Gut health and its impact on insulin resistance

Written by: Dr Natasha Patel
Edited by: Karolyn Judge

The gut, or the gastrointestinal system, which includes the stomach, intestines and colon, is often referred to as the ‘second brain’. That’s because it’s home to gut microbiota, which play a crucial role in digestion, nutrient absorption, and immune system regulation.


This microbiota, which is made up of trillions of both beneficial and harmful microorganisms, is vital to health overall. When this is out of balance, insulin resistance can decrease and the gut-insulin axis may be affected. Leading endocrinologist in Esher and London Dr Natasha Patel tells us more in this informative article.

Young woman with gut health issues holding her stomach

What is the gut-insulin axis?

It’s been found recently that the composition of gut microbiota has a significant role in regulating the body’s sensitivity to insulin. When the gut microbiota is healthy, it’s associated with diverse microbial species that contribute to fermentation of dietary fibre and produce short chain fatty acids (SCFAs). These fatty acids are renowned for their anti-inflammatory properties and enhancing insulin sensitivity, through modulating cellular processes that are involved in glucose metabolism.    


On the other hand, a gut microbiome that’s imbalanced due to a reduced diversity of microbial species, has been linked to these conditions and symptoms:

  • increased inflammation;
  • obesity, and;
  • insulin resistance.

Furthermore, there are certain strains of bacteria that may produce metabolites which negatively affect insulin signals. This adds to development of metabolic disorders, which include phenylketonuria and mitochondial disorders. 



What is gut permeability?

The gut barrier is at the heart of the gut-insulin connection. It’s a membrane that’s semi-permeable (where some things can pass into, or pass through) and separates the contents of the gut from the rest of the body. However, when this barrier becomes compromised due to factors such as poor diet, stress, or antibiotic use, it can lead to an increase in permeability of the gut. This allows harmful substances to leak into the bloodstream, which is known as ‘leaky gut’. Leaky gut triggers and inflammatory response that may contribute to resistance of insulin.



What’s the connection between inflammation and insulin resistance?

Inflammation is the body’s natural response to:

  • stress;
  • infection, or;
  • injury.

It can become chronic, and when this is the case, it can have detrimental effects on various systems, include the metabolic system. In regards to insulin resistance, inflammation causes disruption in the normal signalling pathways of insulin. This then leads to decreased insulin sensitivity in cells, and the gut, which has an extensive network of immune cells, either exacerbates or relieves inflammation.



Taking care of the gut-insulin axis

Introduce fibre to your diet

Consume a diet that’s rich in fibre. Whole grains, fruits, vegetables, and legumes promote the growth of beneficial gut bacteria that result in SCFAs. They can help to reduce inflammation and enhance sensitivity to insulin.  


Consume foods rich in probiotic and prebiotics

Probiotic-rich foods such as yoghurt, kefir and fermented vegetables like kimchi, and foods with prebiotics in such as garlic, onion and bananas can support a gut microbiome that’s diverse and balanced.  


Reduce the amount of sugar and processed food in your diet

Consuming large amounts of sugar and processed food can cause imbalance in the gut microbiome and lead to inflammation. By minimising these foods, this may contribute to a healthier gut and improved insulin sensitivity.


Manage stress

Gut health can be impacted by chronic stress, and it can contribute to inflammation. Beneficial practices such as:

 can help to manage stress and promote a healthier gut.



What's the future of gut health and insulin resistance?

The gut-insulin axis is a complex and intricate dynamic between the digestive system and metabolic health. There’s more and more evidence which shows how nurturing a healthy gut via a suitable diet and lifestyle choices can have a positive impact of sensitivity to insulin and overall metabolic well-being. Furthermore, research shows that taking care of our gut health could lead to new avenues of prevention and management of insulin resistance-related conditions such as hyperglycaemia, hypertension and endothelial dysfunction.




Arrange a consultation with Dr Patel via her Top Doctors profile.

By Dr Natasha Patel
Endocrinology, diabetes & metabolism

Dr Natasha Patel is a leading consultant diabetologist based in London who specialises in diabetes and acute medicine, including Type 1 and Type 2 diabetes, diabetes complications, and the use of diabetes technology. In addition to diabetes, her main areas of focus are also the thyroid gland and all aspects of functional medicine. Dr Patel sees patients through e-Consultation.

Dr Patel qualified from Imperial College London in 1999, having previously obtained a BSc (Hons) in Neurosciences in 1996. She took up a consultant post at St George’s Healthcare in 2008, and was soon named joint diabetes clinical director at Health Innovation Network, responsible for numerous projects across South London. Dr Patel became a fellow of the Royal College of Physicians in 2014 and was appointed as a consultant in diabetes at Guy’s and St Thomas’ a year later. She is also a Functional Medicine Practitioner with a holistic approach to the management of her patients.

Further to her clinical practice, Dr Patel is an experienced healthcare services professional. She is actively involved in several hospital and healthcare industry projects, and acts as a consultant for start ups, where she also uses her MBA knowledge.

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