Editing Insulin resistance (section)

==Prevention and management==
Maintaining a healthy body weight and engaging in regular physical activity can help mitigate the risk of developing insulin resistance.<ref name=":4" />

The primary treatment for insulin resistance is [[exercise]] and [[weight loss]].<ref>{{cite journal | vauthors = Davidson LE, Hudson R, Kilpatrick K | title = Effects of Exercise Modality on Insulin Resistance and Functional Limitation in Older Adults | journal = Archives of Internal Medicine | publisher = JAMA | date=Jan 2009 | volume = 169 | issue = 2 | pages = 122–131 | url = https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/414732 | doi=10.1001/archinternmed.2008.558 | pmid = 19171808 | access-date = 17 Sep 2020 | doi-access = }}</ref> Both [[metformin]] and [[thiazolidinedione]]s improve insulin sensitivity. Metformin is approved for prediabetes and type 2 diabetes and has become one of the more commonly prescribed medications for insulin resistance.<ref>{{cite journal | vauthors = Giannarelli R, Aragona M, Coppelli A, Del Prato S | title = Reducing insulin resistance with metformin: the evidence today | journal = Diabetes & Metabolism | volume = 29 | issue = 4 Pt 2 | pages = 6S28–35 | date = September 2003 | pmid = 14502098 | doi = 10.1016/s1262-3636(03)72785-2 }}</ref>

The ''Diabetes Prevention Program'' (DPP) showed that exercise and diet were nearly twice as effective as [[metformin]] at reducing the risk of progressing to type 2 diabetes.<ref name="Knowler_2002">{{cite journal | vauthors = Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM | title = Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin | journal = The New England Journal of Medicine | volume = 346 | issue = 6 | pages = 393–403 | date = February 2002 | pmid = 11832527 | pmc = 1370926 | doi = 10.1056/NEJMoa012512 }}</ref> However, the participants in the DPP trial regained about 40% of the weight that they had lost at the end of 2.8 years, resulting in a similar incidence of diabetes development in both the lifestyle intervention and the control arms of the trial.<ref>{{cite journal | vauthors = Kahn R | title = Reducing the impact of diabetes: is prevention feasible today, or should we aim for better treatment? | journal = Health Affairs | volume = 31 | issue = 1 | pages = 76–83 | date = January 2012 | pmid = 22232097 | doi = 10.1377/hlthaff.2011.1075 | doi-access = }}</ref> In epidemiological studies, higher levels of physical activity (more than 90 minutes per day) reduce the risk of diabetes by 28%.<ref name="BMJ2016">{{cite journal|vauthors=Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJ, Forouzanfar MH|date=August 2016|title=Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013|journal=BMJ|volume=354|pages=i3857|doi=10.1136/bmj.i3857|pmc=4979358|pmid=27510511}}</ref>

Furthermore, physical training has also generally been seen to be an effective antagonist of insulin resistance in obese or overweight children and adolescents (under the age of 19).<ref name="Marson 211–218"/> As per the 2016 systematic review and meta-analysis conducted by Marson et al., aerobic exercise is associated with fasting insulin reduction; however, resistance and combined exercise are not.<ref name="Marson 211–218">{{cite journal | vauthors = Marson EC, Delevatti RS, Prado AK, Netto N, Kruel LF | title = Effects of aerobic, resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis | journal = Prev Med | volume = 93 | issue = | pages = 211–218 | date = December 2016 | pmid = 27773709 | doi = 10.1016/j.ypmed.2016.10.020 }}</ref> The authors caution against demeaning the importance of resistance and combined exercise, as this type of training is generally less researched than aerobic training.<ref name="Marson 211–218"/> Overall, physical training can be used in both adolescents and adults to prevent the progression of insulin resistance and future possible metabolic and cardiovascular disease.

[[Resistant starch]] from high-amylose corn, [[amylomaize]], has been shown to reduce insulin resistance in healthy individuals, in individuals with insulin resistance, and in individuals with type 2 diabetes.<ref>{{cite journal | vauthors = Keenan MJ, Zhou J, Hegsted M, Pelkman C, Durham HA, Coulon DB, Martin RJ | title = Role of resistant starch in improving gut health, adiposity, and insulin resistance | journal = Advances in Nutrition | volume = 6 | issue = 2 | pages = 198–205 | date = March 2015 | pmid = 25770258 | pmc = 4352178 | doi = 10.3945/an.114.007419 }}</ref>

Some types of [[Polyunsaturated fat|polyunsaturated fatty acids]] ([[omega-3]]) may moderate the progression of insulin resistance into type 2 diabetes,<ref name=Lovejoy_2002>{{cite journal | vauthors = Lovejoy JC | title = The influence of dietary fat on insulin resistance | journal = Current Diabetes Reports | volume = 2 | issue = 5 | pages = 435–40 | date = October 2002 | pmid = 12643169 | doi = 10.1007/s11892-002-0098-y | s2cid = 31329463 }}
</ref><ref name = Fukuchi_2004>
{{cite journal | vauthors = Fukuchi S, Hamaguchi K, Seike M, Himeno K, Sakata T, Yoshimatsu H | title = Role of fatty acid composition in the development of metabolic disorders in sucrose-induced obese rats | journal = Experimental Biology and Medicine | volume = 229 | issue = 6 | pages = 486–93 | date = June 2004 | pmid = 15169967 | doi = 10.1177/153537020422900606 | s2cid = 20966659 }}
</ref><ref name = Storlien_1996>
{{cite journal | vauthors = Storlien LH, Baur LA, Kriketos AD, Pan DA, Cooney GJ, Jenkins AB, Calvert GD, Campbell LV | display-authors = 6 | title = Dietary fats and insulin action | journal = Diabetologia | volume = 39 | issue = 6 | pages = 621–31 | date = June 1996 | pmid = 8781757 | doi = 10.1007/BF00418533 | s2cid = 33171616 }}
</ref> however, omega-3 fatty acids appear to have limited ability to reverse insulin resistance, and they cease to be efficacious once type 2 diabetes is established.<ref>
{{cite journal | vauthors = Delarue J, LeFoll C, Corporeau C, Lucas D | title = N-3 long chain polyunsaturated fatty acids: a nutritional tool to prevent insulin resistance associated to type 2 diabetes and obesity? | journal = Reproduction, Nutrition, Development | volume = 44 | issue = 3 | pages = 289–99 | year = 2004 | pmid = 15460168 | doi = 10.1051/rnd:2004033 | doi-access = free }}
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