Insulin resistance (sometimes called insulin insensitivity) is one of the most common health problems in America, affecting over 100 million. It is the driving force behind prediabetes, type 2 diabetes, fatty liver disease, obesity, and many other chronic health problems.

Type 2 Diabetes

Type 2 diabetes is simply insulin resistance that has gotten out of hand. Approximately 32 million Americans have diabetes. About 95% of them have type 2 diabetes. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. Type 1 diabetes is a state where the body cannot produce insulin. Type 2 diabetics produce insulin, but the body simply does not respond. Much of the advice given here is for type 2 diabetics and not type 1 diabetics.

Treating Insulin Resistance Naturally

Monitor your blood sugar when taking a drug: This is especially true if you are making lifestyle changes, because it will make your prescription needs change. If you are taking a diabetes drug, do not simply stop taking it because you are improving your lifestyle. The dietary advice here will help to lower your blood sugar and your need for the drug. As you get healthier, monitor your sugar levels, and talk to your doctor about adjusting the dose.

Diet for Insulin Resistance: Avoid Foods with a Glycemic Load Over 10

Research has shown lifestyle to be more effective than drugs in preventing diabetes and a valuable therapy for treating it1,2,3,4. These four studies do not include supplementation, but there is much research that shows supplementation to be beneficial to patients with type 2 diabetes.

Diet: Carbohydrates, particularly refined carbohydrates like refined sugar, and refined white flour, create problems for people with insulin insensitivity or diabetes. The American Diabetes Association does not recommend one specific diet. Overall, you should avoid refined carbohydrates. Carbohydrate consumption should be limited, and processed foods should be avoided. Eat a lot of green and other brightly colored vegetables (not corn or potatoes). Vegetables should dominate the diet.

Eat food with a glycemic load of 10 or less: A study that appeared in (Diabetes Res Clin Pract. 2011 Apr;92(1):37-45) looked at 79 obese adults with type 2 diabetes. The researchers concluded, “Results suggest that targeting glycemic load, rather than dietary fat, in a low-calorie diet can significantly enhance the effect of weight loss on HbA(1c) in patients with type 2 diabetes.” Focusing on glycemic load can help you lower A1C and lose weight. There are several studies that support this idea. Consider following the Roadmap to Health.

Bottom line: The less your body has to process carbohydrate, the easier it is to control diabetes. Controlling carbohydrate is what the diabetes drugs (for type 2 diabetes) are all about. Focus on diet can accomplish this with lower dosages of drugs or possibly no drugs at all. Pay attention to the glycemic load of the food you eat.

Lifestyle Changes to Help Insulin Insensitivity

Intermittent fasting: This is not for everyone; some people do not tolerate it well (especially those with stress/adrenal problems). Discuss with your doctor and do what works for you.

You have two hormones, one is insulin, which stores fat. The other is glucagon, which burns fat. When you eat, and for three hours afterward, insulin is the dominant hormone. After three hours glucagon is the dominant hormone. This is why snacking is such a bad idea when you are trying to lose weight, because it makes you produce insulin and store fat. Snacking prevents you from burning fat three hours after a meal.

Intermittent fasting is a well-researched way to get insulin insensitivity under control and to lose weight. You have an eight-hour window to eat. There needs to be 16 hours between dinner and breakfast the next morning. If you eat dinner at 5:00 pm, breakfast is at 9:00 am the next morning. It works because when you fast you produce glucagon, which is a hormone that helps to break down fat5,6.

Exercise: This should be obvious. For one thing, exercise helps prevent diabetes. The authors of one study stated, “Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT [glucose insensitivity].”7 There are literally hundreds of scientific studies showing the benefits of exercise for diabetics. There are too many to list here. They consistently show a lowering of A1C scores for diabetics who begin an exercise regimen. Light exercise is best, and it should be done daily.

Supplements to Help Insulin Insensitivity

The importance of magnesium: Most Americans are magnesium deficient, and diabetics are exceptionally prone to magnesium deficiency.  Magnesium and its role in blood sugar control have been extensively studied. Insulin insensitivity and the overproduction of insulin found in type 2 diabetes may actually interfere with magnesium absorption8. One study compared 42 subjects with type 2 diabetes who were randomly chosen to receive 250 mg of elemental magnesium per day or a placebo. At the end of three months, the group receiving the magnesium experienced a significant improvement in HbA1C9.  Magnesium has even been shown to improve the cholesterol and triglyceride levels of people with type 2 diabetes10. Magnesium intake can help prevent the transition from prediabetes (glucose resistance) to diabetes11. Poor magnesium status may even increase the risk for neuropathy in diabetics. Research found that diabetic patients with polyneuropathy tended to have low levels of magnesium when tested in the red blood cells11.

Berberine has been well-researched and shown to reduce blood sugar and A1C. Studies have shown that berberine can help and that berberine performs similarly to metformin. Subjects have had significant decreases in A1C, fasting blood glucose, postprandial blood glucose, and plasma triglycerides12,13,15,16,20. It has even been shown to lower cholesterol25,28,29, reduce BMI21, and it may also help with fatty liver disease20.

Lipoic acid has been studied and shown to improve the cholesterol and triglyceride levels of patients with diabetes and insulin insensitivity. One study22 has investigated 22 obese subjects with insulin insensitivity (obese-IGT), 13 of whom received lipoic acid. The patients receiving the lipoic acid had improved insulin sensitivity as well as lower cholesterol, triglycerides, and lower LDL (“bad”) cholesterol. They also experienced a reduction in inflammatory markers (chemicals that cause inflammation). A meta-analysis of studies (a meta-analysis is a review of a collection of scientific studies) also found that giving lipoic acid can produce similar results23.

