How to improve insulin resistance?

From the Guidelines

To improve insulin resistance, engaging in regular physical activity, specifically aerobic and resistance exercise, is crucial, with a goal of at least 30 minutes of moderate-intensity exercise per day, most days of the week, as recommended by the 2022 standards of medical care in diabetes 1. Improving insulin resistance involves a multifaceted approach that includes lifestyle modifications and, when necessary, medication. Key components of this approach include:

• Regular physical activity: Aerobic exercise should be performed for at least 10 minutes per session, aiming for 30 minutes per day or more, most days of the week. Resistance training should be done 2-3 times a week on non-consecutive days, tailored to individual capabilities and preferences 1.
• Dietary changes: While not explicitly detailed in the provided study, general recommendations for improving insulin resistance include adopting a balanced diet low in refined carbohydrates and added sugars, similar to a Mediterranean-style diet, which is rich in vegetables, fruits, whole grains, lean proteins, and healthy fats.
• Weight management: For individuals who are overweight, weight loss can significantly improve insulin sensitivity.
• Other lifestyle modifications: Prioritizing quality sleep and practicing stress management techniques can also contribute to improved insulin sensitivity.

In terms of specific exercise recommendations, adults with diabetes should aim for at least 150 minutes of moderate-intensity exercise per week, which can be achieved through a combination of aerobic and resistance training activities 1. For those who can perform high-intensity exercise, such as running at 6 miles per hour for at least 25 minutes, shorter but more intense activity sessions (75 minutes per week) may also be beneficial. However, it's essential to tailor exercise plans to individual capabilities and preferences, ensuring sustainability and safety.

From the FDA Drug Label

ACTOS improves insulin sensitivity in insulin-resistant patients. ACTOS enhances cellular responsiveness to insulin, increases insulin-dependent glucose disposal, improves hepatic sensitivity to insulin, and improves dysfunctional glucose homeostasis Pharmacological studies indicate that ACTOS improves sensitivity to insulin in muscle and adipose tissue and inhibits hepatic gluconeogenesis.

To improve insulin resistance, pioglitazone (ACTOS) can be used as it enhances cellular responsiveness to insulin and increases insulin-dependent glucose disposal. The medication has been shown to improve hepatic sensitivity to insulin and dysfunctional glucose homeostasis in patients with type 2 diabetes 2. Additionally, pioglitazone has been found to improve sensitivity to insulin in muscle and adipose tissue and inhibit hepatic gluconeogenesis 2.

• Key benefits of using pioglitazone (ACTOS) include:
  • Improved insulin sensitivity
  • Enhanced cellular responsiveness to insulin
  • Increased insulin-dependent glucose disposal
  • Improved hepatic sensitivity to insulin
  • Inhibition of hepatic gluconeogenesis 2 2

From the Research

Improving Insulin Resistance

To improve insulin resistance, several lifestyle and nutritional interventions can be implemented.

• Modifiable factors such as diet, exercise, smoking, and stress contribute to insulin resistance, and addressing these factors is crucial 3.
• A diet rich in whole grains, non-starchy vegetables, and raw fruit, with reduced intake of simple sugars, especially from sweet drinks and sweets, is recommended 4.
• The Dietary Approaches to Stop Hypertension (DASH diet) and the Mediterranean diet have been shown to have beneficial effects on insulin resistance 4.
• Increasing calorific intake during the first half of the day, especially from a high-energy and low-glycemic-index breakfast, and practicing slow and mindful eating can also be beneficial 4.

Nutritional Substances

Certain nutritional substances may help improve insulin resistance.

• Minerals such as magnesium, calcium, potassium, zinc, chromium, and vanadium have associations with insulin resistance or its management 3.
• Amino acids like L-carnitine, taurine, and L-arginine might play a role in reversing insulin resistance 3.
• Other nutrients, including glutathione, coenzyme Q10, and lipoic acid, also appear to have therapeutic potential 3.

Pharmacological Interventions

Pharmacological interventions, such as metformin and thiazolidinediones, can also be used to improve insulin resistance.

• Metformin and thiazolidinediones counter insulin resistance by different cellular mechanisms and with complementary effects, making them suited for use in combination 5, 6.
• Pioglitazone, a thiazolidinedione, has been shown to be superior to metformin for improving insulin resistance and adiponectin in subjects with impaired glucose tolerance and early diabetes 7.
• Both metformin and thiazolidinediones can improve components of the lipid profile and reduce markers of low-grade inflammation 5, 6.