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Medication For Insulin Resistance

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Last Updated: 02 July 2021

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Insulin is a hormone produced by beta cells of the pancreas. These cells are scattered throughout the pancreas in small clusters known as islets of Langerhans. Insulin produce is Release into the blood stream and travels throughout the body. Insulin is an essential hormone that has many actions within the body. Most actions of insulin are direct to metabolism of carbohydrates, lipids, and proteins. Insulin also regulates the functions of the body's cells, including their growth. Insulin is critical for the body's use of glucose as energy. Insulin resistance is a condition in which the body's cells become resistant to the effects of insulin. That is, normal response to the amount of insulin is reduce. As a result, higher levels of insulin are needed in order for insulin to have its proper effects, and the pancreas compensates by trying to produce more insulin. This resistance occurs in response to the body's own insulin or when insulin is administered by injection. With insulin resistance, pancreas produces more and more insulin until the pancreas can no longer produce sufficient insulin for the body's demands, and then blood sugar rises. Insulin resistance is a risk factor for development of Diabetes and heart disease. Type 2 Diabetes Mellitus is a type of Diabetes that occurs later in life or with Obesity at any age. Insulin resistance precedes development of type 2 Diabetes, sometimes by years. In individuals who will ultimately develop type 2 Diabetes, research shows that blood glucose and insulin levels are normal for many years, until at some point in time, insulin resistance develop. High insulin levels are often associated with central Obesity, cholesterol abnormalities, and / or high blood pressure. When these disease processes occur together, it is called Metabolic syndrome. One action of insulin is to cause the body's cells to remove and use glucose from blood. This is one way by which insulin Control level of glucose in the blood. Insulin has this effect on cells by binding to insulin receptors on the surface of cells. You can think of it as insulin knocking on doors of muscle and fat cells. Cells hear knock, open up, and let glucose in to be used With insulin resistance, muscles don't hear knock. So the pancreas is notified it needs to make more insulin, which increases the level of insulin in the blood and causes louder knock. Resistance of cells continues to increase over time. As long as the pancreas is able to produce enough insulin to overcome this resistance, blood glucose levels remain normal. When the pancreas can no longer produce enough insulin, blood glucose levels begin to rise. Initially, this happens after meals-when glucose levels are at their highest and more insulin is needed eventually while fasting too. When blood sugar rises abnormally above certain levels, type 2 Diabetes arise

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* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

What Is Insulin Resistance?

When you have insulin resistance, your pancreas makes extra insulin to make up for it. For a while, this will work and your blood sugar levels will stay normal. Over time, though, your pancreas wo be able to keep up. If you do make changes in the way you eat and exercise, your blood sugar levels will rise until you have prediabetes. Your doctor will look for these blood test results: fasting plasma glucose test: 100-125 oral glucose tolerance test: 140-199 after second test A1C results of 5. 7 % to 6. 4 % if you arenat able to manage prediabetes, youall be diagnosed with type 2 Diabetes when your test levels reach: fasting plasma glucose test: 126 or higher oral glucose tolerance test: 200 or higher after second test A1C results of 6. 5 % or above

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Biguanides

Biguanides are derivatives of the compound biguanide that exert blood glucose-lowering effect in type 2 Diabetes mellitus. The main biguanides are Metformin and phenformin, which were described in 1957, and buformin, which was described in 1958 Schafer, bailey. Phenformin and buformin were withdrawn from clinical use in most countries in the late 1970s due to high incidence of associated lactic acidosis. Metformin, which has a much lower risk of lactic acidosis, is used widely in the treatment of type 2 Diabetes. Biguanides do not increase plasma insulin concentrations and do not cause severe hypoglycemia, hence they are regarded as antihyperglycemic agents.


