Lifestyle Before Medication

A pharmacist's perspective on health and metabolic disease

Hyperinsulinaemia: Best management practice

A major aspect of my thesis was reviewing the literature to find out just how much of an impact hyperinsulinaemia had on metabolic disease.   I posted that review back in November.

What bugged me though about that review is that it only told part of the story.  It had been drummed into me as a clinician that you do not attempt to diagnose a condition unless you have a clear plan for treating said condition should the test come back positive.  To me, this meant that I should not go to the effort of working out the best way of diagnosing hyperinsulinaemia, unless I could also give the clinicians a clear plan for how to tell their patients to manage their condition.

Today, that review was published and you can read it here  “Hyperinsulinaemia: Best management practice.”  The abstract is below.  I’ll admit that I don’t like the layout, but this was pointed out to them during the proofing process.

A big thank you to my co-authors, Grant Schofield (The Fat Professor), Caryn Zynn (The Whole-Food Dietitian) and Mark Wheldon.

Also, though a big thank you to those of you who, late last year, gave me suggestions as to which supplements I should investigate.  I could not include them all but it was certainly interesting to find which ones had the evidence and should be included.

My review shows that restricting carbohydrates is probably the best dietary option for managing hyperinsulinaemia, although you will get some success with low-fat and Mediterranean regimes.  Physical activity is also important, while medication may or may not be beneficial.





Chronic hyperinsulinemia associated with insulin resistance is directly and indirectly associated with many metabolic disorders that contribute to significant morbidity and mortality. Because hyperinsulinemia is not widely recognised as an independent health risk, there are few studies that assess management strategies. Medication management may not address the multiple issues associated with hyperinsulinemia. Lifestyle management includes physical activity, especially high intensity interval training, and dietary management. Reducing carbohydrate quantity and increasing nutrient density are discussed with carbohydrate-restricted and Mediterranean diets conferring additional benefits to a low-fat diet. Physical activity and dietary management provide the foundation for hyperinsulinemia management and may work synergistically. Of these principles, a combination of resistance and high intensity interval training, and carbohydrate restriction provide the two most effective frontline management strategies for managing hyperinsulinemia.

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