Insulin Resistance - Treatment Options
WEIGHT LOSS
Body weight is the commonest and easily measurable indicator of insulin resistance. Combating obesity brings immense benefits as sited elsewhere in this site. Most studies (DPP, Finnish DPS, Da Qing, XENDOS) have demonstrated the positive effect of weight loss on improved glucose tolerance with prevention of progression of IGT to T2DM. . In the XENDOS study involving 3304 patients (80% with IGT) for 4 years, the orlistat group had a 37% risk reduction in progression from IGT to T2DM (weight reduction in placebo and orlistat group: 7.5 vs. 11.4 kg; Conversion rate from IGT to T2DM in placebo and orlistat groups: 9% vs. 6.2% respectively) Diabetes Obes Metab. 2003 Sep;5(5):356. Weight loss improves vascular response to L- arginine, reduces fasting insulin concentrations, and reduces IL 6 and TNF α levels. Increasing the dietary carbohydrate with lowering of dietary fat has been shown to improve glucose tolerance secondary to an increase in insulin secretion and an improvement in insulin sensitivity in older people J Clin Endocrinol Metab. 1988 Nov;67(5):951-7. and type 2 diabetics. N Engl J Med. 1971 Mar 11;284(10):521-4.