Insulin resistance medical therapy: Difference between revisions

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==Overview==
==Overview==
==Medical Therapy==
The primary treatment for insulin resistance is [[exercise]] and [[weight loss]].  In some individuals, a low [[glycemic index]] or a low carbohydrate diet may also help.  Fasting might also help.  Both [[metformin]] and the [[thiazolidinedione]]s improve insulin resistance, but are only approved therapies for type 2 diabetes, not insulin resistance, per se.  By contrast, [[Growth hormone treatment|growth hormone replacement therapy]] may be associated with increased insulin resistance.<ref name=Bramnert_2003>{{cite journal | author=Bramnert M, Segerlantz M, Laurila E, Daugaard JR, Manhem P, Groop L | title=Growth hormone replacement therapy induces insulin resistance by activating the glucose-fatty acid cycle | journal=THE JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM| year=2003| volume=88 | issue=4 | pages=1455-1463 | url=http://jcem.endojournals.org/cgi/content/full/88/4/1455 | id=PMID 12679422}}</ref>
The ''Diabetes Prevention Program'' showed that exercise and diet were nearly twice as effective as [[metformin]] at reducing the risk of progressing to type 2 diabetes.<ref name=Knowler_2002>{{cite journal | author=Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group | title=Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin | journal=[[New England Journal of Medicine]]| year=2002 | volume=346 | issue=6 | pages=393-403 | url=http://content.nejm.org/cgi/content/abstract/346/6/393 | id=PMID 11832527}}</ref>
Some types of [[Monounsaturated fat|Monounsaturated fatty acids]] and saturated fats appear to promote insulin resistance, whereas some types of [[Polyunsaturated fat|polyunsaturated fatty acids]] (omega 3) can increase insulin sensitivity.<ref name=Lovejoy_2002>{{cite journal | author=Lovejoy, JC | title=The influence of dietary fat on insulin resistance | journal=Current Diabetes Reports | year=2002 | volume=2 | issue=5 | pages= 435&ndash;440  | id=PMID 12643169}}</ref><ref name=Fukuchi_2004>{{cite journal | author=Fukuchi S | title=Role of Fatty Acid Composition in the Development of Metabolic Disorders in Sucrose-Induced Obese Rats | journal=Experimental Biology and Medicine | year=2004 | volume=229 | issue=6 | pages= 486&ndash;493 | url=http://www.ebmonline.org/cgi/content/full/229/6/486 | id=PMID 15169967}}</ref><ref name=Storlien_1996>{{cite journal | author=Storlien LH | title=Dietary fats and insulin action | journal=Diabetologica | year=1996 | volume=39 | issue=6 | pages=621&ndash;631 | id=PMID 8781757}}</ref>
There are scientific studies showing that [[chromium picolinate]] can increase insulin sensitivity, especially in type 2 diabetics, but other studies show no effect. The results are controversial.
Naturopathic approaches to insulin resistance have been advocated including supplementation of vanadium, bitter melon (momordica) and [[Gymnema sylvestre]].<ref name=Harinantenaina_2006>{{cite journal | author=Harinantenaina L | title=Momordica charantia constituents and antidiabetic screening of the isolated major compounds | journal=Chemical & Pharmaceutical Bulletin (Tokyo) | year=2006 | volume=54 | issue=7 | pages= 1017&ndash;21 | url=http://www.jstage.jst.go.jp/article/cpb/54/7/54_1017/_article | id=PMID 16819222}}</ref>


==References==
==References==

Latest revision as of 14:41, 19 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Medical Therapy

The primary treatment for insulin resistance is exercise and weight loss. In some individuals, a low glycemic index or a low carbohydrate diet may also help. Fasting might also help. Both metformin and the thiazolidinediones improve insulin resistance, but are only approved therapies for type 2 diabetes, not insulin resistance, per se. By contrast, growth hormone replacement therapy may be associated with increased insulin resistance.[1]

The Diabetes Prevention Program showed that exercise and diet were nearly twice as effective as metformin at reducing the risk of progressing to type 2 diabetes.[2]

Some types of Monounsaturated fatty acids and saturated fats appear to promote insulin resistance, whereas some types of polyunsaturated fatty acids (omega 3) can increase insulin sensitivity.[3][4][5]

There are scientific studies showing that chromium picolinate can increase insulin sensitivity, especially in type 2 diabetics, but other studies show no effect. The results are controversial.

Naturopathic approaches to insulin resistance have been advocated including supplementation of vanadium, bitter melon (momordica) and Gymnema sylvestre.[6]

References

  1. Bramnert M, Segerlantz M, Laurila E, Daugaard JR, Manhem P, Groop L (2003). "Growth hormone replacement therapy induces insulin resistance by activating the glucose-fatty acid cycle". THE JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM. 88 (4): 1455–1463. PMID 12679422.
  2. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group (2002). "Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin". New England Journal of Medicine. 346 (6): 393–403. PMID 11832527.
  3. Lovejoy, JC (2002). "The influence of dietary fat on insulin resistance". Current Diabetes Reports. 2 (5): 435&ndash, 440. PMID 12643169.
  4. Fukuchi S (2004). "Role of Fatty Acid Composition in the Development of Metabolic Disorders in Sucrose-Induced Obese Rats". Experimental Biology and Medicine. 229 (6): 486&ndash, 493. PMID 15169967.
  5. Storlien LH (1996). "Dietary fats and insulin action". Diabetologica. 39 (6): 621&ndash, 631. PMID 8781757.
  6. Harinantenaina L (2006). "Momordica charantia constituents and antidiabetic screening of the isolated major compounds". Chemical & Pharmaceutical Bulletin (Tokyo). 54 (7): 1017&ndash, 21. PMID 16819222.

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