Options for Treating Insulin Resistance

Insulin resistance affects as many as 70% of women with PCOS and is believed to be a main contributing factor to metabolic complications like high blood pressure, abdominal weight gain, and type 2 diabetes. The three best ways to improve insulin resistance are with diet, exercise, and medications and/or nutrition supplements.

Close up of woman using hand weight
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Diet Changes

While weight loss can result in reducing insulin resistance, improving the way you eat can also help to lower your insulin levels. The key is to choose foods that don't raise your insulin even more. Changing your diet to include lots of low glycemic-index fruits, vegetables, and lean proteins can be beneficial. Focus on anti-inflammatory foods which have been shown to improve insulin resistance.

Portion size matters: to best manage insulin levels, keep carbohydrate foods to just one or two servings at meals, or one-quarter of your plate. Carbohydrate foods include grains, fruits, vegetables, beans, legumes, and milk and yogurt. Spread these foods out throughout the day.

Physical Activity

Diet alone isn’t enough to properly manage PCOS. Because they have higher testosterone levels, women with PCOS tend to build muscle more easily than those without the condition. More muscle mass increases metabolic rate so you burn calories more effectively, and it helps you to use glucose better resulting in less insulin needing to be secreted. Try to get at least two days of weight training in each week to build and maintain muscle mass.

Adding more activity into your day by taking the stairs instead of the elevator, parking your car further from the door, or taking short walks at lunch or breaks can make a difference in your health and help you to produce less insulin. Some people find the use of fitness trackers helpful to increase their steps each day and even have competitions with co-workers or friends.

Insulin-Lowering Medications

If dietary changes are not sufficient and insulin resistance has been confirmed through testing, you may want to discuss adding an insulin-altering medication with your healthcare provider. Many women have found great success in weight loss by combining medication with lifestyle changes. It is important to know, however, that these drugs have not been approved by the FDA for use in treating PCOS.

Metformin is usually the first choice of most healthcare providers, assuming that the woman is a candidate for taking the medication. It works by increasing the cell's sensitivity to insulin and also suppresses the production of glucose by the liver. For many women, taking this medication can help restore regular ovulation and periods .

Glitazones (like Avandia and Actos) are another class of drugs that are sometimes used, either alone or in conjunction with metformin. These medications directly decrease insulin insensitivity and often have fewer gastrointestinal side effects than metformin. Unfortunately, women taking glitazones may actually gain weight instead of losing it due to fluid retention.

Victoza and other injectable medications have also been studied in women with PCOS and show good results in combination with metformin and a healthy lifestyle.

Insulin-Lowering Supplements

One of the most widely studied dietary supplements in the PCOS population is inositol. And with good reason: A combination of Myo-inositol (MI) and d-Chiro-inositol (DCI) types in a 40:1 ratio has been found to be most physiologic. Combination inositol therapy (MI and DCI) can improve all symptoms, signs, and laboratory anomalies of PCOS. MI can correct insulin resistance and improve the metabolic features of PCOS, while DCI can correct hyperandrogenism, improve menstrual regularity, and promote ovulation and fertility. These benefits include improvements to cholesterol, insulin, androgens, and weight.

N-acetyl cysteine (NAC) is an antioxidant that was shown in comparative trials to work as well as metformin for reducing insulin resistance in women with PCOS. Be sure to consult with a registered dietitian nutritionist and your healthcare provider about choosing which supplement is right for you.

Managing insulin resistance can be key in helping women with PCOS lose weight. By making a few important lifestyle changes, you can help your body increase its response to insulin, and possibly decrease androgen production. This may help reduce symptoms, restore regular ovulation and prevent long-term chronic conditions.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Mcmacken M, Shah S. A plant-based diet for the prevention and treatment of type 2 diabetes. J Geriatr Cardiol. 2017;14(5):342-354.  doi:10.11909/j.issn.1671-5411.2017.05.009

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Additional Reading
  • Colazingari S, Treglia M, Najjar R, Bevilacqua A. The combined therapy myo-inositol plus D-chiro-inositol, rather than D-chiro-inositol, is able to improve IVF outcomes: results from a randomized controlled trial. Arch Gynecol Obstet. 2013 Dec; 288(6):1405-11.
  • Grassi, Angela. PCOS: The Dietitian's Guide, 2013. http://www.pcosnutrition.com/product/pcos-the-dietitians-guide/.
  • Oner G, Muderris II. Clinical, endocrine and metabolic effects of metformin vs N-acetyl-cysteine in women with polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2011.

By Nicole Galan, RN
Nicole Galan, RN, is a registered nurse and the author of "The Everything Fertility Book."