Side effects

Metformin leading side effect is gastrointestinal discomfort. Some people are unable to tolerate Metformin at all, whereas others may be able to tolerate lower dose. Therefore, you may not tolerate the maximum dose but could still get some benefit from using a lower dose. If you cannot tolerate it at all, there is a slower releasing version that is usually better tolerate. Taking the maximum dose requires having 4 tablets per day. If this is in addition to other medications, it can quickly increase your medication burden. Pills are also quite large and therefore, people with swallowing difficulties could struggle. Long term use of Metformin can lower your B12 levels and cause deficiency. It may also exacerbate the build up of lactate in the body. Therefore, any conditions where lactate may accumulate or the body becomes more acidic, such as conditions like; diabetes keto acidosis, respiratory problems, alcohol related acidosis, dehydration amongst others, Metformin should be suspend.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

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Thiazolidinediones (TZDs)

Table

ProsCons
Improved insulin sensitivity Oral, once-daily pills Cheap and generic Good efficacy/A1c reduction Can be combined with other drugsWeight gain Edema (fluid retention) Increased risk of heart failure Increased bone fracture risk

The safety reputation of thiazolidinediones took a huge hit in 2010 after Rosiglitazone-most popularly prescribed Drug in this class-was associated with increased risk of heart attack and a number of studies concluded that heart Failure was a side effect of medication, and that the benefits of Avandia for diabetics NO longer outweigh risks involve. This led to IT being banned in various countries, including the UK, in late 2010. Actos, second most widely prescribed glitazone, also hit headlines that year after being linked with instances of bladder cancer. Reports suggest that extended use of the drug may significantly elevate the risk of bladder cancer, but evidence was deemed insufficient by health regulators to warrant its removal from the market. However, those Actos should be aware of symptoms of bladder cancer

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications. Medications that reduce insulin resistance include biguanides and thiazolidinediones, which have insulin-sensitizing and antihyperglycemic effects. Large quantities of insulin are also used in overcoming insulin resistance. Response to usual dosage of insulin is observed in instances in which resistance is due to enhanced destruction at the subcutaneous injection site. Treatment of type 2 Diabetes and impaired glucose tolerance conditions that are strongly associated with insulin resistance and significant Cardiovascular morbidity and mortalityshould aim at restoring normal relationship between insulin sensitivity and secretion. For Diabetes, this involves pharmacotherapy, which includes stimulation of insulin secretion and insulin sensitivity, as well as treatment intended to support signals that mediate islet adaptation. Pramlintide acts as an amylinomimetic agent by modulating gastric emptying, preventing postprandial increases in plasma glucagon, and promoting satiety, leading to decreased caloric intake and potential weight loss. Antiobesity drugs, such as orlistat, may reduce insulin resistance and related Cardiovascular Risk factors through weight reduction and other mechanisms. Other currently available drugs include liraglutide, phentermine, phentermine / topiramate extend release, lorcaserin, and naltrexone ER / bupropion ER. Weight-loss medications are prescribed as Adjunct to lifestyle measures and to help achieve a greater degree of weight loss than that produced by dietary changes and physical activity alone. In selecting optimal weight-loss medication for each patient, clinician needs to consider differences in efficacy, side effects, precautions, and warnings that characterize medications approved for chronic management of obesity. In most patients, administration of insulin is also crucial in the treatment of Diabetes. Most experts recommend early preventive strategies in children, especially lifestyle changes such as diet and increased level of physical activity, whereas pharmacotherapy is reserved for select cases. Samuel T Olatunbosun, MD, FACP, FACE Chief of Endocrinology Service, 60 Medical Group, uniform Services University of Health Sciences, F Edward Hebert School of Medicine Samuel T Olatunbosun, MD, FACP, FACE is a member of the following Medical societies: American Association of Clinical Endocrinologists, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, Endocrine Society Disclosure: Nothing to disclose. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: receive salary from Medscape for employment. For: Medscape. George T Griffing, MD, Professor Emeritus of Medicine, Louis University School of Medicine. George T Griffing, MD is a member of the following Medical societies: American Association for Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society Disclosure: Nothing to disclose.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Class Summary

