Insulin Resistance

Last Updated: April 26, 2023

Insulin resistance is a condition where many of the body's tissues don't respond well to insulin. This means the pancreas has to to pump out more insulin to get the same effect.

Summary

Insulin resistance is an important issue in public health due to its increasing prevalence[1] among nondiabetic adults and because it often precedes the development of metabolic diseases like type 2 diabetes, which, once present, increases the risk for other diseases, including cancers[2]. Insulin resistance is thought to have an inflammatory component[3].

There are lots of ways[4] to measure insulin resistance. The gold standard is the euglycemic hyperinsulinemic clamp. In this technique, insulin is infused into a vein to reach a constant level in the blood. Since insulin is being pumped into the blood, the person has artificially high insulin, or hyperinsulinemia. Simultaneously, glucose is also infused at a varying rate until the blood glucose level stabilizes at a normal level. When a person’s blood glucose is normal, this is called eugylcemia (the Greek root “eu-” means “good”). At this point, the rate of glucose infusion exactly equals the amount being taken up by the body’s tissues, which is a direct measure of insulin sensitivity. The more glucose that has to be infused to keep euglycemic, the more’s being taken up, meaning the tissue is more sensitive to insulin.

The problem with this technique is it takes a couple of hours and is relatively expensive. Thus, estimates of insulin resistance that are cheaper and easier to measured have been developed. Two major ones are HOMA-IR and QUICKI. Both just require a single blood draw where fasting glucose and C-peptide (a byproduct of insulin synthesis) are measured. These values are then plugged into an equation that estimates insulin sensitivity. However, these estimations aren’t perfect.

Examine Database: Insulin Resistance
What works and what doesn't?

