle can help prevent and reverse the metabolic changes that lead to hyperinsulinemia. Medication may be necessary sometimes.
Other reasons for hyperinsulinemia include noncancerous tumors in the pancreas and genetic conditions present at birth.