The American Diabetes Association emphasizes that the causal link between Insulin Resistance and components of Syndrome is not conclusive and that there is currently NO sound evidence showing that treatment of Insulin Resistance reduces morbidity or mortality. 2 Nevertheless, treatment of Insulin Resistance involves lifestyle changes from which everyone can benefit. Because Insulin Resistance often precedes development of its consequences by years, if not decades, Identifying and treating it encourages patients to develop good habits at a young age. Exercise training improves Insulin Sensitivity. 19 Patients with suspected Insulin Resistance should be advised to increase their level of physical activity. Even regular, sustain, moderate increases in physical activity, such as daily walking, can substantially decrease Insulin Resistance. 20 this is compatible with the standard recommendation that everyone should accumulate at least 30 minutes of moderate-intensity physical activity on most or, even better, all days of the week. 21 Insulin Sensitivity improved within a few days of caloric restriction, before any significant weight loss occur. 13 Weight reduction leads to further improvement. The amount of weight loss needed for sustained decreases in Insulin Resistance is still unclear. In obese women without Diabetes, weight loss of approximately 15 percent has been linked to significantly lower Insulin levels. 22 Regaining even modest amount of lose Weight, However, with body weight that was still 10 percent below starting values, result in an increase in Insulin levels to baseline. Women in this study were very obese and remain obese even with a loss of 15 percent of body weight. The implication is that all obese patients should be encouraged to attain healthy body weight. This can be accomplished and sustained through dietary modification and exercisea, recommendation that is easy to make, of course, but difficult to follow. The amount of dietary fiber consumed is inversely related to Insulin levels. 23 this observation may explain lower incidence of hypertension, hyperlipidemia and cardiovascular disease among people with diets high in fiber. A Diet high in natural sources of fiber helps combat Insulin Resistance. Metformin has been successfully used for some time to treat Diabetes. It increases Insulin Sensitivity, 24 As do new thiazolidinedione class of drugs. 25 these drugs are not labelled For Treatment of isolated Insulin Resistance. Pending more evidence, American Diabetes Association does not recommend Drug therapy For Treatment of Insulin Resistance in absence of Diabetes.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Approach Considerations

The first approach to IR in children consists of lifestyle interventions, including dietary modifications and increased physical activity. Some studies suggest that exercise may have a major impact on improvement of Insulin Sensitivity than isolated reduction of body mass Index. The Framingham Heart Study gives evidence that there is a significant association between physical activity and sedentary time and Insulin Sensitivity and adipokine blood levels. In particular, physical activity is associated with higher Insulin Sensitivity, while sedentary time is positively associated with leptin and fatty acid binding protein levels. In addition, it has been observed that the number of steps per day is directly related to IGF-1 levels and inversely related to high Sensitivity C-reactive protein values. Despite evidence of the role of exercise training programmes in improvement of Insulin Sensitivity, mechanisms through which physical activity reduce this pathological condition and whether this response is simply an effect of changes in body composition is still unknown. It has been demonstrated that reducing fat intake through diet improves Insulin Sensitivity in adolescents. In fact, diet based on high intake of whole-grain and fibers seems to promote weight loss and lower IR. Pharmacologic intervention in obese children is sometimes needed to implement the effects of these primary Prevention interventions. However, rare but serious side effects have been observed with all available medications, therefore they should be used in selected cases. Patients' age, weight and comorbidities should be listed when considering pharmacological therapies and close monitoring is needed once they are introduce. Moreover, longer-term evidence of benefits in youth is still missing. Metformin, biguanide derivate, has been demonstrated to have beneficial results in further decreasing BMI. It reduces Insulin Resistance by decreasing fasting plasma Glucose and Insulin concentrations in adults, as demonstrated in large, randomize, Clinical trials. Metformin has been approved by the US Food and Drug Administration for Treatment of T2D in 10-year-old or older children and it is the only treatment evaluated in formal Clinical trials concerning prediabetes in children. In non-diabetic obese adults, it reduces food intake, causing weight loss and reduction of fasting plasma Glucose, Cholesterol, and Insulin concentrations. In addition, metformin has been demonstrated to improve BMI, body fat composition, fasting Glucose, Insulin, glycated hemoglobin, IR expressed by HOMA-IR, blood pressure and lipid profile in SHORT trials conducted on small sample sizes of children and adolescents 13. Although it has been observed that metformin improves Insulin Sensitivity in adolescents with T2D and PCOS, metformin is not yet indicated as a treatment for isolated IR. Long-term and consistent data is still missing to establish its role in the pediatric population. Gastro-intestinal adverse drug reactions, among which abdominal pain, nausea, metallic taste, bloating, and diarrhea, are commonly observed in patients treated with metformin and can be prevented or intensely reduced by starting its administration with low doses and increasing dose gradually or using extend-release formulations.


