Nutritional guidelines for the management of insulin resistance

Abstract

Obesity and its related co-morbidities, namely type 2 diabetes (T2D), pose a significant global public health problem. Insulin resistance (IR) in muscle and liver is the core pathophysiologic defect that underlies obesity preceding and predicting the onset of T2D in susceptible humans. There is a broad population with IR that has no indication for prescription of medications, who still need medical consultation and specific advice in this respect. This prevalent need can be achieved by appropriate diet, exercise, and other behavioral therapies for lifestyle interventions. Despite a well-recognized role of IR in the progression to metabolic diseases, no specific nutritional recommendations exist to manage this condition, to the best of our knowledge. An international panel of experts reviewed and critically appraised the updated literature published about this topic. This review primarily examines the evidence for areas of consensus and ongoing uncertainty or controversy about diet and exercise approaches for IR. The aim of this article is to present the most common IR states, namely obesity and Polycystic Ovary Syndrome (PCOS), and provide nutritional advice to manage IR, hyperinsulinemia, and reactive hypoglycemia. These nutritional guidelines could prevent progression or worsening of IR with resultant beta-cell failure and, as a result, T2D.

Keywords:

• Type 2 diabetes
• insulin resistance
• nutrition management
• guidelines
• obesity
• polycystic ovary syndrome

Disclosure statement

The authors have nothing to disclose. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions

The authors’ responsibilities were as follows: GM, LB, MC, FC, AOC, ME, EF, RJM and VM : were responsible for the concept of this paper and drafted the manuscript; GM, LB, SAP, AP, SS and AC: provided a critical review of the paper. All authors contributed to and agreed on the final version of the manuscript.

Table 1. Lifestyle modification for the prevention reactive hypoglycemia.