Unlock the full potential of Examine

Get started

Don't miss out on the latest research

References
  1. ^Li C, Ford ES, McGuire LC, Mokdad AH, Little RR, Reaven GMTrends in hyperinsulinemia among nondiabetic adults in the U.SDiabetes Care.(2006 Nov)
  2. ^Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA, Pollak M, Regensteiner JG, Yee DDiabetes and cancer: a consensus reportDiabetes Care.(2010 Jul)
  3. ^Dali-Youcef N, Mecili M, Ricci R, Andrès EMetabolic inflammation: connecting obesity and insulin resistanceAnn Med.(2013 May)
  4. ^Gutch M, Kumar S, Razi SM, Gupta KK, Gupta AAssessment of insulin sensitivity/resistanceIndian J Endocrinol Metab.(2015 Jan-Feb)
Examine Database References
  1. 16:8 Intermittent Fasting - Kelsey Gabel, Kristin K Hoddy, Nicole Haggerty, Jeehee Song, Cynthia M Kroeger, John F Trepanowski, Satchidananda Panda, Krista A VaradyEffects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot studyNutr Healthy Aging.(2018 Jun 15)
  2. Saffron - Armaghan Moravej Aleali, Reza Amani, Hajieh Shahbazian, Frough Namjooyan, Seyed Mahmoud Latifi, Bahman CheraghianThe effect of hydroalcoholic Saffron (Crocus sativus L.) extract on fasting plasma glucose, HbA1c, lipid profile, liver, and renal function tests in patients with type 2 diabetes mellitus: A randomized double-blind clinical trialPhytother Res.(2019 Jun)
  3. OMAD And 20:4 Intermittent Fasting - Carlson O, Martin B, Stote KS, Golden E, Maudsley S, Najjar SS, Ferrucci L, Ingram DK, Longo DL, Rumpler WV, Baer DJ, Egan J, Mattson MPImpact of reduced meal frequency without caloric restriction on glucose regulation in healthy, normal-weight middle-aged men and womenMetabolism.(2007 Dec)
  4. Vitamin D - Abolfazl Mehdizadehkashi, Samaneh Rokhgireh, Kobra Tahermanesh, Neda Eslahi, Sara Minaeian, Mansooreh SamimiThe effect of vitamin D supplementation on clinical symptoms and metabolic profiles in patients with endometriosisGynecol Endocrinol.(2021 Jan 29)
  5. Saffron - Mostafa Asadollahi, Parisa Nikdokht, Boshra Hatef, Seyed Shahabeddin Sadr, Hedayat Sahraei, Farhad Assarzadegan, Gila Pirzad JahromiProtective properties of the aqueous extract of saffron (Crocus sativus L.) in ischemic stroke, randomized clinical trialJ Ethnopharmacol.(2019 Jun 28)
  6. Saffron - Fatemeh Ebrahimi, Amirhossein Sahebkar, Naheed Aryaeian, Naseh Pahlavani, Soudabeh Fallah, Nariman Moradi, Davoud Abbasi, Agha Fatemeh HosseiniEffects Of Saffron Supplementation On Inflammation And Metabolic Responses In Type 2 Diabetic Patients: A Randomized, Double-Blind, Placebo-Controlled TrialDiabetes Metab Syndr Obes.(2019 Oct 14)
  7. Vitamin D - Elisabeth Lerchbaum, Christian Trummer, Verena Theiler-Schwetz, Martina Kollmann, Monika Wölfler, Annemieke C Heijboer, Stefan Pilz, Barbara Obermayer-PietschEffects of vitamin D supplementation on androgens in men with low testosterone levels: a randomized controlled trialEur J Nutr.(2019 Dec)
  8. Spirulina - Szulinska M, Gibas-Dorna M, Miller-Kasprzak E, Suliburska J, Miczke A, Walczak-Gałezewska M, Stelmach-Mardas M, Walkowiak J, Bogdanski PSpirulina maxima improves insulin sensitivity, lipid profile, and total antioxidant status in obese patients with well-treated hypertension: a randomized double-blind placebo-controlled studyEur Rev Med Pharmacol Sci.(2017 May)
  9. OMAD And 20:4 Intermittent Fasting - Sutton EF, Beyl R, Early KS, Cefalu WT, Ravussin E, Peterson CMEarly Time-Restricted Feeding Improves Insulin Sensitivity, Blood Pressure, and Oxidative Stress Even without Weight Loss in Men with PrediabetesCell Metab.(2018 Jun 5)
