Nutritional guidelines for the management of insulin resistance

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.

Automated summary

Obesity and its related comorbidities, such as type 2 diabetes, are significant global public health issues. Insulin resistance in muscle and liver is the underlying pathophysiologic defect leading to obesity and predicting the onset of type 2 diabetes. Despite the well-recognized role of insulin resistance in metabolic diseases, there are currently no specific nutritional recommendations for managing this condition. An international panel of experts reviewed the literature on this topic and aimed to provide nutritional advice for managing insulin resistance, hyperinsulinemia, and reactive hypoglycemia to prevent the progression or worsening of insulin resistance and, ultimately, type 2 diabetes.