Insulin Insensitivity and Type 2 Diabetes

TL;DR

Type 2 diabetes is driven by insulin insensitivity (insulin resistance).
Refined carbs/sugar → chronically high insulin → fat storage, high triglycerides, metabolic syndrome.
Lifestyle and targeted nutrition can beat drugs for prevention and significantly improve control.
Key helpers: low–glycemic-load eating (vegetable-forward), intermittent fasting, daily light exercise, and research-backed nutrients (α-lipoic acid, magnesium, berberine).
Liver/bile issues (fatty liver, biliary stasis) commonly coexist and can stall weight loss and glycemic control—treating them helps everything work better.

How common is insulin insensitivity and type 2 diabetes?

More than 100 million U.S. adults are now living with diabetes or prediabetes (CDC)

4% of the U.S. population (34 million Americans) has diabetes.
Nearly 1 in 4 four adults living with diabetes – 7.2 million Americans don’t know they have the condition.
Only 11.6% of adults with prediabetes knew they had it.
Diabetes costs $237 billion (direct medical costs) each year.

What Is Insulin Insensitivity?

Insulin escorts glucose into cells. When insulin is high, you store fat (lipogenesis) and don’t burn it. Overeating carbohydrates (especially refined carbohydrates and sugar) desensitizes receptors → insulin insensitivity. Result: elevated triglycerides, belly weight, cravings, brain fog, post-meal crashes.

Common early signs:

Fatigue, weight gain, cravings
Post-meal sleepiness (reactive hypoglycemia)
Brain fog
~50% of people with hypertension are insulin insensitive
~30% of U.S. adults have insulin insensitivity; ~25% have metabolic syndrome

Metabolic Syndrome (“Syndrome X”)

Seen with insulin resistance:

↑ total cholesterol, ↑ LDL, ↓ HDL, ↑ triglycerides
High blood pressure
Central weight gain (belly/hips/thighs)
Contributors: refined carbs/sugar, stress, poor sleep, inactivity, toxins.

Insulin touches everything: weight, BP, lipids, pain/inflammation, mood, menstrual issues, PCOS, and cardiovascular risk.

Type 2 Diabetes

Type 2 diabetes is simply insulin resistance that has gotten out of hand. Approximately 32 million Americans have diabetes. About 95% of them have type 2 diabetes. An A1C level of 6.5 percent or higher on two separate tests indicates that you have diabetes. Type 1 diabetes is a state where the body cannot produce insulin. Type 2 diabetics produce insulin, but the body simply does not respond. Much of the advice given here is for type 2 diabetics and not type 1 diabetics.

If You’re on Diabetes Medication, Read This

Lifestyle changes can lower glucose quickly. If you’re improving diet/activity while on medication, monitor regularly and work with your prescriber to adjust doses safely. Don’t stop meds abruptly.

Overview of Type 2 Diabetes Drug Classes

Biguanides (Metformin): lowers hepatic output, improves uptake; may deplete B12; GI upset early; rare lactic acidosis in severe renal/heart failure—take with food.
Alpha-glucosidase inhibitors (acarbose, miglitol, voglibose): block carb breakdown; GI gas/diarrhea common; avoid in significant GI/liver/renal disease; treat lows with glucose tabs (not sucrose).
GLP-1 receptor agonists (e.g., semaglutide/Ozempic®): slow gastric emptying, reduce appetite; nausea common; debated risks include pancreatitis/thyroid cancer.
Meglitinides: rapid insulin secretagogues; risk hypoglycemia/weight gain; not for pregnancy/breastfeeding/children.
SGLT2 inhibitors: increase urinary glucose excretion; FDA warnings for acute kidney injury, UTIs, and Fournier’s gangrene—seek urgent care for genital/perineal pain/redness/fever.
Sulfonylureas: increase insulin output; risk hypoglycemia and weight gain.

Theme: Most drugs reduce glucose by blocking absorption/production or forcing more insulin. Diet + lifestyle can achieve the same goal by reducing the glucose load and improving sensitivity—often with fewer side effects.

Diet for Insulin Insensitivity & Type 2 Diabetes

Research has shown lifestyle to be more effective than drugs in preventing diabetes and a valuable therapy for treating it [^1,2,3,4]. These four studies do not include supplementation, but there is much research that shows supplementation to be beneficial to patients with type 2 diabetes.

The American Diabetes Association does not recommend one specific diet. Overall, you should avoid refined carbohydrates. Carbohydrate consumption should be limited, and processed foods should be avoided. Eat a lot of green and other brightly colored vegetables (not corn or potatoes). Vegetables should dominate the diet.