  10. Paleolithic Diet - Mohammad Hassan Sohouli, Somaye Fatahi, Abolfazl Lari, Mojtaba Lotfi, Maryam Seifishahpar, Mihnea-Alexandru Găman, Seyedeh Tayebeh Rahideh, Saud K AlBatati, Abdullah M AlHossan, Sara A Alkhalifa, Sara A Alomar, Ahmed Abu-ZaidThe effect of paleolithic diet on glucose metabolism and lipid profile among patients with metabolic disorders: a systematic review and meta-analysis of randomized controlled trialsCrit Rev Food Sci Nutr.(2021 Jan 25)
  11. Spirulina - Elias E Mazokopakis, Maria G Papadomanolaki, Andreas A Fousteris, Dimitrios A Kotsiris, Ioannis M Lampadakis, Emmanuel S GanotakisThe hepatoprotective and hypolipidemic effects of Spirulina ( Arthrospira platensis) supplementation in a Cretan population with non-alcoholic fatty liver disease: a prospective pilot studyAnn Gastroenterol.(2014)
  12. Paleolithic Diet - Małgorzata Jamka, Bartosz Kulczyński, Agata Juruć, Anna Gramza-Michałowska, Caroline S Stokes, Jarosław WalkowiakThe Effect of the Paleolithic Diet vs. Healthy Diets on Glucose and Insulin Homeostasis: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsJ Clin Med.(2020 Jan 21)
  13. OMAD And 20:4 Intermittent Fasting - B D Horne, J B Muhlestein, D L Lappé, H T May, J F Carlquist, O Galenko, K D Brunisholz, J L AndersonRandomized cross-over trial of short-term water-only fasting: metabolic and cardiovascular consequencesNutr Metab Cardiovasc Dis.(2013 Nov)
  14. Paleolithic Diet - Barbara Frączek, Aleksandra Pięta, Adrian Burda, Paulina Mazur-Kurach, Florentyna TyrałaPaleolithic Diet-Effect on the Health Status and Performance of Athletes?Nutrients.(2021 Mar 21)
  15. Magnesium - Nicola Veronese, Ligia J Dominguez, Damiano Pizzol, Jacopo Demurtas, Lee Smith, Mario BarbagalloOral Magnesium Supplementation for Treating Glucose Metabolism Parameters in People with or at Risk of Diabetes: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled TrialsNutrients.(2021 Nov 15)
  16. Magnesium - Guerrero-Romero F, Tamez-Perez HE, González-González G, Salinas-Martínez AM, Montes-Villarreal J, Treviño-Ortiz JH, Rodríguez-Morán MOral magnesium supplementation improves insulin sensitivity in non-diabetic subjects with insulin resistance. A double-blind placebo-controlled randomized trial.Diabetes Metab.(2004-Jun)
  17. Magnesium - Farsinejad-Marj M, Azadbakht L, Mardanian F, Saneei P, Esmaillzadeh AClinical and Metabolic Responses to Magnesium Supplementation in Women with Polycystic Ovary Syndrome.Biol Trace Elem Res.(2020-Aug)
  18. Magnesium - Mohammad Alizadeh, Majid Karandish, Mohammad Asghari Jafarabadi, Lida Heidari, Roshan Nikbakht, Hossein Babaahmadi Rezaei, Reihaneh MousaviMetabolic and hormonal effects of melatonin and/or magnesium supplementation in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trialNutr Metab (Lond).(2021 Jun 6)
  19. Magnesium - Salehidoost R, Taghipour Boroujeni G, Feizi A, Aminorroaya A, Amini MEffect of oral magnesium supplement on cardiometabolic markers in people with prediabetes: a double blind randomized controlled clinical trial.Sci Rep.(2022-Oct-28)
  20. Magnesium - Norouzi M, Rezvankhah B, Haeri MR, Heydari H, Tafaroji J, Shafigh N, Avval JO, Dahmardeh AR, Masoumzadeh N, Gharehbeglou MMagnesium supplementation and insulin resistance in patients with rheumatoid arthritis.Eur J Transl Myol.(2022-Jul-05)
  21. Magnesium - Qu Q, Rong R, Yu JEffect of magnesium supplementation on pregnancy outcome in gestational diabetes mellitus patients: A meta-analysis of randomized controlled trials.Food Sci Nutr.(2022-Oct)