There are several studies that show lipoic acid to help prevent and reduce suffering from diabetic neuropathy. In one study24, 72 patients with painful diabetic neuropathy were given lipoic acid for 40 days (600 mg/day). The subjects had a reduction in pain and other symptoms of neuropathy. Half of the subjects rated their health condition as ‘very much better’ or ‘much better’ following α-lipoic acid administration. The supplementation also reduced triglyceride levels. Another double-blind, placebo-controlled study13 looked at 328 patients. The researchers concluded, “intravenous treatment with alpha-lipoic acid (600 mg/day) over 3 weeks is safe and effective in reducing symptoms of diabetic peripheral neuropathy, and oral treatment with 800 mg/day for 4 months may improve cardiac autonomic dysfunction in NIDDM [type 2 diabetes].” Many other double-blind studies found similar results with oral doses25-30.

All these studies not only find that lipoic acid is beneficial to diabetics, but it is also safe. Supplementation should be considered for improving the lipid profile and for protecting against neuropathy in diabetics.

Essential fatty acids: Insulin is highly inflammatory; so, insulin insensitivity can cause inflammation. It is part of the reason so many diseases are associated with it, like heart disease. The chemicals that create and suppress inflammation are oil soluble. The type of fat in the diet can either promote or suppress inflammation. Avoid hydrogenated oils, trans fats, and highly refined vegetable oils. Use extra virgin olive oil for cooking and for salads. Studies have shown that taking vegetable sourced omega-3 fatty acids, like linolenic acid from flax seeds will reduce inflammation as well as improve blood sugar control31-39.

Insulin Resistance, Fatty Liver and the Gallbladder

Your liver and gallbladder are also affected by insulin resistance. Over time, excess sugar and insulin resistance can contribute to fatty liver disease, sluggish bile flow (biliary stasis), and gallstones. The same lifestyle changes that improve insulin sensitivity often support the health of the liver and gallbladder as well. See our articles on fatty liver, biliary stasis, and natural gallbladder support for more information.

Bottom line: For the most part, insulin insensitivity and type 2 diabetes are self-inflicted. One of the best places to block sugar is your mouth. Focusing on lifestyle and the proper supplementation can help normalize your metabolism. If you are on medication for diabetes, make sure you monitor your blood sugar and discuss this with your doctor

Selected References:

  1. N Engl J Med February 7, 2002;346:393-403 Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
  2. N Engl J Med. 2001 May 3;344(18):1343-50 Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance
  3. 2017 Aug 15;318(7):637-646 Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial
  4. 2012 Dec 19;308(23):2489-96 Association of an intensive lifestyle intervention with remission of type 2 diabetes
  5. BMJ Case Rep. 2018 Oct 9;2018:bcr2017221854 Therapeutic use of intermittent fasting for people with type 2 diabetes as an alternative to insulin
  6. J Clin Endocrinol Metab. 1995 Apr;80(4):1376-81 Effects of insulin on plasma magnesium in noninsulin-dependent diabetes mellitus: evidence for insulin resistance
  7. Diabetes Care. 1997 Apr;20(4):537-44. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study
  8. J Clin Endocrinol Metab. 1995 Apr;80(4):1376-81 Effects of insulin on plasma magnesium in noninsulin-dependent diabetes mellitus: evidence for insulin resistance
  9. 2018 Dec 26;11(1):44 The Effects of Oral Magnesium Supplementation on Glycemic Response among Type 2 Diabetes Patients
  10. Magnes Res. 1994 Mar;7(1):43-7 Effects of oral magnesium supplementation on plasma lipid concentrations in patients with non-insulin-dependent diabetes mellitus
  11. Diabetes Care. 2014 Feb;37(2):419-27 Higher magnesium intake reduces risk of impaired glucose and insulin metabolism and progression from prediabetes to diabetes in middle-aged americans
  12. 2008 May;57(5):712-7 Efficacy of berberine in patients with type 2 diabetes mellitus
  13. J Ethnopharmacol. 2015 Feb 23;161:69-81 Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension
  14. Nat Med. 2004 Dec;10(12):1344-51 Berberine is a novel cholesterol-lowering drug working through a unique mechanism distinct from statins
  15. 2010 Feb;59(2):285-92 Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression
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  22. Obesity (Silver Spring). 2011 Aug;19(8):1647-53 Amelioration of lipid abnormalities by α-lipoic acid through antioxidative and anti-inflammatory effects
  23. 2018 Oct;87:56-69 The effects of alpha-lipoic acid supplementation on glucose control and lipid profiles among patients with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials
  24. J Int Med Res. 2018 May;46(5):1779-1790 Effect of α-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy
  25. 1997 Sep;46 Suppl 2:S62-6 Alpha-lipoic acid in the treatment of diabetic peripheral and cardiac autonomic neuropathy
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  27. Drugs R D. 2012 Mar 1;12(1):29-34 Combination of alpha lipoic acid and superoxide dismutase leads to physiological and symptomatic improvements in diabetic neuropathy
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  29. 1995 Dec;38(12):1425-33 Treatment of symptomatic diabetic peripheral neuropathy with the anti-oxidant alpha-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study)
  30. Free Radic Res. 1999 Sep;31(3):171-9 Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (alpha-lipoic acid): a two year multicenter randomized double-blind placebo-controlled trial (ALADIN II). Alpha Lipoic Acid in Diabetic Neuropathy
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