Insulin resistance is preventable and reversible through lifestyle changes, proper nutrition, supplements, exercise and stress management. Weight loss and exercise are the best treatments for restoring the body's ability to respond to insulin.

Metabolic syndrome and insulin resistance are a significant health care problem in the United States. Type 2 diabetes affects more than 300 million people, and up to 15% of these patients cannot take metformin because of kidney damage risks.

There are many different cofactors that can improve dysglycemia such as zinc, alpha lipoic acid, chromium, and vanadium. According to a study published earlier this month, researchers demonstrated that Ginkgo biloba extract can significantly reduce HA1c, fasting glucose, insulin, BMI, and waist circumference.

This study included 60 patients ranging from 25 to 65 years of age with type 2 diabetes who had a glycemic status uncontrolled by metformin alone. These individuals were randomized to treatment of 120 mg/d of ginkgo extract or placebo for 90 days. Biomarkers were assessed at baseline and at 90 days, including HA1c, fasting glucose, insulin, waist circumference, and visceral adiposity index (VAI).

As a result, the ginkgo extract significantly reduce HA1c, fasting glucose, insulin, and waist circumference. Treatment with ginkgo combined with metformin decreased BMI significantly after 90 days.

Previous studies have shown that ginkgo can lower fasting glucose levels and protect islet β-cell function. It is suggested that ginkgo’s polyphenol content is responsible for improving the sensitivity to insulin. Animal studies have demonstrated ginkgo’s ability to inhibit adipogenesis and regulate lipid metabolism. It would be interesting to see a study combing ginkgo with berberine, as berberine also has positive effects on waist circumference and dyslipidemia not seen with metformin.

Inositol is another nutrient that should also be considered for patients with diabetes.

Inositol acts as second messenger which regulates several hormones such as thyroid stimulating hormone and insulin.

Studies have shown that an inositol deficiency is common in patients with insulin resistance. There appears to be a reduced ability to process, metabolize, and effectively use inositol from foods, which is a distinctive characteristic feature of insulin resistance. As a result, the nutritional requirements of these patients may not be met by a simple change in the diet, and inositol should be viewed as a conditionally essential nutrient in these individuals.

Since diabetes is an increased risk factor for cognitive decline, other nutrients such as phosphatidylserine, GPC, and acetyl-l-carnitine are important. Phosphatidylserine is an essential brain nutrient that has been shown to improve the brain’s energy consumption of glucose.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Aziz TA, Hussain SA, et al. The efficacy and safety of Ginkgo biloba extract as an adjuvant in type 2 diabetes mellituspatients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial. Drug Des Devel Ther. 2018 Apr 5;12:735-742. doi: 10.2147/DDDT.S157113