  22. Magnesium - Xiaoqing Tan, Yi HuangMagnesium supplementation for glycemic status in women with gestational diabetes: a systematic review and meta-analysisGynecol Endocrinol.(2021 Dec 15)
  23. Magnesium - Asbaghi O, Moradi S, Kashkooli S, Zobeiri M, Nezamoleslami S, Hojjati Kermani MA, Lazaridi AV, Miraghajani MThe effects of oral magnesium supplementation on glycaemic control in patients with type 2 diabetes: a systematic review and dose-response meta-analysis of controlled clinical trials.Br J Nutr.(2022-Dec-28)
  24. Zinc - Ghaedi K, Ghasempour D, Jowshan M, Zheng M, Ghobadi S, Jafari AEffect of zinc supplementation in the management of type 2 diabetes: A grading of recommendations assessment, development, and evaluation-assessed, dose-response meta-analysis of randomized controlled trials.Crit Rev Food Sci Nutr.(2023-May-15)
  25. Zinc - Laura M Pompano, Erick BoyEffects of Dose and Duration of Zinc Interventions on Risk Factors for Type 2 Diabetes and Cardiovascular Disease: A Systematic Review and Meta-AnalysisAdv Nutr.(2020 Jul 28)
  26. Nicotinamide Mononucleotide - Yi L, Maier AB, Tao R, Lin Z, Vaidya A, Pendse S, Thasma S, Andhalkar N, Avhad G, Kumbhar VThe efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial.Geroscience.(2023-Feb)
  27. Creatine - Delpino FM, Figueiredo LMDoes creatine supplementation improve glycemic control and insulin resistance in healthy and diabetic patients? A systematic review and meta-analysis.Clin Nutr ESPEN.(2022-Feb)
  28. Berberine - Jing Guo, Hongdong Chen, Xueqin Zhang, Wenjiao Lou, Pingna Zhang, Yuheng Qiu, Chao Zhang, Yaoxian Wang, Wei Jing LiuThe Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsOxid Med Cell Longev.(2021 Dec 15)
  29. Berberine - Ye Y, Liu X, Wu N, Han Y, Wang J, Yu Y, Chen QEfficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.Front Pharmacol.(2021)
  30. Berberine - Zamani M, Zarei M, Nikbaf-Shandiz M, Hosseini S, Shiraseb F, Asbaghi OThe effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis.Front Nutr.(2022)
  31. Nicotinamide Mononucleotide - Huang HA Multicentre, Randomised, Double Blind, Parallel Design, Placebo Controlled Study to Evaluate the Efficacy and Safety of Uthever (NMN Supplement), an Orally Administered Supplementation in Middle Aged and Older Adults.Front Aging.(2022)
  32. Nicotinamide Mononucleotide - Mihoko Yoshino, Jun Yoshino, Brandon D Kayser, Gary J Patti, Michael P Franczyk, Kathryn F Mills, Miriam Sindelar, Terri Pietka, Bruce W Patterson, Shin-Ichiro Imai, Samuel KleinNicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic womenScience.(2021 Jun 11)
  33. Inositol - Miñambres I, Cuixart G, Gonçalves A, Corcoy REffects of inositol on glucose homeostasis: Systematic review and meta-analysis of randomized controlled trialsClin Nutr.(2019 Jun)
  34. Vitamin D - Rajakumar K, Moore CG, Khalid AT, Vallejo AN, Virji MA, Holick MF, Greenspan SL, Arslanian S, Reis SEEffect of vitamin D3 supplementation on vascular and metabolic health of vitamin D-deficient overweight and obese children: a randomized clinical trial.Am J Clin Nutr.(2020-Apr-01)
  35. Vitamin D - Wallace HJ, Holmes L, Ennis CN, Cardwell CR, Woodside JV, Young IS, Bell PM, Hunter SJ, McKinley MCEffect of vitamin D3 supplementation on insulin resistance and β-cell function in prediabetes: a double-blind, randomized, placebo-controlled trial.Am J Clin Nutr.(2019-Nov-01)
  36. Chromium - Tang XL, Sun Z, Gong LChromium supplementation in women with polycystic ovary syndrome: Systematic review and meta-analysisJ Obstet Gynaecol Res.(2018 Jan)
