Rodney Goodie: Insulin Resistance – The Metabolic Disruptor Behind Type 2 Diabetes

Rodney Goodie, a Houston-based healthcare executive, serves as chief executive officer of the St. Hope Foundation, a Federally Qualified Health Center he founded in 1999. Under his leadership, the organization has earned multiple Top Workplace and Better Business Bureau awards while expanding access to comprehensive health and wellness services for underserved communities. With a master of business administration in healthcare from Texas Tech University and ongoing doctoral studies in public health at Emory University, Mr. Goodie’s work emphasizes prevention science and health equity. Drawing on his extensive experience in public health and organizational leadership, Rodney Goodie highlights the critical role of metabolic health in disease prevention—specifically, how insulin resistance functions as the key disruptor behind Type 2 Diabetes and how individuals can take steps to manage it effectively.

Insulin Resistance – The Metabolic Disruptor Behind Type 2 Diabetes

Insulin is a hormone that regulates blood glucose, or sugar levels. Insulin resistance (IR), also known as impaired insulin sensitivity, is a condition where muscle, fat, and liver cells fail to respond to insulin as they should. This resistance serves as a fundamental mechanism underlying many chronic diseases, including Type 2 Diabetes Mellitus.

The body breaks down consumed food into glucose that circulates in the bloodstream. A blood glucose elevation stimulates the pancreas to secrete insulin, which facilitates glucose transportation into body cells for energy production and promotes glycogen storage in the liver for future metabolic needs. Following these actions, blood sugar levels return to normal.

Insulin resistance develops when the body experiences elevated blood sugar over an extended time. High glucose amounts in the bloodstream prompt the pancreas to release high insulin levels, a state known as hyperinsulinemia, attempting to drive glucose into the cells. Over time, cells become tolerant and stop responding effectively to insulin.

To compensate, the pancreas pumps out more insulin to overcome this resistance and maintain healthy blood glucose levels. Notably, the pancreatic beta cells’ ability to increase insulin production initially means that IR may have no noticeable symptoms.

However, IR tends to worsen over time, eventually causing these cells to wear out. When the pancreas can no longer produce sufficient insulin to overcome the cells’ resistance, blood glucose levels become persistently elevated – hyperglycemia. This imbalance sets the stage for prediabetes and ultimately T2DM.

Because high blood glucose is harmful to the body, it tries to manage this excess sugar by storing it in the liver and muscles. Once these storage sites are full, the liver redirects the remaining sugar to be stored as body fat. This explains why insulin resistance also typically leads to weight gain.

A combination of genetic, environmental, and lifestyle factors influences IR’s development. IR risk factors include genes, physical inactivity, body composition, diet, age, hormonal issues, and medications. To begin, scientists have hypothesized that several genes can influence the condition’s development. A family history of T2DM, prediabetes, or polycystic ovary syndrome (PCOS) can also contribute to IR.

A lack of movement or exercise makes the body less sensitive to insulin. With body composition, excess body fat, particularly visceral fat located around the belly and organs, increases the risk of IR. Such extra fat tissue may cause inflammation, physiological stress, or other cellular changes that contribute to IR. Regarding diet, consuming highly processed foods, rich in carbohydrates and saturated fats, is linked to the condition.

Further, older people are more prone to developing IR than young people. Hormonal conditions like Cushing’s syndrome, which causes excess cortisol, Acromegaly, resulting from high growth hormone (GH) levels, and Hypothyroidism – low thyroid hormone levels – can cause IR. Lastly, certain drugs, including steroids, blood pressure medications, and HIV treatments, can induce IR.

Although it is not entirely possible to eliminate IR, body cells can be made more sensitive to insulin. Importantly, lifestyle modifications are the primary treatment approach, especially since not all causes, such as age or genetics, are reversible.

Effective strategies that help address IR and, in turn, aid in avoiding or addressing T2DM include exercise, weight loss, and dietary changes. Regular physical activity is the most effective strategy, as it improves glucose use and muscle insulin sensitivity. Weight loss further enhances insulin response by easing bodily strain and enhancing insulin sensitivity. A balanced diet rich in whole foods and low in sugars, refined carbs, and unhealthy fats stabilizes blood sugar, reduces insulin demand, and supports reversing IR.

While no medications are approved to treat IR directly, diabetes medications classified as insulin sensitizers, such as metformin and thiazolidinediones (TZDs), help lower blood glucose levels partly by reducing IR. Traditional Chinese treatments, including herbs and acupuncture, may also help in managing IR.

About Rodney Goodie

Rodney Goodie is the chief executive officer of the St. Hope Foundation, a Houston-based Federally Qualified Health Center that he founded in 1999. He oversees all aspects of administration, strategic growth, and community engagement for the organization. Mr. Goodie holds a master’s degree in healthcare administration from Texas Tech University and is pursuing a doctorate in public health at Emory University. Dedicated to prevention science and equitable access to care, he continues to advance initiatives that address chronic disease management and improve community health outcomes.