Insulin resistance is a metabolic disorder characterized by a decreased sensitivity of target tissues—such as the liver, muscles, and adipose tissue—to insulin, a hormone essential for regulating glucose, lipid, and protein metabolism. This diminished response forces the body to produce excessive amounts of insulin, leading to hyperinsulinemia, and ultimately contributes to the development of prediabetes and type 2 diabetes.The primary factors contributing to the development of insulin resistance include genetic predisposition, a highly processed diet, lack of physical activity, and obesity, particularly the accumulation of visceral fat. Excess adipose tissue disrupts normal metabolic pathways and triggers chronic inflammation and oxidative stress. Over time, these pathological processes lead to endothelial dysfunction, vasoconstriction, and hypertension, significantly increasing the risk of cardiovascular diseases, including atherosclerosis, heart failure, and stroke. If left unmanaged, chronic hyperglycemia can result in severe microvascular and macrovascular complications, such as diabetic retinopathy, nephropathy, neuropathy, and diabetic foot syndrome.Common symptoms associated with hyperglycemia and metabolic disturbances include excessive thirst, frequent urination, unexplained weight loss, severe fatigue, increased sleepiness, and recurrent skin or genitourinary infections. Diagnosis is typically based on fasting glucose and insulin levels, oral glucose tolerance tests (OGTT), and the calculation of the HOMA-IR index. A HOMA-IR value exceeding 2.0 is generally considered indicative of insulin resistance.The cornerstone of managing insulin resistance and preventing its progression to diabetes is comprehensive lifestyle modification.

• Dietary interventions: A balanced diet is crucial. Carbohydrates should account for 40-50% of daily caloric intake, with a strong preference for foods with a low glycemic index (GI) and low glycemic load. Recommended foods include whole grains, legumes, raw vegetables, and certain fruits like berries. Patients should strictly limit or eliminate simple sugars, highly processed foods, sugary beverages, and saturated animal fats. Healthy plant-based fats, such as olive oil and nuts, along with lean proteins, should be incorporated into daily meals.
• Physical activity: Regular exercise enhances tissue sensitivity to insulin and aids in weight reduction. Both aerobic exercises (like nordic walking or cycling) and resistance training are highly recommended. Furthermore, NEAT (Non-Exercise Activity Thermogenesis)—which includes everyday activities like walking, standing, or doing household chores—plays a massive, often underestimated role in increasing daily caloric expenditure and fighting insulin resistance.
• Sleep and stress management: Adequate sleep (7-8 hours per night) and minimizing chronic stress are vital, as poor sleep and high stress levels exacerbate inflammation and metabolic dysfunction.

When lifestyle changes are insufficient, pharmacological treatment may be introduced. Metformin is the most commonly prescribed medication to improve insulin sensitivity. Depending on the cardiovascular risk and the presence of diabetes, other advanced therapies like SGLT-2 inhibitors, GLP-1 receptor agonists, or insulin therapy may be utilized. Additionally, evidence suggests that specific dietary supplements possessing strong antioxidant and anti-inflammatory properties, such as curcumin, berberine, anthocyanins, and omega-3 fatty acids, can support metabolic health, improve lipid profiles, and further sensitize cells to insulin.

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