  37. Chromium - Omid Asbaghi, Naeini Fatemeh, Rezaei Kelishadi Mahnaz, Ghaedi Ehsan, Eslampour Elham, Nazarian Behzad, Ashtary-Larky Damoon, Alavi Naeini AmirmansourEffects of chromium supplementation on glycemic control in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trialsPharmacol Res.(2020 Jul 28)
  38. Beta-Alanine - Joseph J Matthews, Eimear Dolan, Paul A Swinton, Lívia Santos, Guilherme G Artioli, Mark D Turner, Kirsty J Elliott-Sale, Craig SaleEffect of Carnosine or β-Alanine Supplementation on Markers of Glycemic Control and Insulin Resistance in Humans and Animals: A Systematic Review and Meta-analysisAdv Nutr.(2021 Jul 31)
  39. L-Carnitine - Zamani M, Pahlavani N, Nikbaf-Shandiz M, Rasaei N, Ghaffarian-Ensaf R, Asbaghi O, Shiraseb F, Rastgoo SThe effects of L-carnitine supplementation on glycemic markers in adults: A systematic review and dose-response meta-analysis.Front Nutr.(2022)
  40. L-Carnitine - Gong Y, Jiang T, He H, Wang Y, Wu GL, Shi Y, Cai Q, Xiong CL, Shen R, Li JEffects of carnitine on glucose and lipid metabolic profiles and fertility outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis.Clin Endocrinol (Oxf).(2023-May)
  41. Hesperidin - Shams-Rad S, Mohammadi M, Ramezani-Jolfaie N, Zarei S, Mohsenpour M, Salehi-Abargouei AHesperidin supplementation has no effect on blood glucose control: A systematic review and meta-analysis of randomized controlled clinical trials.Br J Clin Pharmacol.(2020-Jan)
  42. Whey Protein - Amirani E, Milajerdi A, Reiner Ž, Mirzaei H, Mansournia MA, Asemi ZEffects of whey protein on glycemic control and serum lipoproteins in patients with metabolic syndrome and related conditions: a systematic review and meta-analysis of randomized controlled clinical trials.Lipids Health Dis.(2020-Sep-21)
  43. Resistant Starch - Xiong K, Wang J, Kang T, Xu F, Ma AEffects of resistant starch on glycaemic control: a systematic review and meta-analysis.Br J Nutr.(2021-Jun-14)
  44. Inulin - Wang L, Yang H, Huang H, Zhang C, Zuo HX, Xu P, Niu YM, Wu SSInulin-type fructans supplementation improves glycemic control for the prediabetes and type 2 diabetes populations: results from a GRADE-assessed systematic review and dose-response meta-analysis of 33 randomized controlled trials.J Transl Med.(2019-Dec-05)
  45. Inulin - Rao M, Gao C, Xu L, Jiang L, Zhu J, Chen G, Law BYK, Xu YEffect of Inulin-Type Carbohydrates on Insulin Resistance in Patients with Type 2 Diabetes and Obesity: A Systematic Review and Meta-Analysis.J Diabetes Res.(2019)
  46. L-Carnitine - Li Y, Xie Y, Qiu C, Yu B, Yang F, Cheng Y, Zhong W, Yuan JEffects of L-carnitine supplementation on glucolipid metabolism: a systematic review and meta-analysis.Food Funct.(2023-Mar-06)
  47. Fish Oil - Hou M, Zhou W, Sun L, Wang B, Shen J, Cao L, Lv HEffect of Fish Oil on Insulin Sensitivity in Children: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials.Can J Diabetes.(2021-Aug)
  48. Fish Oil - Zhou J, Zuo W, Tan Y, Wang X, Zhu M, Zhang HEffects of n-3 polyunsaturated fatty acid on metabolic status in women with polycystic ovary syndrome: a meta-analysis of randomized controlled trials.J Ovarian Res.(2023-Mar-17)
  49. Alpha-Linolenic Acid (ALA) - Brown TJ, Brainard J, Song F, Wang X, Abdelhamid A, Hooper L, Omega-3, omega-6, and total dietary polyunsaturated fat for prevention and treatment of type 2 diabetes mellitus: systematic review and meta-analysis of randomised controlled trials.BMJ.(2019-Aug-21)
