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Which is more effective to treat Insulin Resistance: Diet & Exercise or Metformin? — 3 Comments

  1. I would definitely say diet and exercise. Diabetes management does not necessarily require metformin. There are a lot of people that can manage diabetes for a while after dietary and exercise counseling and there are a lot of people that are diet controlled diabetics. Exercise is one of the most important things for your body to control insulin resistance as well as reduce your risk of so many other things. Giving medication should be done secondary to diet and exercise management.

  2. Diet and exercise.
    The first line treatment of type 2 Diabetes is diet, weight control and exercise. You are only given medication if your blood sugar levels remain high despite lifestyle changes such as I have mentioned. Although there is a family tendency with type 2 diabetes, type 2 diabetes is generally associated with being overweight and mainly affects people aged >40. It occurs overtime, not not overnight.

    It was your question I answered the other day about PCOS wasn’t it? You are not taking Metformin at the moment for Type 2 Diabetes Prophylaxis. The reason you are taking Metform is because you have PCOS. Metformin is commonly given to people suffering from PCOS because women with PCOS are usually insulin resistant. This basically means that cells in your body are resistant to the effect of a normal level of insulin, so more insulin is produced to keep the blood sugar normal and it’s this raised level of insulin in the bloodstream that is thought to be the main underlying reason why PCOS develops.

    The raised level of insulin causes the ovaries to make too much testosterone. A high level of insulin and testosterone interfere with the normal development of follicles in the ovaries. As a result of this, many follicles tend to develop but often do not develop fully. This causes problems with ovulation; hence period problems and reduced fertility one often gets with PCOS.

    Metformin is a drug that is commonly used to treat people with type 2 diabetes. It makes the body’s cells more sensitive to insulin. This may result in a decrease in the blood level of insulin which may help to counteract the underlying cause of PCOS, this is why you have been prescribed it.

    Having PCOS does mean that you are at an increased risk of developing type 2 diabetes though. The best exercise you can do is aerobic exercise or basically anything that works the large groups of muscles such as your legs, arms and shoulders etc. In answer to your question; The best thing you can do right now to prevent diabetes later down the line is staying as close to your ideal weight as possible and exercise.

  3. Thank you for the question.

    No, diabetes management does not necessarily require metformin; however, the vast majority of patients who are obese and severely insulin resistant and refuse to exercise do require it.

    The answer to your question is diet & exercise. And I MEAN . . . REGULAR . . . SUSTAINED . . . AEROBIC . . . exercise!!! This is a proven treatment for pre-diabetes in those patients who are both willing and able to do so.

    Conversely, those obese pre-diabetics who cannot are destined for metformin.

    A caveat: some patient may have only modest success in partially reversing insulin resistance, and they may need to be treated with metformin nonetheless. Every patient is different, and treatment must be individualized.

    Recently, one of my patients who I had successfully treated with metformin for nine months had started an AGGRESSIVE aerobics exercise regimen. She ended up losing 42 pounds — more weight than she had lost prior to having been on metformin treatment. All of her indices for pre-diabetes and insulin resistance (i.e, 2-hour glucose, fasting insulin level) completely normalized. She has been the ONLY patient whom I’ve recommended discontinuing metformin treatment (temporarily) after the fact and to continue with diet/aerobic exercise alone for pre-diabetes management. Obviously, this anecdotal case is the extreme exception to the rule, but it can be accomplished.

    I think your diet & exercise regimen is excellent. I cannot say with certainty whether your low-dose metformin (250 mg daily) will be of benefit (the lowest dose of metformin that I’ve used to clincial benefit has been 500 mg daily), but you and your doctor will be the ultimate judge.

    Good luck!!!!

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