My Struggle With Insulin Resistance

I sat in my doctor’s office as the 1,000 grams of Solu-Medrol dripped down the clear IV tube and into my arm. Solu-Medrol looks like water, but I wasn’t fooled. This powerful steroid would stop the lupus flare developing into inflammation in my brain, saving my life. However, steroid infusions come with side effects. Over the next few hours, I would develop weird food cravings for anything from hamburgers and banana pudding to cheese-flavored ice cream. Over the next month, clumps of my hair would clog my shower drain. And over the next year, I would struggle to lose the 50 pounds I gained, despite exercising frequently and eating healthy.

Long-term steroid use consequences

Insulin resistance is one of the many side effects of long-term and emergency IV steroid use. The Cleveland Clinic defines insulin resistance as a syndrome in which "cells in your muscles, fat, and liver don’t respond as they should to insulin."¹ This means that while your pancreas is producing insulin, your body just isn’t accepting it. Over time, insulin resistance can lead to diabetes and obesity.

Insulin resistance and lupus

Here’s what insulin resistance looked like and felt like for me: After gaining around 50 pounds in 3 months after the emergency steroid infusion, I waited a few months until I could safely exercise. However, I didn't lose a pound despite exercising 5 days a week for several months. I would increase my workout intensity, hoping to lose weight, only to struggle with severe fatigue due to post-exertional malaise. Determined to reach my goal weight, I ate extremely healthy food: a small bowl of cereal with skim milk for breakfast, sandwiches with ham, lettuce, and no condiments, and baked chicken over rice for dinner. When the number on the scale didn’t budget, I started skipping meals. I was hungry all the time but still wasn’t losing weight. I felt sluggish mentally and physically and always fought sugar cravings.

My rheumatologist was understanding about my inability to lose weight. "You might have insulin resistance," she told me. After my appointment, I went home and ordered a book on insulin resistance, half guide, and half cookbook. It didn’t take me long to realize that all the "healthy" foods I’d been eating were making my body’s struggle to process insulin even worse. Little did I know that the skim milk, bread from sandwiches, sugar in salad dressing, and plain rice overloaded my body with carbs it couldn’t process.

Insulin resistance is treated not with medication but with diet changes. The recipes in the insulin-resistant book I bought all stuck to the following guidelines:

• No simple carbohydrates, like bread or white rice
• No dairy
• No sugar
• High protein

Food substitutes

I substituted skim milk with coconut milk. Instead of cereal, I made myself a bowl of old-fashioned oats with blueberries and a spoonful of almond butter each morning. I stopped eating bread, instead cooking brown rice or sweet potatoes with my chicken. My diet change introduced me to some interesting foods I might not have tried otherwise, like barley and kale, which make a great stew when combined with vegetable broth, chopped onions, celery, and chunks of baked chicken.

After a few days on my new diet, I suddenly had much more energy and felt less sluggish. I finally began losing weight, despite cutting back my workout schedule. I feel so much better after changing my eating habits that I might indefinitely stick to a low-carb, low-sugar diet.

Sometimes I still crave bread or banana pudding. And occasionally, I’ll have a slice of cake at a friend’s birthday party. But overall, choosing to sacrifice foods I used to eat frequently so that I feel better is a choice I’d make any day.