Insulin Resistance Health Article

Treatment

Among the most important treatment modalities are diet and exercise, weight loss if obese, endocrine hormone correction if unbalanced. In 2001, the National Institutes of Health completed the Diabetes Prevention Program (DPP), a clinical trial designed to find the most effective ways of preventing type 2 diabetes in overweight people with prediabetes. The researchers found that lifestyle changes reduced the risk of diabetes by 58 percent. Also, many people with prediabetes showed a return to normal blood glucose levels.

According to the DDP results, a mere half hour of brisk walking or bicycling five days a week can significantly reduce the risk of developing type 2 diabetes. Patients should use diet and exercise to reduce their body mass index (BMI) to 25 or below.

Smoking has been associated with insulin resistance, as well as with some of the more severe problems associated with diabetes. Discontinuing smoking should be a top priority.

A healthful diet, in addition to assisting in weight loss, may reduce serum lipids and reduce some of the risk factors for diabetes. One study recommended the Mediterranean diet as being the most beneficial for people with insulin resistance. Diet improvements include reducing sweets, desserts and high glycemic meals; eating balanced meals that contain protein, complex carbohydrates, fiber, greens and healthy oils, eating at regular times, and avoiding excess junk food and sugar.

No complimentary or alternative therapies have been proven to cure insulin resistance. Although several herbal remedies have been traditionally used for treatment of diabetes, none have been adequately documented as effective. Among medicinal plants shown to help lower elevated blood sugar are the Asian bitter melon and the Navaho Optunia cactus. Such herbal bitters as dandelion root and yellow dock can improve digestive strength and sometimes help, though no herbal remedy alone "cures" insulin resistance or diabetes. Guar gum, glucomannan, and psyllium seed all have demonstrated some ability to lower blood sugar in insulin resistance or diabetes, but none have been shown to be reliably effective for use in treatment of humans.

Allopathic treatment

Insulin resistance does not normally require drug therapy; however, some studies have shown that the drugs used to treat type 2 diabetes may delay development of diabetes. Two classes of drugs now used to treat diabetes act by increasing insulin sensitivity, the biguanides and the thiazolidinediones; the other drugs used to treat diabetes act in different ways.

Although drugs from both classes have been effective in treatment of insulin resistance, neither drug has been as effective as a regimen of diet and exercise. Both classes of drugs have the potential for very severe adverse effects. They are also not approved by the FDA for control of insulin resistance, although physicians may prescribe them for this use if the condition appears to be getting worse without drug therapy. In one study, oral hypoglycemic drugs of various mechanisms that help reduce elevated blood blood glucose reduced the rate of disease progression from insulin resistance to diabetes by about one-third over a three-year period.

Expected results

In mild asymptomatic insulin resistance, proper treatment may lead to a complete reversal, with normalization of blood sugar.

Even if complete normalization is impossible, treatment will lead to control of the condition, and a significant reduction in its rate of progression to diabetes.

Prevention

In insulin resistance, prevention is even better than treatment. Maintaining a normal weight, eating a balanced diet, and keeping up a regular program of aerobic exercise are the best preventive measures.

BOOKS

Beers, M. H., and R. Berkow, eds. The Merck Manual of Diagnosis and Therapy, 17th ed. Whitehouse Station, New Jersey: Merck and Co., 2004.

Blumenthal, M., ed. The Complete German Commission E Monographs. Austin, TX: American Botanical Council, 1999.

Blumenthal, M., ed. Herbal Medicine. Austin, TX: American Botanical Council, 2000.

Hart, C. R., and M. K. Grossman. The Insulin Resistance Diet. Chicago: Contemporary Books, 2001