From the Guidelines
High serum insulin levels should be addressed through lifestyle modifications, including a low-carbohydrate diet, regular exercise, and weight loss if overweight, as these changes can improve insulin sensitivity and reduce the risk of developing type 2 diabetes and other related conditions. According to the American Diabetes Association 1, insulin responses during an oral glucose tolerance test (OGTT) increase significantly from toddler ages to adolescence, and then decline after puberty. This suggests that puberty-related insulin resistance is a key factor in the development of high serum insulin levels.
The evidence suggests that growth hormone and sex steroids may contribute to insulin resistance during puberty, but growth hormone is the most likely cause 1. Additionally, obesity is a significant risk factor for hyperinsulinemia, as it accounts for 55% of the variance in insulin sensitivity in healthy white children 1.
Key recommendations for managing high serum insulin levels include:
- Adopting a low-carbohydrate diet to improve insulin sensitivity
- Engaging in regular exercise, such as 30 minutes of moderate activity most days, to enhance insulin action
- Achieving and maintaining a healthy weight through a combination of diet and exercise
- Considering medications like metformin, which can improve insulin sensitivity and reduce glucose levels 1
It is essential to monitor blood glucose levels regularly, ideally fasting and 2 hours after meals, to assess the effectiveness of these interventions and adjust the treatment plan as needed. By prioritizing lifestyle modifications and, when necessary, medication, individuals with high serum insulin levels can reduce their risk of developing type 2 diabetes and other related conditions, such as metabolic syndrome and cardiovascular disease 1.
From the Research
High Serum Insulin Levels
- High serum insulin levels can be an indicator of various health issues, including diabetes and insulin resistance 2, 3.
- In patients with type 2 diabetes, high serum insulin levels can be managed with oral antihyperglycaemic agents such as metformin, sulfonylureas, and thiazolidinediones like pioglitazone 3, 4.
- Pioglitazone has been shown to improve insulin sensitivity and reduce postload glycemia in patients with type 2 diabetes, with efficacy similar to metformin and sulfonylureas 3, 4.
- However, high-dose insulin infusions can have adverse effects, including hypoglycemia and increased mortality, especially in ICU patients 5.
- Personalized treatment approaches may be necessary to manage high serum insulin levels and prevent cardiovascular complications in patients with type 2 diabetes 6.
Management of High Serum Insulin Levels
- Treatment options for high serum insulin levels include metformin, sulfonylureas, and thiazolidinediones like pioglitazone 2, 3, 4.
- Pioglitazone has been shown to have cardiovascular benefits, especially in patients with high cardiovascular risk 6.
- Individualized treatment approaches may be necessary to manage high serum insulin levels and prevent cardiovascular complications in patients with type 2 diabetes 6.
Cardiovascular Effects
- Pioglitazone has been shown to have cardiovascular benefits, especially in patients with high cardiovascular risk 6.
- The cardiovascular effects of pioglitazone and sulfonylureas can vary depending on the patient's pretreatment risk profile 6.
- Personalized treatment approaches may be necessary to manage high serum insulin levels and prevent cardiovascular complications in patients with type 2 diabetes 6.