Insulin Resistance - Management

Management

The primary treatment for insulin resistance is exercise and weight loss. Low-glycemic load diet has also been shown to help. Both metformin and the thiazolidinediones improve insulin resistance, but are only approved therapies for type 2 diabetes, not insulin resistance. By contrast, growth hormone replacement therapy may be associated with increased insulin resistance.

Metformin has become one of the more commonly prescribed medications for insulin resistance, and currently a newer drug, exenatide (marketed as Byetta), is being used. Exenatide has not been approved in the UK except for use in diabetics, but often improves insulin resistance in healthy individuals by the same mechanism as it does in diabetics.

The Diabetes Prevention Program showed that exercise and diet were nearly twice as effective as metformin at reducing the risk of progressing to type 2 diabetes. One 2009 study has found that carbohydrate deficit after exercise, but not energy deficit, contributed to insulin sensitivity increase.

Resistant starch from high amylose corn has been shown to reduce insulin resistance in healthy individuals, and in individuals with type 2 diabetes. Animal studies demonstrate that it cannot reverse insulin resistance, but that it reduces the development of insulin resistance.

Some types of monounsaturated fatty acids, saturated, and trans fats promote insulin resistance. Some types of polyunsaturated fatty acids (omega-3) can moderate the progression of insulin resistance into type 2 diabetes. However, omega-3 fatty acids appear to have limited ability to reverse insulin resistance, and they cease to be efficacious once type 2 diabetes is established.

Caffeine intake limits insulin action, but not enough to increase blood sugar levels in healthy persons. People who already have diabetes II can see a small increase in levels if they take 2 or 2 cups of coffee per day.