How to treat insulin resistance

  1. Can drugs help?
  2. Low-carb nutrition
  3. Other dietary evidence
  4. Intermittent fasting
  5. Physical activity
  6. Sleep
  7. Stress
  8. Tobacco use
  9. Tin insulin resistance exist cured?
  10. Summary

Insulin resistance is a mutual, nearly silent condition in which the body'south cells become less able to efficiently respond to the hormone insulin.1 This causes the pancreas to secrete even more insulin to keep blood sugar stable.

As described in our in-depth companion guide: What you lot need to know well-nigh insulin resistance, this becomes a vicious wheel with insulin rise higher and college and cells becoming even more than resistant.2

Eventually this may lead to pre-diabetes, type 2 diabetes, PCOS, or other chronic wellness conditions.

For more information almost how and why insulin resistance happens, the health conditions related to insulin resistance, and how insulin resistance is diagnosed please refer to our companion guide.

Doctor consulting with patient presenting results on digital tablet tablet sitting at table

What you lot need to know about insulin resistance

GuideInsulin is an essential hormone we tin't live without. What happens, however, when it is chronically too loftier? Our tissues terminate responding to it effectively. That'south insulin resistance.

In this guide nosotros describe what y'all can do to treat insulin resistance, especially with powerful lifestyle interventions.

Can drugs help?

If you lot take been diagnosed with insulin resistance, your offset question may be whether whatever medications can care for this condition. While the FDA has non approved any drugs specifically to treat insulin resistance, there are ii commonly prescribed drugs for diabetes that can ameliorate insulin sensitivity.

Many doctors prescribe metformin for patients with prediabetes and/or insulin resistance. It works by decreasing glucose production by the liver and increasing the insulin sensitivity of cells.3 Yet, information technology does not address the underlying cause of the insulin resistance.

Pioglitazone is another medication that lowers blood saccharide by enhancing the body'south sensitivity to insulin.4 This drug tends to not exist every bit pop as metformin, even so, in part due to the potential side effect of mild weight gain.

Though drugs may play a role in improving insulin sensitivity and delaying the onset of type 2 diabetes, they are rarely acceptable as a sole intervention. What else can you practice if you have insulin resistance? This guide explores the lifestyle changes yous can brand as supported past the latest evidence.

The depression-carb diet

Practically whatsoever dietary intervention that results in weight loss, especially fatty loss within the abdomen, can temporarily improve insulin sensitivity.5 A low-carb diet certainly fits this description, and may be more effective than low-fat diets for improving insulin sensitivity.6 One observational study even suggested improved survival for those with prediabetes who ate a lower carbohydrate nutrition, and a nonrandomized trial reported glucose normalization in over 50% of participants with prediabetes.7

The reason why low-carb diets are practiced for people with insulin resistance elementary: if you are non eating sugar — or carbohydrates that rapidly digest to sugar — you will have less sugar inbound your bloodstream and therefore less of a need to make insulin to motion carbohydrate (glucose) out of the blood and into cells.

If your torso is already resistant to insulin, creating this internal environment in which high levels of insulin are non needed to maintain normal blood sugars is extremely helpful.

Studies show that a low-carb diet tin be an effective diet for improving blood sugar command and achieving type two diabetes remission.8 Since insulin resistance plays a major office in causing type 2 diabetes, a depression-carb nutrition is likely also good for addressing pre-existing insulin resistance before total-diddled blazon 2 diabetes develops.

One brusk study in 2005 showed a 75% improvement in insulin sensitivity in ten patients with obesity and blazon 2 diabetes who went on a low-carb nutrition.9

In two other studies, a very-low-carbohydrate diet was ameliorate at lowering insulin levels than a low-fat diet.ten Of notation, both groups in the 2006 study demonstrated equal weight loss, suggesting that it was the limerick of the diet, not the weight loss alone, that was the most effective intervention to bring insulin levels down.

Yet another trial showed that a depression-carb nutrition was better than a low-fat diet plus a pop prescription weight loss drug for lowering insulin, glucose and HbA1c levels.eleven Again, both groups lost the same amount of weight, but the diet with the lower carbohydrate levels achieved better results in blood sugar control and insulin levels.

Finally, i report reports that people with insulin resistance have worse compliance with a low-fat diet, and meliorate compliance with a low-carb nutrition.12

Takeaway: Reducing your intake of saccharide and carbs that digest to carbohydrate volition likely result in reduced insulin product and improved insulin resistance.