Ketogenic diet: A ketogenic diet is an extremely low carbohydrate diet. It is one approach to controlling diabetes. The ketogenic diet has been studied and found to improve A1C levels and weight loss in diabetics [^5,6,7,8,9]. Usually, about 50 grams of carbohydrate are allowed per day. It can be hard on the kidneys–discuss this with you doctor.

Glycemic load:

Avoiding food with a glycemic load greater than 10 is a great strategy. It differs from glycemic index, which is a measure of how fast a food will raise your blood sugar. Watermelon, for example, has a high glycemic index, but it has a low glycemic load. A bagel has a similar glycemic index, but a much higher glyemic load. Charts are available, click here for one.

A study that appeared in (Diabetes Res Clin Pract. 2011 Apr;92(1):37-45) looked at 79 obese adults with type 2 diabetes. The researchers concluded, “Results suggest that targeting glycemic load, rather than dietary fat, in a low-calorie diet can significantly enhance the effect of weight loss on HbA(1c) in patients with type 2 diabetes.” Focusing on glycemic load can help you lower A1C and lose weight. There are several studies that support this idea.

Bottom line: The less your body has to process carbohydrate, the easier it is to control diabetes. Controlling carbohydrate is what the diabetes drugs (for type 2 diabetes) are all about. Focus on diet can accomplish this with lower dosages of drugs or possibly no drugs at all. Call us for a consultation and we will discuss strategies with you. The type of diet can be something that suits you. The Mediterranean diet is one possibility, the DASH diet has been used, the Paleo diet is another, and we have already discussed the ketogenic diet. Pay attention to the glycemic load of the food you eat.

Supplements for Insulin Resistance

Lipoic Acid

Lipoic acid has been studied and shown to improve the cholesterol and triglyceride levels of patients with diabetes and insulin insensitivity. One study [¹⁰]has investigated 22 obese subjects with insulin insensitivity (obese-IGT), 13 of whom received lipoic acid. The patients receiving the lipoic acid had improved insulin sensitivity as well as lower cholesterol, triglycerides, and lower LDL (“bad”) cholesterol. They also experienced a reduction in inflammatory markers (chemicals that cause inflammation). A meta-analysis of studies (a meta-analysis is a review of a collection of scientific studies) also found that giving lipoic acid can produce similar results [¹¹].

There are several studies that show lipoic acid to help prevent and reduce suffering from diabetic neuropathy. In one study[¹²], 72 patients with painful diabetic neuropathy were given lipoic acid for 40 days (600 mg/day). The subjects had a reduction in pain and other symptoms of neuropathy. Half of the subjects rated their health condition as ‘very much better’ or ‘much better’ following α-lipoic acid administration. The supplementation also reduced triglyceride levels. Another double-blind, placebo-controlled study[¹³] looked at 328 patients. The researchers concluded, “intravenous treatment with alpha-lipoic acid (600 mg/day) over 3 weeks is safe and effective in reducing symptoms of diabetic peripheral neuropathy, and oral treatment with 800 mg/day for 4 months may improve cardiac autonomic dysfunction in NIDDM [type 2 diabetes].” Many other double-blind studies found similar results with oral doses [^{14,15,16,17,18}].

Magnesium

Most Americans are magnesium deficient, and diabetics are exceptionally prone to magnesium deficiency. There is a LOT of research that shows it to be beneficial to patients with insulin insensitivity and diabetes. Magnesium is another supplement that can benefit both type 1 and type 2 diabetics.

Magnesium and its role in blood sugar control have been extensively studied. Insulin insensitivity and the overproduction of insulin found in type 2 diabetes may actually interfere with magnesium absorption[¹⁹]. One study compared 42 subjects with type 2 diabetes who were randomly chosen to receive 250 mg of elemental magnesium per day or a placebo. At the end of three months, the group receiving the magnesium experienced a significant improvement in HbA1C [²⁰]. Magnesium has even been shown to improve the cholesterol and triglyceride levels of people with type 2 diabetes [²¹]. Magnesium intake can help prevent the transition from prediabetes (glucose resistance) to diabetes [²²]. Poor magnesium status may even increase the risk for neuropathy in diabetics. Research found that diabetic patients with polyneuropathy tended to have low levels of magnesium when tested in the red blood cells[²²].

