Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
To improve insulin sensitivity in a patient with acanthosis nigricans, which is a cutaneous marker of insulin resistance and hyperinsulinemia, lifestyle modifications are key Shiana et al. 2025.
Weight Management:
- Achieving and maintaining a healthy weight is crucial for improving insulin sensitivity and reducing the risk of diseases associated with overweight and obesity, such as type 2 diabetes NICE.
- Effective weight-loss programmes should be tailored to individual needs, encourage regular physical activity, and aim for a gradual loss of 0.5 to 1 kg (1 to 2 lb) per week NICE.
Dietary Modifications:
- Patients should be advised to base meals on starchy foods, choosing wholegrain options where possible, such as potatoes, bread, rice, and pasta NICE.
- Encourage the consumption of fibre-rich foods, including oats, beans, peas, lentils, grains, seeds, fruit, vegetables, wholegrain bread, and brown rice and pasta NICE.
- Patients should aim to eat at least five portions of a variety of fruit and vegetables each day, replacing foods higher in fat and calories NICE.
- Adopting a low-fat diet and avoiding increased fat or calorie intake is recommended NICE.
- Minimise the consumption of fried food, drinks and confectionery high in added sugars (e.g., cakes, pastries, sugar-sweetened drinks), and other foods high in fat and sugar (e.g., some take-away and fast foods) NICE.
- Minimise calorie intake from alcohol NICE.
- Patients should be mindful of portion sizes for meals and snacks, and the frequency of eating throughout the day NICE.
- Eating breakfast is also recommended NICE.
Physical Activity:
- Regular physical activity is essential for improving insulin sensitivity Shiana et al. 2025.
- Patients should make enjoyable activities, such as walking, cycling, swimming, aerobics, and gardening, a routine part of their life NICE.
- Building other activity into their daily routine, such as taking the stairs instead of the lift or walking at lunchtime, is beneficial NICE.
- Minimise sedentary activities, such as sitting for long periods watching television, at a computer, or playing video games NICE.
- Using physically active forms of travel, like walking and cycling, should be encouraged NICE.
Supporting Behaviour Change:
- When recommending these changes, it is important to help patients understand the short, medium, and longer-term consequences of their health-related behaviour NICE.
- Help them feel positive about the benefits and value of health-enhancing behaviours NICE.
- Recognise how people's social contexts and relationships may affect their behaviour NICE.
- Help patients plan changes in terms of easy, sustainable steps over time NICE.
- Identify and plan for situations that might undermine changes, developing explicit 'if–then' coping strategies to maintain new behaviours NICE.