How to lower insulin resistance

How to Lower Insulin Resistance: What Moves It, and How to Tell

Insulin resistance is lowered through food, sleep, movement and weight loss, with the weight goal written as a percentage; 5 percent is the national prevention program’s target. You know it is working by rechecking fasting insulin beside fasting glucose, A1c, kidney function and body composition against your own baseline.

Long-standing pain usually comes with adjectives: mild, degenerative, chronic. Adjectives cannot be rechecked in a few months. Insulin, A1c and body composition can, which is how you find out whether anything you changed is working.

How to lower insulin resistance is a question most people ask only after a diagnosis, and it is hard to answer without a starting number. When the body resists insulin, it tends to make more of it, so insulin can climb while glucose still looks acceptable. For someone who has lived with pain for years, that quiet climb is one of the few parts of the story that can be measured, changed and measured again; what a fasting insulin test shows is covered separately. The chapter video, Empowered Individuals Change Their Communities, closes The Pained Brain by Dr. Gurpreet Singh Padda, MD, MBA, MHP, and Dr. KrisJay Fucanan, MD, with a school bus driver whose A1c went from 8.1 to 5.8 over two years. Her story is one person’s course, not a trial outcome, and individual results vary.

The odds nobody prints, and the part that moves

In a national sample of American adults with chronic pain in 2019, 61.4 percent still had it a year later and 10.4 percent reported no pain. In Norway, recovery among people with moderate or severe chronic pain was 8 percent within a year, and the researchers found the outlook worsens once pain has lasted several years. Across eight survey waves in another Norwegian group, only 11 percent followed a path of steady improvement, while 31 percent moved back and forth across the line between chronic pain and none.

Those are averages for people handed nothing but time. Belief is part of the math: in 406 people whose back pain had just become chronic, every point of higher expected risk that the pain would last slowed recovery, a hazard ratio of 0.91. The body is the other part. Blood sugar, insulin, body fat, kidney function, sleep and movement are not fixed traits, and each one has a number attached.

Why can a normal blood sugar test miss insulin resistance?

Fasting glucose or A1c is where most screening stops. Those numbers matter, and research defines remission of type 2 diabetes by an A1c under 6.5 percent. But glucose tends to be the late signal. In one remote-coaching program built on carbohydrate restriction, a measure of insulin resistance called HOMA-IR fell 55 percent in a year, a shift a glucose value alone would not reveal. That study was funded by the company running the program, which is worth knowing when weighing it.

Kidney function belongs in the same conversation. When 1,779 people from the national diabetes prevention trial were reassessed about 21 years after they entered it, painful nerve symptoms tracked higher body weight and lower kidney filtration and were not associated with blood sugar. For someone with burning or aching feet, that points at weight and the kidneys as much as at the glucose meter.

The scale can mislead in the other direction too. In 20 people with type 2 diabetes and a body mass index under 27, losing 6.5 percent of body weight put 70 percent into remission as liver fat returned to normal, and about one in six people is at that kind of weight when diagnosed. A normal BMI does not guarantee normal metabolism, which is why fat mass is worth measuring directly.

Which numbers should you track to lower insulin resistance?

• Fasting insulin, read beside fasting glucose, to look for insulin resistance before glucose rises.
• A1c, the average of blood sugar over roughly three months, with a target written down.
• Kidney function, especially when nerve pain is part of the picture.
• A weight goal written as a percentage. In knee arthritis trials, pain relief was expected at about 7 percent of body weight lost, and 5 percent is the goal the national prevention program uses.
• Body composition, so fat and lean mass are measured instead of guessed from BMI.
• Your own expectation of recovery, recorded where you and your physician can both see it.

More on the metabolic side is at insulin resistance and metabolic health, and the evidence behind each marker is in the book companion for chapter 22.

What Measura measures

Measura [Cardiometabolic and Autonomic Health Analysis] is a testing service. It measures and reports to your physician; it does not diagnose disease on its own, prescribe or treat. Two of its measurements match the list above. Laboratory panels are where blood markers such as glucose, A1c and kidney function are drawn; ask your physician whether fasting insulin is included in the panel being ordered. Bioimpedance body composition estimates fat mass and lean mass with a small, painless electrical signal, showing what a scale reading and a BMI cannot. Whether testing makes sense for you is covered in who should be tested.

How do you know insulin resistance is getting better?

Teaching fades. Across diabetes education programs, A1c improved by about 0.57 on average, ten or more contact hours marked the point where programs reliably worked, and the early gain drifted back toward baseline by 52 weeks no matter how intense the program had been. Feedback slows the fade. Among 9,768 smart-scale owners, a break of 30 days or more without weighing was followed by 1.37 kilograms of gain in people with obesity. A number that gets checked again is a number that tends to hold.

The same logic applies to blood work and body composition. A baseline shows where you are. A repeat later shows whether changes in food, sleep and movement are working, before memory and motivation decide the question for you. What insulin resistance looks like before diabetes describes the pattern those repeats can catch.

