How to prevent insulin resistance?

Question

Hello doctor,

I recently underwent a blood test, including an insulin resistance test. The results indicated a high level of insulin resistance, which was corroborated by an oral glucose tolerance test (GTT) that I subsequently undertook, as reflected in the attached report.

I have been prescribed Metformin 500 mg for several years, though I confess to not taking it regularly. I am interested in understanding the potential methods to decrease insulin resistance through medication, as well as the recommended duration for sustained usage of these medications. I would appreciate your expert suggestions for the same.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and your concern.

I went through the reports (attachment removed to protect the patient's identity). Your HbA1c (glycated hemoglobin) is fine. Blood sugar levels are clinically acceptable. Insulin resistance is high which is expected and is reflected in high plasma glucose levels at hour. Normally in my practice, I do not start medications for such situations. What is more important for you is to reduce weight. For your height, acceptable weight is between 165 to 176 pounds. The healthy way of reducing weight is by regular physical exercises and following a healthy diet. This itself will significantly reduce the insulin resistance or increase insulin sensitivity.

Considering you are young and overweight I would strongly recommend you lose weight to bring your BMI (body mass index) within normal range which automatically brings down insulin resistance in natural ways. Although Metformin (Cellulose acetate and Hypromellose) increases insulin sensitivity, its response is best when combined with diet and physical exercise. As far as the duration of it is concerned, there is no fixed duration recommended. It all depends on the extent of sugar control achieved in diabetics. But in your case, you are not diabetic yet. So more than medicine what is required is diet and physical exercise to reduce weight.

Hope this helps you.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

I read your query.

I understand you are trying to lose weight, but unfortunately, it is not happening. I am not sure if you are getting help from a dietician who can help you with a customized diet plan by considering your body habits. Physical exercise has to be daily, or at least five days a week, with a mix of aerobic and strength exercises. Although some weight-reducing medications can be considered, they are in addition to diet and exercise.

Unfortunately, I cannot prescribe medications for patients outside India. I would suggest you discuss this with your diabetician. Also, it is equally important to find out the reason for weight gain when you are already following some diet and exercise. If there is any cause, treating that would be key to controlling weight gain.

I hope I have answered your question.

Let me know if I can assist you further.

Regards.