From the Guidelines
After a diagnosis of insulin resistance based on Cardio IQ Insulin test results, the next steps should involve immediate lifestyle modifications, including dietary changes and regular physical activity, with metformin therapy considered if lifestyle efforts are insufficient, as recommended by the 2016 American Diabetes Association standards of medical care in diabetes 1. The first-line approach should focus on reducing refined carbohydrates and sugars while increasing fiber intake through vegetables, legumes, and whole grains, with a Mediterranean or low-glycemic diet often recommended.
- Regular physical activity should be initiated, aiming for at least 150 minutes of moderate exercise weekly, combining both aerobic exercise and resistance training.
- Weight loss of 5-10% of body weight is beneficial for those who are overweight.
- Medication may be considered if lifestyle changes prove insufficient, with metformin being the most commonly prescribed option, starting at 500mg daily, gradually increasing to 1000-2000mg daily in divided doses, as it is inexpensive, has a long-established evidence base for efficacy and safety, and may reduce risk for cardiovascular events and death 1. Key aspects of management include:
- Regular monitoring, including follow-up glucose testing, HbA1c measurements every 3-6 months, and lipid panels.
- Education on matching prandial insulin doses to carbohydrate intake, preprandial blood glucose levels, and anticipated activity level, although this is more relevant to patients with type 1 diabetes or those requiring insulin therapy 1. These interventions help improve insulin sensitivity by reducing fat in liver and muscle tissue, decreasing inflammation, and enhancing cellular glucose uptake, potentially preventing progression to type 2 diabetes and reducing cardiovascular risk.
From the Research
Next Steps After Diagnosis
After a patient is diagnosed with insulin resistance based on Cardio IQ(R) Insulin test results, such as Impaired Glucose Regulation, the following steps can be taken:
- Dietary modifications to manage insulin resistance, as insulin resistance is a condition encompassing hyperglycemia and compensatory hyperinsulinemia 2
- Inclusion of regular exercise routines in everyday life to improve insulin sensitivity 2
- Pharmacological agents, such as metformin, which has been shown to lower blood glucose and triglyceride levels, assist with weight reduction, and reduce hyperinsulinaemia and insulin resistance 3, 4
- Other interventions tailored to each individual patient's needs, as the management of insulin resistance can be achieved through a holistic, personalized approach 2
Treatment Options
Treatment options for insulin resistance include:
- Metformin, which has been shown to have anti-hyperglycemic effects and improve insulin sensitivity 3, 4
- Propolis, which has been shown to have anti-hyperglycemic effects and improve insulin sensitivity, although more research is needed to confirm its effectiveness 4
- Short-term insulin therapy, which can stabilize pancreatic beta-cell function in some patients with type 2 diabetes 5
- Lifestyle modifications, such as diet and exercise, which can improve insulin sensitivity and manage insulin resistance 2, 6
Monitoring and Maintenance
Monitoring and maintenance of insulin resistance include:
- Regular check-ups with a healthcare provider to monitor blood glucose levels and insulin sensitivity 2
- Adjustments to treatment plans as needed to manage insulin resistance and prevent complications 2, 6
- Education on lifestyle modifications and self-management techniques to empower patients to take control of their condition 2, 6