One kitchen changes more than one person

A change made by one person rarely stays with that person. In a large diabetes lifestyle trial, spouses who were never enrolled lost 2.2 kilograms against 0.2 among spouses in the comparison group, and about a quarter of those spouses, against 9 percent in the comparison group, dropped 5 percent or more of their weight, with fewer high-fat foods kept at home. Pain moves through families as well: a mother’s chronic pain was tied to 1.59 times the odds of pain complaints in her children. The household is part of the terrain, which makes it worth bringing someone from home to the appointment.

The health system has not solved this for you. The best-proven prevention program in the country reached 455,954 people in eight years against more than 88 million adults at risk, and the people who needed it most lost the least weight. A person holding their own numbers does not have to wait for that gap to close. And if hopelessness about your condition has set in, say it out loud: among 720 hospital inpatients, it carried 5.69 times the odds of a positive suicide risk screen, more than chronic pain itself, and it is a treatable medical finding. How mood and metabolism connect is covered in inflammation and depression, and physicians can read the referral version.

Frequently asked questions

What can a fasting insulin result tell me?

It reflects the amount of insulin circulating after an overnight fast. Higher levels can point toward insulin resistance, a state in which the body needs more insulin to manage the same amount of sugar, and this can be present while fasting glucose still reads in range. It does not diagnose diabetes by itself; your physician reads it with glucose, A1c and your history. Ordering details are under laboratory panels.

Can a normal weight still hide insulin resistance?

Yes. In a small study of people with type 2 diabetes and a body mass index under 27, a modest weight loss of 6.5 percent put most of them into remission as liver fat fell, and roughly one in six people are diagnosed at that kind of weight. BMI cannot see where fat is stored, which is why fat and lean mass are measured directly. Body composition, not BMI explains the difference.

How much weight loss makes a difference for pain?

In knee osteoarthritis trials, meaningful pain relief was expected once people lost at least 7 percent of their body weight. Weight-loss programs helped arthritis pain more than minimal care did, though not more than exercise alone. The goal works best as a percentage of your own starting point, tracked on repeat measurements. Why body composition is not the same as weight shows why the scale is only part of it.

Will my chronic pain ever get better?

For many people it improves more than it disappears. In national data, about six in ten adults with chronic pain still had it a year later, and recovery grows harder once pain has lasted for years. What moves more readily is how far pain spreads and how much it interferes, along with the metabolic and belief factors that shape it. Chronic pain and metabolic health covers that connection.

How often should these numbers be rechecked?

Often enough to catch drift before it becomes a setback. Education effects on A1c faded toward baseline within a year, and gaps in self-weighing were followed by regain, so a single baseline is not a plan. Your physician sets the interval based on what is being treated and what has changed since the first result. How often to repeat cardiometabolic testing gives the general reasoning.

How do I naturally get rid of insulin resistance?

Through food, sleep, movement and weight loss, with the weight goal written as a percentage of where you started; 5 percent is the national prevention program’s target, and knee arthritis trials expected pain relief at about 7 percent. Start with a baseline of fasting insulin, fasting glucose, A1c, kidney function and body composition, then recheck the same numbers to see whether the changes are working.

Can insulin resistance be reversed?

The numbers can move. In 20 people with type 2 diabetes and a body mass index under 27, losing 6.5 percent of body weight put 70 percent into remission as liver fat returned to normal. In the chapter video, a school bus driver’s A1c went from 8.1 to 5.8 over two years; that is one person’s course, not a trial outcome, and individual results vary. Repeat measurement shows whether yours is moving.

References

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• Herman, W. H., Ciarleglio, A., Callaghan, B. C., Edelstein, S. L., Goldberg, R., White, N. H., & Albers, J. W. (2025). Nonglycemic and Glycemic Risk Factors for Painful Neuropathic Symptoms and for Distal Symmetrical Polyneuropathy (DSPN) in the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study. Diabetes Care, 48(10), 1676–1684. https://doi.org/10.2337/dc25-0596
• Shahid, A., Thirumaran, A. J., Christensen, R., Venkatesha, V., Henriksen, M., Bowden, J. L., & Hunter, D. J. (2024). Comparison of weight loss interventions in overweight and obese adults with knee osteoarthritis: A systematic review and network meta-analysis of randomized trials. Osteoarthritis and Cartilage, 33(4), 518–529. https://doi.org/10.1016/j.joca.2024.08.012
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• Vuorinen, A.-L., Helander, E., Pietilä, J., & Korhonen, I. (2021). Frequency of Self-Weighing and Weight Change: Cohort Study With 10,000 Smart Scale Users. Journal of Medical Internet Research, 23(6), e25529. https://doi.org/10.2196/25529
• Gorin, A. A., Wing, R. R., Fava, J. L., Jakicic, J. M., Jeffery, R., West, D. S., Brelje, K., & Dilillo, V. G. (2008). Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect. Int J Obes (Lond), 32(11), 1678–84. https://doi.org/10.1038/ijo.2008.150
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Related reading

• Chronic Pain and Depression: What Your Blood Work Can Show
• Laboratory Panels

Medically reviewed by Dr. Gurpreet Singh Padda, MD, MBA, MHP, medical director of Measura. Last reviewed September 12, 2026.