From the Guidelines
Insulin resistance treatment should primarily involve lifestyle modifications, including weight loss through a balanced diet and regular exercise, and medication such as metformin, as it has been shown to improve insulin sensitivity and reduce glucose production by the liver 1. The most effective approach to treating insulin resistance is through a combination of lifestyle changes and, in some cases, medication.
- Weight loss is a crucial aspect of treating insulin resistance, with a goal of losing at least 5% of body weight through a balanced diet and regular exercise, aiming for 150 minutes of moderate activity weekly 1.
- Dietary changes should focus on reducing refined carbohydrates and increasing fiber intake from vegetables, fruits, and whole grains.
- Medications like metformin are often prescribed as first-line pharmaceutical treatment, starting at 500mg daily and increasing to 1000-2000mg daily as tolerated, as it improves insulin sensitivity and reduces glucose production by the liver 1.
- Other options include thiazolidinediones, GLP-1 receptor agonists, or SGLT-2 inhibitors.
- Adequate sleep (7-9 hours nightly) and stress management also help reduce insulin resistance by regulating stress hormones that can affect glucose metabolism.
- Regular monitoring of blood glucose levels and periodic HbA1c testing are important to track progress. Insulin resistance develops when cells become less responsive to insulin, requiring the pancreas to produce more insulin to maintain normal blood glucose levels, and effective treatment can prevent progression to type 2 diabetes and reduce cardiovascular risk, as supported by the American Diabetes Association standards of medical care in diabetes 2. Key considerations in the treatment of insulin resistance include the patient's overall health, disease characteristics, and patient preferences, as well as the potential side effects and cost of treatment 1. It is essential to consider the most recent and highest quality studies when making treatment decisions, and to prioritize lifestyle modifications and medication as the primary approach to treating insulin resistance 1, 2.
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 In patients with type 2 diabetes, the decreased insulin resistance produced by ACTOS results in lower plasma glucose concentrations, lower plasma insulin levels, and lower HbA1c values.
The treatment options for Insulin Resistance (IR) include pioglitazone (PO), which improves insulin sensitivity in insulin-resistant patients.
- Key benefits of pioglitazone include: + Enhanced cellular responsiveness to insulin + Increased insulin-dependent glucose disposal + Improved hepatic sensitivity to insulin + Improved dysfunctional glucose homeostasis + Lower plasma glucose concentrations + Lower plasma insulin levels + Lower HbA1c values 3