What does this diet look similar? Dozens of guides on our site delve into all aspects of depression-carb and ketogenic eating. Check out these two to start:

Other dietary evidence

It is important to annotation that studies besides evidence that any diet that causes weight loss can reduce insulin resistance and improve insulin sensitivity — at least for a time.13

The reverse is truthful, too. Any nutrition that causes a rapid increase in bodyweight, such as from consuming high-carb, loftier-fatty, high calorie foods (sometimes called over-diet), can immediately cause insulin resistance — within days — even amongst healthy young men.14

Over the years, other areas of research take explored the possibility of specific diets decreasing insulin resistance:

  • increasing protein intakexv
  • increasing dietary fiber intake16
  • eating low-glycemic-index foods17
  • lowering dietary fat intake18

To learn more than about the strengths and weakness of these other dietary approaches, and why we recommend low-carb eating, click beneath:

 

Takeaway: A diet that is low in carbs, higher in protein, and high in soluble fiber from above-footing vegetables appears to take the best current evidence for reducing insulin resistance.

Intermittent fasting/time-restricted eating

Intermittent fasting is a popular dietary trend that entails exactly what information technology sounds like: not eating during certain time periods. Though it may seem like a fad to some, studies suggest intermittent fasting can improve insulin sensitivity.19

Although non all studies agree. For instance, one RCT that did not control for how much or what the subjects ate, didn't demonstrate a benefit in insulin sensitivity for those doing a 16:8 fourth dimension-restricted eating.xx Ane potential lesson is that your dietary quality and full caloric intake still make a meaningful bear on even with time-restricted eating.

There are multiple mechanisms past which fasting may amend insulin sensitivity. Cells can increase the number of insulin receptors on their surface, and those receptors can demonstrate an increased affinity for binding insulin during fasting.21

Also, diverse hormone levels increase during fasting and are thought to increase insulin sensitivity.22 For case, adiponectin – a fat-cell specific hormone – appears to enhance insulin sensitivity through increased fat acid oxidation and inhibition of glucose production by the liver.23

When it comes to implementing intermittent fasting, fourth dimension-restricted eating is one type of fasting that involves eating meals in a gear up time-frame each solar day, such as betwixt 11 am and 7 pm. A review of studies in healthy subjects showed that eating fewer meals during a shorter feeding window resulted in ameliorate glucose and insulin levels.24

Some other type of IF is alternating 24-hour interval fasting. Healthy males who fasted for 20 hours every other day for 15 days showed greater glucose uptake with the aforementioned insulin levels, in essence improving their insulin sensitivity.25

Another trial reported greater improvements in insulin resistance amongst women using intermittent caloric restriction (fasting) compared to chronic caloric restriction.26

Based on the fact that both fasting and low-carb diets have been shown to improve insulin sensitivity, nosotros hypothesize that the combination of a low-carb diet with periodic intermittent fasting is likely the nearly effective nutritional intervention for treating insulin resistance and hyperinsulinemia.

Intermittent fasting may seem daunting, only if you are interested in exploring it, check out our guide:

Intermittent fasting

Intermittent fasting for beginners

Guide Intermittent fasting can help you lot lose weight, increment energy and gain several health benefits. Yous can too relieve lots of time and money. There are, yet, many questions almost how to do IF in a safe and constructive way. In this guide by Dr. Jason Fung, a elevation fasting expert, you lot'll rapidly learn how to do it.

Physical activity and do

Muscles burn glucose for free energy. The more you motility, the more than glucose your muscles accept out of the blood for energy use, which helps to lower your blood saccharide levels. This allows for a reduction in insulin secretion, lessening the brunt on your pancreas.

Also, muscles that don't move don't use upwards claret carbohydrate, so insulin levels can rise to process whatsoever excess. Studies testify that a mere five days of bed residue induces a state of insulin resistance in completely healthy volunteers.27 Multiple studies show that long-term inactivity is strongly associated with insulin resistance, metabolic syndrome and pre-diabetes.28

Any type of regular motility tin can help. Studies suggest that high-intensity interval training (HIIT), resistance preparation, and cardio training all amend glucose utilization and thereby better insulin sensitivity.29

No matter what your preferred class of movement or exercise, it is clear: inactivity can atomic number 82 to insulin resistance. And movement increases insulin sensitivity every bit long as the exercise continues.30 And so if you lot cease moving regularly, insulin resistance may come dorsum. (Move information technology or lose it!)

One more than thing on exercise: you likely cannot outrun a bad diet. Exercising regularly only still eating a high-saccharide, high-carbohydrate diet volition likely partially, if not completely, annul many of the benefits derived from exercise.31

Based on the bear witness, it appears that the combination of regular exercise and a well formulated low-carb nutrition is an effective approach for treating insulin resistance and hyperinsulinemia.