Magnesium deficiency is common in the US. As many as 75% of the population may have inadequate magnesium intake. Because insulin insensitivity interferes with magnesium absorption, it is a safe assumption that most type 2 diabetics need magnesium.

Berberine

Berberine has been well-researched and shown to reduce blood sugar and A1C. Studies have shown that berberine can help and that berberine performs similarly to metformin. Subjects have had significant decreases in A1C, fasting blood glucose, postprandial blood glucose, and plasma triglycerides [^{23,24,26,27,31}] It has even been shown to lower cholesterol [^25,28,29], reduce BMI [³²], and it may also help with fatty liver disease [³⁰].

Other Nutrients

Various nutrients help balance insulin and blood sugar: Several nutrients have been researched and shown to be beneficial to people with insulin insensitivity and high blood sugar. For example, vitamin A addresses both insulin insensitivity and diabetes; it has been extensively researched^33,34,35,36. Vitamin A has even been shown to help prevent type 1 diabetes [³⁷].

Vitamins D and K also directly address insulin resistance [^38,39,40,41]. Similarly, biotin [⁴²], and B vitamins [^43,44,45], like niacin, B₁₂, [45] and thiamin [^44,45,46,47] have all been studied. Minerals, like zinc, chromium [⁴⁸], molybdenum, vanadium [^49,50] and especially magnesium [^51,52] have all been shown to have a positive effect on insulin insensitivity. Lysine and taurine both improve glucose tolerance [^53,54].

Insulin insensitivity affects the liver and the gallbladder:

Insulin insensitivity is linked to fatty liver and biliary stasis. Fatty liver can progress to cirrhosis of the liver. Eating sugar and insulin insensitivity can progress to serious problems with the liver and gallbladder. One study [⁵⁵] linked insulin insensitivity and sugar consumption to gallstones and even cancer. The researchers stated, “Our findings suggest that metabolic syndrome and insulin resistance have a role in the aetiology of biliary tract cancers and biliary stones, and if confirmed, they imply that lifestyle control of these factors may lower the risk of biliary stones and biliary tract cancer.” Many studies have found that eating sugar and developing insulin insensitivity causes problems with the liver and gallbladder [^59,60,61,62].

What can be done for biliary stasis and fatty liver?

Fortunately, other studies have shown that the lifestyle suggestions in this report can protect the liver and gallbladder [^63,64]. Making the dietary changes mentioned earlier in this report will go a long way in improving the health of your liver and gallbladder. If you are having some of the symptoms mentioned earlier, supplementation may help. There are supplements that are designed to thin bile, some of the best ones contain artichoke extract.

Essential Fatty Acids

Essential fatty acids: Insulin is highly inflammatory; so, insulin insensitivity can cause inflammation. It is part of the reason so many diseases are associated with it, like heart disease. The chemicals that create and suppress inflammation are oil soluble. The type of fat in the diet can either promote or suppress inflammation. Avoid hydrogenated oils, trans fats, and highly refined vegetable oils. Use extra virgin olive oil for cooking and for salads. Studies have shown that taking vegetable sourced omega-3 fatty acids, like linolenic acid from flax seeds will reduce inflammation as well as improve blood sugar control [^{65,66,67,68,69,70,71,72,73,73}]. Omega-3 fatty acids from fish oil have also been extensively studied.

Lifestyle to Control Insulin Insensitivity

Intermittent fasting: You have two hormones, one is insulin, which stores fat. The other is glucagon, which burns fat. When you eat, and for three hours afterward, insulin is the dominant hormone. After three hours glucagon is the dominant hormone. This is why snacking is such a bad idea when you are trying to lose weight, because it makes you produce insulin and store fat. Snacking prevents you from burning fat three hours after a meal.

Intermittent fasting is a well-researched way to get insulin insensitivity under control and to lose weight. You have an eight-hour window to eat. There needs to be 16 hours between dinner and breakfast the next morning. If you eat dinner at 5:00 pm, breakfast is at 9:00 am the next morning. It works because when you fast you produce glucagon, which is a hormone that helps to break down fat [^75,76].

Exercise: This should be obvious. For one thing, exercise helps prevent diabetes. The authors of one study stated, “Diet and/or exercise interventions led to a significant decrease in the incidence of diabetes over a 6-year period among those with IGT [glucose insensitivity].” [⁷⁷] There are literally hundreds of scientific studies showing the benefits of exercise for diabetics. There are too many to list here. They consistently show a lowering of A1C scores for diabetics who begin an exercise regimen. Light exercise is best, and it should be done daily.

References to Scientific Studies