PCOS and Insulin Resistance

Ways to Treat Insulin Resistance When You Have PCOS:

The good news is that we can lower insulin resistance (its symptoms and complications) through lifestyle changes. 

Nutritional Approaches to Insulin Resistance

What kind of a dietitian would I be if we didn’t start here? A balanced plate is essential to treat insulin resistance where it starts: our food choices.

It’s not just about what we do or do not eat, it’s also about how much of those foods are consumed. I always like to start with talking about protein. You need ample protein on your plate to improve your insulin resistance. Protein will help slow down absorption of carbohydrates and blunt the blood sugar response after a meal or snack. That is a good thing. The more slowly we increase your blood sugar, the more slowly we will raise insulin levels.

Another useful tool we have with food and insulin resistance is increasing fiber. Fiber is awesome for slowing down blood sugar spikes as well. The fiber essentially “coats” the intestinal lining making absorption times slow down and again delaying insulin’s response. This process of slowing done blood sugar spikes after a meal will help your body over time create less insulin. As your body feels less bombarded with insulin’s message, it won’t feel so annoyed when insulin comes knocking on the door.

Notice we haven’t talked about cutting anything out. Include more protein, include more fiber. Almost everyone would benefit from that. Treating insulin resistance doesn’t have to alienate you at dinner time. You can eat what others are, just serve yourself an extra portion of the meat or eggs. Use extra large scoops when putting the broccoli or salad on your plate.

I have an entire approach to meeting nutritional needs, feeling amazing, enjoying the food you eat AND managing insulin resistance. I call it the PCOS+ Plate. I teach you all about it in the RECIPES section of The PCOS App.  

Sleep and Stress Management’s Affects on Insulin Resistance and Behaviors

We know that sleep quality and stress management are very important in balancing hormones. Calming techniques like yoga, stretching, therapy, journaling, and meditation, can be helpful to manage stress and relax you enough for proper sleep. Sleep hygiene can be very important too, especially setting a bedtime and reducing screen time before bed. 

Managing cravings, energy levels, and total amount of food eaten is more difficult to do when you are tired. Think about it, the last time you had a really poor night of sleep, did you make a balanced breakfast? Probably not, those are the morning you are more likely to hit the McDonalds or Starbucks drive thru line. We are hard wired to crave more sweets and carbs on a day we are physically tired. You can’t fight this biology, but you can choose to work with it. Establishing good sleep habits and respecting your body’s need for adequate, quality sleep is really important. It critically important to look at this category of well-being while trying to improve health and specifically insulin resistance. 

 Movement and Exercise Affect Levels of Insulin Resistance

Movement is an important lifestyle behavior that is easy to overlook the benefits regarding insulin resistance. We often think about movement and exercise for weight management and for good reason, but movement can also help re-sensitize your body to insulin. Research has shown your body can make improvements in insulin resistance after just a few weeks of consistent exercise.

Regular movement can help you relax, manage stress, improve your sleep, and even improve clinical symptoms of PCOS like insulin resistance. Choose a movement that works for you and that you can enjoyably do on a regular basis, whether it is a sport, dancing, biking, lifting weights or even walking. I honestly think that walking is highly under-rated and is a great, low impact way to get your body moving. It also has an added benefit of keeping your heart rate in a range that helps your body use fat for fuel instead of using stored carbohydrates.

 Supplement Solutions for Insulin Resistance in PCOS

Supplements have some very promising roles in assisting an individual with PCOS with their insulin resistance. Many of the nutritional deficiencies that are more common in PCOS like vitamin B12, magnesium and vitamin D can all indirectly impact insulin resistance. Repleting nutritional deficiencies, which is just a fancy way of saying recovering those levels can be a very useful strategy for combatting insulin resistance.

In PCOS there are certain metabolic disadvantages many of us have and we have narrowed in on some specific supplements that can improve areas where we just don’t function at our most optimal level. I often use supplements such as myo-inositol, berberine, NAC, alpha lipoic acid and cinnamon to help with blood sugar and insulin levels.

Prescriptions Your Doctor May Offer to Help with Insulin Resistance

There are some medications recommended to help you manage insulin resistance, like Metformin. Certain medications can also block androgen production and its related physical symptoms, like birth control. While birth control may help some symptoms it has actually been shown to increase insulin resistance, so have a thorough conversation with your physician about if birth control or other hormonal contraceptives for symptom management are good fits for your needs and goals.

Metformin and other insulin sensitizing drugs are used in an “off label” capacity for PCOS. That essentially means that they were designed and approved by the FDA to be used for other things like diabetes, preventing pregnancy, etc. Using them to treat PCOS is common, but not the primary purpose. That doesn’t mean you shouldn’t use them, but it’s important for you to know so you can consider all your options.

I have even seen doctors prescribe diet pills that impact your appetite to try and help patients lose weight. In my opinion this almost always back fires and contributes to under-nourishing the individual and not dealing with other behaviors that may be making insulin resistance worse like: poor sleep quality or lack of movement.

Medications are often one of the doctor’s only abilities to help you with PCOS so you may feel like it’s the only solution available. It is not and if you don’t feel comfortable being on one of these medications, you are not alone. Above, there are many natural ways you can control all of these clinical symptoms of PCOS and live a healthy life. 

Weight Loss Surgery Has Been Offered to Many PCOS Patients

I am hearing that this is an increasingly common solution provided to patients. It is true that weight loss that can be associated with these GI Tract Reconstructive Surgeries and due to the weight loss there can be improvement in insulin resistance. However, I have cautioned many people to not be so quick to turn to this solution as it can have permanent consequences and so many of my PCOS patients have learned to manage their insulin resistance with natural- easy to implement- solutions that are not as drastic and scary.