From the Guidelines
To address insulin resistance, the most effective approach is to combine lifestyle modifications, including a balanced diet, regular exercise, and weight management, with potential pharmacological interventions like metformin, as supported by the American Diabetes Association standards of medical care in diabetes 1.
Lifestyle Modifications
- Regular exercise: Aim for at least 150 minutes of moderate-intensity aerobic activity per week, incorporating resistance training at least twice a week for most adults with diabetes 1.
- Balanced diet: Focus on fiber-rich foods, lean proteins, and healthy fats, while limiting intake of refined carbohydrates, sugars, and processed foods.
- Weight management: Modest weight loss has been shown to improve insulin resistance in overweight and obese individuals, with structured programs emphasizing lifestyle changes being most effective for long-term weight loss 1.
- Quality sleep and stress management: Prioritize 7-9 hours of sleep nightly and engage in stress-reducing techniques like meditation.
Pharmacological Interventions
- Metformin is the preferred initial pharmacologic agent for treating insulin resistance and type 2 diabetes, due to its efficacy, safety, and potential to reduce cardiovascular events and death 1. It can be started at 500mg daily and potentially increased to 2000mg daily in divided doses.
- Other medications like thiazolidinediones may be considered if metformin is not sufficient or tolerated.
Monitoring and Guidance
- Regular monitoring of blood glucose levels is crucial to track progress and adjust treatment plans as necessary.
- Consulting with healthcare providers for personalized guidance is recommended, especially for individuals with other health conditions or those requiring adjustments to their treatment plans 1.
From the FDA Drug Label
Clinical studies demonstrate that 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
- Treatments for insulin resistance (IR) include:
- Pioglitazone (ACTOS): improves insulin sensitivity and enhances cellular responsiveness to insulin
- Combination therapy: ACTOS in combination with sulfonylurea, metformin, or insulin had an additive effect on glycemic control 2
From the Research
Treatments for Insulin Resistance
The treatments for insulin resistance (IR) can be categorized into lifestyle interventions, dietary changes, and nutritional supplements.
- Lifestyle interventions:
- Physical exercise, including aerobic, resistance, and combined training, can effectively reduce IR in individuals with obesity 3
- Weight loss and aerobic and resistive exercise training result in losses of total body fat and abdominal fat, increasing insulin sensitivity and improving glucose tolerance 4
- Dietary changes:
- Consumption of diets high in total carbohydrate does not adversely affect insulin sensitivity compared with high fat diets 5
- Increased intake of dietary fiber appears to improve insulin action and may protect against the development of diabetes 5
- Whole grains, fruits, and vegetables, and lean sources of animal proteins, including low-fat dairy products, may be beneficial in reducing IR 6
- The Mediterranean diet is a useful dietary approach to glucose metabolism control 3
- Nutritional supplements:
- Minerals such as magnesium, calcium, potassium, zinc, chromium, and vanadium may have associations with IR or its management 7
- Amino acids, including L-carnitine, taurine, and L-arginine, might play a role in the reversal of IR 7
- Other nutrients, including glutathione, coenzyme Q10, and lipoic acid, may have therapeutic potential in managing IR 7
- Herbal medicines, such as silymarin and Inula racemosa, may have positive effects on IR, although more research is needed 7