Review Article
Volume 16 Issue 7 - 2021
Insulin Resistance in Primary Dietary Care Practice. Review of the Evidence and a Proposal for Daily Use
Elisabeth Govers1,2*, Ismay Wiggers1,3, Harriet Verkoelen1,4 and Dave Schweitzer1,5
1Knowledge Centre for Dietitians on Overweight and Obesity, Amsterdam, The Netherlands
2European Federation of Associations of Dietitians, European Specialist Network of Dietitians on Obesity, Emmerich, Germany
3Primary Care Dietitian Practice Dietiek Op Maat, Bavel, The Netherlands
4Primary Care Dietitian and Diabetic Nurse Practice, Buren, The Netherlands
5Department of Endocrinology, Reinier de Graaf Hospital, Delft, The Netherlands
*Corresponding Author: Elisabeth Govers, Knowledge Centre for Dietitians on Overweight and Obesity, Amsterdam, The Netherlands.
Received: May 26, 2021; Published: June 30, 2021




Abstract

Background: Insulin resistance (IR) is a relevant metabolic problem in overweight, obesity, type 2 diabetes mellitus, cardiovascular disease, malignant disease and Alzheimer’s. According to the guidelines, dietitians measure body weight, body mass index, comorbidities, and waist circumference to assess baseline characteristics and propose treatment goals to patients. Vigorous sustained insulin resistance suppression is usually overlooked. Our research focused on the importance of the determination of IR in dietary practice and to use IR as priority measure in the dietary management of patients with the metabolic syndrome and related comorbidities.

Methods: A literature review on the relevant data on insulin resistance, its related pathologies and how to treat it.

Results: We selected 100 articles on the etiology, pathology and diagnosis of IR. The pathogenesis is mainly caused by a diet rich in carbohydrates and fat combined with a sedentary lifestyle and enhanced by medication. IR lies at the basis of a large number of diseases. Several practical methods for IR quantification are summarized on which we based a composite score (the diagnostic IR score card) to be used in those patients in urgent need of a nutritional intervention. Preferably as early as possible before irreparable damage is a fact.

Conclusion: IR is one of the leading causes of metabolic disorders to be addressed in primary and nutritional care. We pledge to shift the focus on management in dietitians’ practices from body weight as a clinical endpoint to deep and sustainable IR suppression. To quantify IR at baseline and to define it as an clinical endpoint, we propose a composite score for use as a measure for dietary carbohydrate restriction. Future diagnostic and diet intervention studies are needed to strengthen the evidence for tailor made carbohydrate restriction in patients with insulin resistance and metabolic syndrome.

Keywords: Insulin Resistance; Metabolic Syndrome; HOMA-IR; Comorbidities; Waist Circumference

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Citation: Elisabeth Govers., et al. “Insulin Resistance in Primary Dietary Care Practice. Review of the Evidence and a Proposal for Daily Use”. EC Nutrition 16.7 (2021): 125-138.

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