Management

Insulin sensitivity improves within a few days of caloric restriction, before any significant weight loss occur. 13 Weight reduction leads to further improvement. The amount of weight loss needed for sustained decreases in insulin resistance is still unclear. In obese women without Diabetes, weight loss of approximately 15 percent has been linked to significantly lower insulin levels. 22 Regaining even a modest amount of lose weight, however, with body weight that was still 10 percent below starting values, results in an increase in insulin levels to baseline. Women in this study were very obese and remain obese even with a loss of 15 percent of body weight. The implication is that all obese patients should be encouraged to attain healthy body weight. This can be accomplished and sustained through dietary modification and exercisea, recommendation that is easy to make, of course, but difficult to follow.


Insulin Resistance in Children

During recent decades, several studies have defined several and well-characterize risk factors for IR, including ethnicity, puberty, adipose tissue variant depots, polycystic ovary syndrome, gene variants, family history of Diabetes or gestational Diabetes, and fetal growth pattern during pregnancy. Two most important unchangeable risk factors for IR in children are ethnicity and puberty. Several studies have demonstrated that Caucasian children are affected by IR more often than African, American, Hispanic, Pima Indian and Asian children. Puberty is physiologically responsible for IR; in fact, during this period of life, insulin sensitivity undergoes decline of around 25-50 % and improves when puberty ends. There is a strong association between IR and abdominal obesity, which is known to represent one of the main elements of MS. According to large-Population base studies, subcutaneous adipose tissue, and visceral adipose tissue seem to be both related to HOMA-IR. In addition, VAT correlates more strongly to insulin variables than SAT. Pathogenesis on the basis of this evident correlation is still not known exactly but several hypotheses have been consider. SAT and VAT secrete free fatty acids into the blood, and higher plasmatic free fatty acid levels seem to be associated with IR. Moreover, VAT presents strong correlation with endothelial dysfunction and higher blood C-reactive protein values, which may give explanation for inflammation secondary to higher VAT depots. Since adipose tissues act as endocrine organ, these two tissues play a fundamental role in this field. VAT is more strongly associated with adiponectin levels and releases interleukin-6 and plasminogen activator inhibitor-1 to a greater extent than SAT. These main factors may be the causes of higher IR in patients with elevated VAT, in fact IL-6, and PAI-1 reduce in case of weight loss and properly correlate with parallel improvement of insulin sensitivity. Adolescents affected by PCOS often present IR, whose severity has been observed to be higher in obese patients than in lean ones. Risk factors include genetics, which is considered a great determinant in the incidence of IR. Principal variants which increase the risk of developing type 2 DM, that could represent the final effect of IR, are listed in Table 3. Peroxisome proliferator-activate receptor gamma variant Pro12Ala was one of the first genetic variants found to be related to decreased risk of developing T2D. Gene variants of transcription factor 7-like 2 are associated to risk of developing Diabetes more than any other gene 7. Rs972283 is located near KLF14. KLF14 gene and protein expression have been observed to be significantly decreased in both muscle and adipose tissue in individuals affected by T2D. Insulin receptor substrate 1 is one of the loci responsible for insulin signaling pathway. Allele C at rs2943641 adjacent to IRS1 was found to be related to IR and hyperinsulinaemia in the European Population, whereas SNP, rs2943650, near IRS1, was found to be related to lower percentage of body fat, higher triglycerides and IR, and decreased HDL-cholesterol.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Pharmacologic Therapy