Sleep

Studies testify that brusque-term sleep deprivation raises glucose levels and worsens insulin resistance.32 A chronic slumber disturbance, such as from obstructive slumber apnea, is also associated with worsening insulin resistance.33

It'south unclear how much sleep is besides little, just enough, or too much. Is there a divergence in insulin sensitivity in someone who gets six hours of slumber per night instead of viii? Is there a certain amount of lost slumber, or a frequency of bad nights that triggers insulin resistance? Nosotros don't know.

Nonetheless, it is clear that there is an association between insulin resistance and sleep. And treating sleep problems may result in improved insulin sensitivity.34

Stress

Studies evidence temporary insulin resistance arises during periods of curt term physiological and psychological stress, such every bit a sudden illness or sudden threat.35 In theory, this could have been an evolutionary advantage at some indicate in human existence and has been termed "adaptive insulin resistance".36 Information technology makes sense that you would desire to mobilize stored free energy during infection, trauma, or stress, and then inhibition of insulin (which stores free energy) would exist a good thing. This type of insulin resistance reverses when the sudden stress is over. Such a response to short-term stress likely has no long-term negative consequences.

However, information technology appears that chronic stress and chronic activation of the body's fight or flight response will too lead to insulin resistance.37 Since this chronic stress is longer-term, without a sudden onset and quick resolution of the trigger, it may pb to longer-term negative consequences.

Ii small controlled studies demonstrated that meditation lone helped reduce claret saccharide in patients with heart disease.38 Since mindfulness training, yoga, meditation, dancing, singing, and walking in nature can be effective ways to reduce stress, increment wellbeing and better overall concrete wellness, they may also help with insulin resistance.

Explore the means that you lot relax best, and yous may exist helping amend your insulin sensitivity.

Tobacco use

No aspect of smoking is skilful for wellness, merely some studies written report that agile smoking is associated with insulin resistance and the development of diabetes.39 Although it is hard to command for other potentially unhealthy activities in which many smokers may as well appoint, an increased hazard does appear to exist.xl

It is clear that quitting smoking is critical for improving health on many unlike levels, and your insulin sensitivity is no exception.

Can we cure insulin resistance?

Once someone has dramatically improved their insulin resistance, bringing insulin and blood sugar levels down by eating a depression-carb nutrition, and improving their exercise, stress direction, and sleep, the question then becomes: are they cured?

Probably not. The give-and-take cure implies that the person can go back to eating even so they desire and the insulin resistance will not return. Unfortunately, that's non how it works. The vast majority of people who reverse their insulin resistance, lower their chronically high insulin levels, and lower their blood sugars will see those all render to previous high levels if they stop their lifestyle interventions and return to their old diets and habits.41

This reinforces the need to make lifestyle changes that tin can be maintained for decades and lifetimes. Crash diets or short-term interventions merely help in the moment. Insulin sensitivity is a lifelong rest.

However, some people may have what amounts to a fractional cure, especially if their insulin resistance is caught early on. Clinical practice suggests that for some people, eating a depression-carb diet, losing weight and getting insulin levels down will restore insulin sensitivity and may allow them to regain the degree of metabolic flexibility found in healthy individuals.42

That metabolic flexibility may permit them to increase the amount of carbs they can safely eat from twenty grams per day upwards to 75 grams, or it may allow them to reduce the corporeality of exercise they need to keep blood saccharide and insulin levels depression.43

In addition to maintaining weight loss, regular blood tests may be required to make up one's mind who will attain metabolic flexibility and how much flexibility they can "become away with" without triggering the cycle of insulin resistance again.

So the best advice may be to stay with the about intensive lifestyle change yous tin can maintain and be vigilant about screening for recurrence of insulin resistance. This starts with keeping an eye on your waist size, but likewise may include regular (every 6-months or so) claret tests for fasting insulin and fasting glucose.

See our companion guide: What you need to know about insulin resistance, which discusses diagnostic tests.

You lot can too measure your 2-hour post-meal blood sugar levels after a low-carb repast and a moderate-carb meal and compare the readings. If a moderate carb meal causes your blood sugar to go over 140 mg/dl (seven.8 mmol/L), that could exist a sign that y'all may still be insulin resistant.44 Note that this is our expert stance, and non based on hard data.

Woman with diabetes checking her blood glucose using her glucose meter

What y'all need to know almost blood sugar

Guide If you have a diagnosis of diabetes, you've probably been tracking your claret carbohydrate for years. But if you've recently decided to try a depression-carb or ketogenic nutrition, you lot may need to sympathise your results in the context of your new dietary design.

Summary

Insulin is of import for survival and adept long-term health just chronically high insulin levels make your body less responsive to this essential hormone, which might increase your hazard of developing serious chronic health conditions.45

Adopting constructive lifestyle changes — like a low-carb nutrition, regular physical activity, and a proficient sleep routine — can lower insulin levels and reduce insulin resistance.

/Dr. Bret Scher, Md