  50. Mediterranean Diet - Takumi Kawaguchi, Michael Charlton, Atsushi Kawaguchi, Sakura Yamamura, Dan Nakano, Tsubasa Tsutsumi, Maryam Zafer, Takuji TorimuraEffects of Mediterranean Diet in Patients with Nonalcoholic Fatty Liver Disease: A Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Randomized Controlled TrialsSemin Liver Dis.(2021 Aug)
  51. Mediterranean Diet - Maryam Ghadimi, Reihaneh Mohammadi, Elnaz Daneshzad, Bobak Moazzami, Zinat MohammadpourEffectiveness of dietary interventions on cardio-metabolic risk factors in patients with nonalcoholic fatty liver disease: a systematic review and meta-analysis of randomized controlled trialsAnn Gastroenterol.(2021)
  52. Mediterranean Diet - Kastorini, C.M., et al.The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individualsJ Am Coll Cardiol.(2011-03-15)
  53. Mediterranean Diet - Asbaghi O, Choghakhori R, Ashtary-Larky D, Abbasnezhad AEffects of the Mediterranean diet on cardiovascular risk factors in non-alcoholic fatty liver disease patients: A systematic review and meta-analysis.Clin Nutr ESPEN.(2020-Jun)
  54. Mediterranean Diet - Veera Houttu, Susanne Csader, Max Nieuwdorp, Adriaan G Holleboom, Ursula SchwabDietary Interventions in Patients With Non-alcoholic Fatty Liver Disease: A Systematic Review and Meta-AnalysisFront Nutr.(2021 Jul 22)
  55. Mediterranean Diet - Liu L, Zhou Y, He LMediterranean diet for the prevention of gestational diabetes: a meta-analysis of randomized controlled trials.J Matern Fetal Neonatal Med.(2022-Dec)
  56. Energy Drinks - Shearer J, Graham TEPerformance effects and metabolic consequences of caffeine and caffeinated energy drink consumption on glucose disposalNutr Rev.(2014 Oct)
  57. Red Yeast Rice - Yuan R, Yuan Y, Wang L, Xin Q, Wang Y, Shi W, Miao Y, Leng SX, Chen K, Cong W, Red Yeast Rice Preparations Reduce Mortality, Major Cardiovascular Adverse Events, and Risk Factors for Metabolic Syndrome: A Systematic Review and Meta-analysis.Front Pharmacol.(2022)
  58. DHEA - Wang X, Feng H, Fan D, Zou G, Han Y, Liu LThe influence of dehydroepiandrosterone (DHEA) on fasting plasma glucose, insulin levels and insulin resistance (HOMA-IR) index: A systematic review and dose response meta-analysis of randomized controlled trials.Complement Ther Med.(2020-Dec)
  59. Folic Acid (Vitamin B9) - Asbaghi O, Ashtary-Larky D, Bagheri R, Moosavian SP, Olyaei HP, Nazarian B, Rezaei Kelishadi M, Wong A, Candow DG, Dutheil F, Suzuki K, Alavi Naeini AFolic Acid Supplementation Improves Glycemic Control for Diabetes Prevention and Management: A Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials.Nutrients.(2021-Jul-09)
  60. Coenzyme Q10 - Tianqing Zhang, Qi He, Hao Xiu, ZiZhu Zhang, Yao Liu, Zhenrong Chen, Hengjing HuEfficacy and Safety of Coenzyme Q10 Supplementation in the Treatment of Polycystic Ovary Syndrome: a Systematic Review and Meta-analysisReprod Sci.(2022 Aug 8)
  61. Coenzyme Q10 - Bakhshayeshkaram M, Lankarani KB, Mirhosseini N, Tabrizi R, Akbari M, Dabbaghmanesh MH, Asemi ZThe Effects of Coenzyme Q10 Supplementation on Metabolic Profiles of Patients with Chronic Kidney Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.Curr Pharm Des.(2018)
  62. Coenzyme Q10 - Shi-Ying Zhang, Kai-Lin Yang, Liu-Ting Zeng, Xiao-He Wu, Hui-Yong HuangEffectiveness of Coenzyme Q10 Supplementation for Type 2 Diabetes Mellitus: A Systematic Review and Meta-AnalysisInt J Endocrinol.(2018 Sep 16)
  63. Coenzyme Q10 - Liang Y, Zhao D, Ji Q, Liu M, Dai S, Hou S, Liu Z, Mao Y, Tian Z, Yang YEffects of coenzyme Q10 supplementation on glycemic control: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials.EClinicalMedicine.(2022-Oct)