If you have diabetes or are at risk of developing it, your insulin sensitivity will play a huge part in your health. Improved insulin sensitivity allows your body to respond more efficiently to insulin, the hormone that regulates your blood sugar, leading to better long-term health and easier diabetes management. Age and genetics play a role in how the body responds to insulin, but it is possible to combat insulin resistance with lifestyle tweaks and medications.
Insulin sensitivity refers to how responsive the body is to the effects of insulin. Insulin is a hormone secreted by the pancreas that helps our muscle, fat, and other body parts convert carbohydrates into energy.
“Insulin helps move sugar from the bloodstream into the cells,” says Jacob Kohlenberg, MD, an assistant professor of medicine at the University of Minnesota Medical School in Minneapolis. “A person who is insulin sensitive will require less insulin to move sugar from the bloodstream into their cells than somebody who has impaired insulin sensitivity, which is also known as insulin resistance.”
Insulin resistance is a root cause of prediabetes and type 2 diabetes, and it can happen in those with any type of diabetes. Complications of insulin resistance include:
Healthy lifestyle changes, as well as medications, can prevent or reverse insulin resistance. If you can boost your insulin sensitivity, your blood sugar will become steadier and easier to manage, slowing the progression of diabetes and improving your long-term health.
Slimming down is one of the most important health changes you can make for diabetes management. Excess weight is a significant risk factor for type 2 diabetes and can worsen insulin resistance, but weight loss, even in modest amounts, can combat that.
“Decreased insulin sensitivity is tightly linked with overweight and obesity,” says Joshua J. Neumiller, PharmD, CDCES, the president of healthcare and education at the American Diabetes Association. “For this reason, achieving and maintaining weight management goals is a cornerstone of type 2 diabetes management.”
Health authorities recommend that people with prediabetes lose about 7 to 10 percent of their body weight to decrease their risk of diabetes.
If you already have diabetes, working with your healthcare provider to come up with a weight loss plan can help you drop extra weight successfully and get your diabetes symptoms under better control. Weight loss can also help make type 1 diabetes management easier.
“Weight loss recommendations should be personalized to fit your lifestyle, likes, and dislikes,” says Deena Adimoolam-Gupta, MD, an endocrinologist and diabetes specialist in New York City. “If you have prediabetes or type 2 diabetes due to insulin resistance, dietary changes such as limiting simple sugars and carbohydrates will help with weight loss and blood sugar control.”
Moving around on the regular is good for our entire bodies, including our blood sugar levels. Research shows that cardiovascular exercise helps muscle cells increase the amount of sugar they take in, and muscle cells become more responsive to insulin afterward.
Strength training also has a positive effect on insulin sensitivity, relatively quickly. One study found that people who did one set of nine exercises three times a week for six weeks boosted insulin sensitivity and built more muscle mass.
Exercise can also combat obesity, which is a significant factor in the development of insulin resistance. Both moderate intensity cardiovascular exercise and high-intensity interval training can help insulin work more effectively and lower body weight, but when study participants abstained from exercise for four days, insulin sensitivity returned to pre-training levels.
If you live a mostly sedentary life, it’s a good idea to ease into exercise slowly and not overdo it. Even light exercise, such as walking or doing chores, offers blood sugar levels and other substantial health benefits.
“It’s important, especially for people who may have chronic health conditions, to talk to their healthcare providers before starting an exercise program to make sure that it's safe for them,” says Dr. Kohlenberg.
A nutritious diet is a critical part of diabetes management. Not only can smart dietary choices contribute to weight loss, they also fight insulin resistance. Dr. Adimoolam-Gupta says increased protein intake and fewer refined and added sugars all help promote better insulin sensitivity.
Evidence suggests that diets high in fiber, particularly the soluble type, can slow down the absorption of glucose into the bloodstream.Soluble fiber can be found in oats, beans, lentils, peas, and some fruits like apples and bananas. But consuming more whole grains in general can help your body use insulin more effectively to lower blood sugar.
Plant-based diets, either vegetarian or vegan, can also promote better insulin sensitivity. They tend to be lower in calories, which aids weight loss, and they are lower in saturated fat and cholesterol, both of which are associated with insulin resistance. The Mediterranean diet may improve your metabolism by improving the health of the microbiome and fighting inflammation.