Medications that reduce insulin resistance include metformin and thiazolidinediones. Metformin is biguanide; it reduces hepatic glucose output and increases uptake in peripheral tissues. Metformin is a major drug in the treatment of patients who are obese and have type 2 Diabetes. The drug enhances weight reduction and improves lipid profile and vascular integrity. Long-term follow-up data from the Diabetes Prevention Program / DPP Outcomes Study find metformin is associated with vitamin B12 deficiency, and routine measurement of vitamin B12 should be considered in patients receiving metaformin. Thiazolidinediones lower plasma insulin levels and treat type 2 Diabetes associated with insulin resistance. In a multicenter, double-blind trial of 3876 insulin-resistant patients who had had recent ischemic stroke or transient ischemic attack, those receiveing pioglitazone had reduced risk of stroke, myocardial infarction, and Diabetes compared to those receiving placebo. However, pioglitazone increases the risk for weight gain, edema, and fracture. Successful treatment of severe type B insulin resistance has been reported with rituximab, cyclophosphamide, and prednisone following failure of immunosuppressive therapy and plasmapheresis to control glucose levels or reduce insulin dosage. Samuel T Olatunbosun, MD, FACP, FACE Chief of Endocrinology Service, 60 Medical Group, uniform Services University of Health Sciences, F Edward Hebert School of Medicine Samuel T Olatunbosun, MD, FACP, FACE is a member of the following Medical societies: American Association of Clinical Endocrinologists, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, Endocrine Society Disclosure: Nothing to disclose. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: receive salary from Medscape for employment. For: Medscape. George T Griffing, MD, Professor Emeritus of Medicine, Louis University School of Medicine. George T Griffing, MD is a member of the following Medical societies: American Association for Advancement of Science, International Society for Clinical Densitometry, Southern Society for Clinical Investigation, American College of Medical Practice Executives, American Association for Physician Leadership, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical and Translational Research, Endocrine Society Disclosure: Nothing to disclose. David S Schade, MD Chief, Division of Endocrinology and Metabolism, Professor, Department of Internal Medicine, University of New Mexico School of Medicine and Health Sciences Center David S Schade, MD is a member of the following Medical societies: American College of Physicians, American Diabetes Association, American Federation for Medical Research, Endocrine Society, New Mexico Medical Society, New York Academy of Sciences, Society for Experimental Biology and Medicine Disclosure: Nothing to disclose.

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Surgical Treatment of Underlying Causes

Type 2 Diabetes is a chronic metabolic disorder that occurs when the body does not produce enough Insulin and / or cannot effectively use the Insulin it produce. This condition is referred to as Insulin Resistance. Left untreated, this resistance leads to raised blood glucose, or sugar, levels, which can adversely affect various organs and tissues, including the heart, kidneys and eyes. Type 2 Diabetes is a progressive disease, characterized by continuing deterioration of Insulin production over time. This leads to an increasing need for medication, while persistent or worsening glycemic control may increase the risk of developing Diabetes complications, such as heart attacks, stroke, kidney failure, eye disease and blindness. Type 2 Diabetes is also associated with various cardio-Metabolic disorders such as: obesity, High blood pressure, increased blood cholesterol and triglycerides Although exact underlying causes of Type 2 Diabetes are not yet fully understood, number of risk factors have been identify, including obesity, diet, lack of physical activity, increasing age, Insulin Resistance, family history of Diabetes and ethnicity.

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Other dietary evidence

Experimental evidence suggests that Metformin may be useful in some clinical conditions different from T2DM. Metformin offers a selective pathophysiological approach by its effect on IR. It has been shown in a number of studies that it improves clinical outcomes in type 2 diabetic patients via multiple biological effects: it has been show, also, to retain platelet antiaggregating effects, to reduce the rate of formation of advanced glycation end products and to decrease cellular oxidative reactions, thus demonstrating its vascular protective Effect. A number of studies have established the favorable effect of Metformin on body weight, IR, hyperinsulinemia, lipid parameters, arterial hypertension, fibrinolysis, and endothelial dysfunction. On this basis, Metformin appears to have a broad set of pharmacological properties, making the drug potentially applicable even in non-diabetic situations such as obesity, extreme insulin resistance with acanthosis nigricans, polycystic ovary syndrome and non-alcoholic fat Liver Disease. Metformin has been demonstrated in the Diabetes Prevention Program to have a role in preventing conversion of IGT to T2DM and to be a drug with multiple therapeutic effects far beyond its effect on lowering blood glucose in T2DM. After binding to its receptor and activating-subunit, insulin is faced with two divergent pathways: one is phosphatidylinositol 3-kinase dependent, while the other is dependent upon activation of mitogen-activate protein kinase. The former mediates most gluco-metabolic and anti-apoptotic effects; latter is linked to liposynthetic, proliferative and mitogenic effects. In obese patients, especially with T2DM, only PI 3-K, but not MAP-K, is resistant to insulin stimulation: hence IR is better defined as gluco-metabolic insulin resistance. Resulting compensatory hyperinsulinemia is an unsuccessful attempt to overcome inhibition of gluco-metabolic pathway at the price of unopposed stimulation of MAP-K pathway and administration of exogenous insulin might worsen metabolic dysfunction. As preferential activation of MAP-K pathway in insulin-resistant patients has atherogenic and mitogenic properties, this may lead to atherosclerosis and cancer. Metformin, in addition, may carry out direct protective action on human cells, inasmuch as it improves both primary and secondary endpoints through selective inhibition of fatty acyl oxidation. Many studies have demonstrated that Metformin is associated with weight reduction in adults and prevention or delay of T2DM onset, in those individuals who are at increased risk. However, consensus is lacking on intervention strategies aimed at reducing this risk, as reported in a recent paper which discusses rationale and evidence for use of Metformin in obese children and young people at high risk of T2DM. Available evidence indicates that, in the short term, administration of Metformin in addition to lifestyle modification is relatively effective in reducing BMI and hyperinsulinemia among obese adolescents, without related morbidity, and displays an acceptable safety pattern. Nevertheless, its long-term impact is unknown. In fact, Metformin appears to be moderately efficacious in reducing BMI and IR in hyperinsulinemic obese children and adolescents in the short term. Larger, long-term studies in different populations are needed to establish its role in treatment of overweight children.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

