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Q&A with Australian Health Practitioners
I have Insulin Resistance and PCOS. What should I do?
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Had results come back to me today with Insulin level of 54 !! Extremely high - also suffer from severe PCOS - have been prescribed Diabex - what else should I be doing / can I be doing / taking ? -
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Arlene Normand
Dietitian
Arlene is a registered practising dietitian, with a private practice in the Eastern Suburbs of Sydney, and has built a strong business over the last … View Profile
Follow a low-glycemic load diet. Years of experience has taught me that this step is vital to limit insulin resistance, balance sex hormones, and increase fertility. What I mean by “low-glycaemic load,” is to limit carbohydrate intake to 16 grams of carbs per meal, and 7 grams per snack. That is the best way to start. For those of you that are more active a slightly higher carb intake may be necessary. In order to keep the glycaemic load down, pair your carbohydrates with fibre, protein, and/or healthy fats. I recommend eliminating all high-fructose syrups, sugar, white flour, white rice, white potatoes, and other highly processed, refined sugars and starches. Carefully limiting refined carbohydrates is crucial to fertility because it reduces your insulin resistance, decreases androgens, and results in more regular ovulation and menses. This is basically what the drug metformin accomplishes, too. Numerous people with insulin resistance get put on Metformin by their doctors. Exercise is a very important part of your regime. You ideally need to reach your ideal weight – so if you are overweight work at losing the excess kilos. An accredited practicing dietitian can assist you by establishing a meal plan for you.
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Kate Marsh
Credentialled Diabetes Educator (CDE), Diabetes Educator, Dietitian
Kate works with clients with type 1 and gestational diabetes, PCOS, and those following a plant-based (vegetarian or vegan) diet. As a diabetes educator, she … View Profile
While metformin (Diabex) can help with insulin resistance and PCOS, the most important thing you can do is make lifestyle changes aimed at improving insulin sensitivity, and losing weight if you are carrying excess weight - lifestyle modification is recommended as the first line of treatment for PCOS.
Lifestyle changes should focus on diet and exercise/activity levels as well as getting adequate sleep and managing stress. In my experience, addressing all of these areas together will give the best results.
The best type of eating plan for women with PCOS is one that is low in saturated fat and high in fibre and which includes carbohydrate foods that have a low glycaemic index. Spreading food intake evenly across the day and avoiding eating large amounts of carbohydrate foods at one time is also important as this helps to prevent large rises in blood glucose and insulin levels. A healthy eating plan for women with PCOS will focus on vegetables, salads, minimally processed wholegrains, legumes and fruit, moderate amounts of lean protein foods and some healthy fats (e.g. from avocado, nuts, seeds, extra-virgin olive oil), while avoiding added sugars and highly processed grains.
Combining a healthy eating plan with regular exercise is also important and women with PCOS should aim to include at least 30-40 minutes of activity on most days. Aim for a combination of both aerobic exercise (eg. walking, running, dancing) and resistance training (using weights). Limiting sedentary time is also important, so if you spend most of your day sitting at work, try to take regular movement breaks throughout the day.
Poor or inadequate sleep, and high stress levels can worsen insulin resistance, so aim for around 7-8 hours sleep, and incorporate strategies to manage stress levels and ensure good quality sleep.
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