Ultimately, people with diabetes who have insulin resistance will need to experiment with different dietary plans and strategies to find the combination of foods that works best for them.
“There is no one specific diet for all people with reduced insulin sensitivity,” says Dr. Neumiller. “But eating patterns should emphasize nonstarchy vegetables, whole fruits, lean proteins, whole grains, nuts and seeds, and low-fat dairy or nondairy alternatives. Consumption of red meat, sugar-sweetened beverages (such as soda), and refined or processed foods should be minimized and eaten in moderation.”
Not getting enough quality shut-eye also has been associated with decreased insulin sensitivity. The reason for the connection is still unclear, but it’s likely due to inflammation and disruptions to the body’s circadian rhythms. Poor or inadequate sleep causes hormonal changes that affect metabolism. In men, the association could also be related to abnormalities in cortisol and testosterone.
Sleep apnea may have a similar effect, and one study found its effects were even worse if a person with that condition slept fewer than five hours a night. Inflammation is one possible explanation, as is a change in the body’s response to stress.
“Insufficient and poor-quality sleep has been linked to reduced insulin sensitivity,” says Neumiller. “Getting seven to eight hours of quality sleep (uninterrupted, consistent) can help improve insulin sensitivity, blood glucose levels, and even blood pressure.”
If you struggle to fall or stay asleep, Kohlenberg says to set a regular sleep and wake schedule, be mindful of the timing of caffeine intake, keep your bedroom dark and quiet, and avoid screen time before bed. If those adjustments don’t help, you may want to consider cognitive behavioral therapy or sleep medications.
“For some people with sleep issues, medication may be beneficial,” says Kohlenberg. “Definitely consult with your healthcare provider if that's something that you're considering.”
The struggle to manage diabetes can lead to an enhanced risk of mental health issues like anxiety and depression, and those conditions can make it more challenging for people to properly manage their condition, upping the odds of developing insulin resistance. One review of 70 studies with more than 240,000 participants found that people with acute depression were more likely to have insulin resistance.
Stress is a big concern among those with chronic disease, and it also has an unhealthy impact on your blood sugar levels.
“Psychological stress leads to the release of hormones such as adrenaline and cortisol that directly promote insulin resistance or reduced insulin sensitivity,” says Kohlenberg. “Chronic stress also has been shown to increase the risk for type two diabetes.”
Stress management is easier said than done, but Kohlenberg says there are many routes to achieving a calmer state of mind. Regular self-care practices and the same behavioral modifications that help you lose weight, particularly a healthy diet and more exercise, can help protect your blood sugar levels from the effects of chronic stress.
If you struggle with insulin resistance, it may be time to talk to your healthcare professional about adjusting your medications or trying new ones. Kohlenberg says finding the right medication plan to improve insulin sensitivity can depend on someone’s age, weight, medical history, and other medical conditions they may have.
“All of these factors play a role in selecting a medication plan,” he says.
Research shows that medications commonly prescribed for diabetes, like thiazolidinediones and metformin, may help improve how cells respond to insulin.
Another group of medications called sulfonylureas may help with insulin sensitivity, as well as encourage the pancreas to make more insulin. Similarly, GLP-1 agonists, such as semaglutide (Ozempic), also help the pancreas release insulin and promote weight loss.
Sometimes, a combination of medications can be more effective than using just one, and Kohlenberg says switching medications can also help people find what works best for them.
“If someone has side effects or doesn't tolerate one particular medicine or one class of medications, we can find another medication class or even another medication in the same class that is well tolerated.”
Insulin sensitivity refers to how well your body responds to insulin, which is the hormone that regulates blood sugar. Good insulin sensitivity means your body requires less insulin to move glucose from the bloodstream into the cells, where it’s converted into energy.
Insulin resistance is a condition where your cells don’t respond normally to insulin, leading to higher blood sugar levels and a higher risk of diabetes and other serious health conditions. Improving insulin sensitivity prevents this from happening.
Several lifestyle factors, including regular exercise, weight loss, a healthier diet, quality sleep, and improvements to mental health can help improve insulin sensitivity and help you manage your diabetes symptoms more effectively.
If you’re struggling with insulin resistance, adjusting your medications may help. Drugs such as metformin and GLP-1 receptor agonists can also improve insulin sensitivity, lowering and steadying your blood sugar measurements.