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Dietary fiber

You may think that receiving a diagnosis of insulin resistance or prediabetes is guarantee you will develop Type 2 Diabetes, but that's not the case. Insulin resistance and prediabetes are very responsive to lifestyle and dietary adjustments. Things like weight loss, improved nutrition, and regular exercise can help your blood glucose levels considerably. Insulin is a hormone created by the pancreas. Insulin resistance occurs when cells in your muscles, liver, and body fat begin to resist signal that insulin is sent out, alerting them to remove excess glucose from the bloodstream. These tissues depend upon insulin to stay properly nourish; they are limited in their ability to draw glucose from the bloodstream on their own. If all systems are working as they should, blood sugar stays in balance, and body muscles and tissues are well fed by excess glucose drawn from the bloodstream. Prediabetes occurs when glucose in the bloodstream is high, but not yet high enough to be classified as Diabetes. Insulin resistance, prediabetes, and Type 2 Diabetes can be manage, and in many cases reverse, by the right lifestyle changes. Medication may also be prescribe. Choose Whole Foods Diet. Try to eat complex carbohydrates. Eliminate refine and process starches, as well as industrially produced fats and processed foods, from your diet. Some good choices are vegetables, legumes, and whole grains. Complex Carbohydrates are more complex at molecular level, and take longer for the body to break down. This means they absorb more slowly, helping to keep blood glucose levels stable. Complex carbs will also help you feel fuller longer, and help with weight and appetite control. Aim to eat Whole Foods, plant-base diet whenever possible. Eliminate Sugary Drinks and Simple Carbohydrates. Simple sugars alone dont cause Diabetes, but they do contribute to insulin resistance and overall poor health. High fructose corn syrup is a particularly bad offender. Avoid Simple Carbohydrates that contain glucose, fructose, and sucrose, such as candies, cakes, soft drinks, and add sugars and sweeteners. Learn to read food labels. You'll discover that processed foods and sweets tend to be loaded with added sugars. Increase Fiber Intake. Research shows that eating insoluble fiber along with whole grains and complex carbohydrates reduces the risk OF Type 2 Diabetes. Aim to eat some insoluble fiber with each meal. Good sources include: Fresh fruits: pears, apples, prunes, dry figs Nuts and seeds Vegetables like leafy greens, squashes, peas Berries Whole grains: brown rice, quinoa, oats Beans: Lentils, navy beans, kidney Beans in addition to dietary changes, it is important to increase your activity and fitness level in order to manage and reverse insulin resistance and prediabetes. Choose physical activity you enjoy doing, and commit to at least three days per week. Moderate exercise is best, such as brisk 30-minute walk each day, yoga, or tai chi. Combine cardio exercise with strength training or weight-bearing exercise. Consider whether you prefer working out alone, with partner, or if you enjoy group sport.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions.

* Please keep in mind that all text is machine-generated, we do not bear any responsibility, and you should always get advice from professionals before taking any actions

Sources

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