How is insulin resistance managed?

An important key feature of type 2 diabetes is Insulin resistance. Overweight and Obese people need to reduce their weight to decrease insulin resistance. Consistent exercise is well-known to improve muscle insulin sensitivity. Furthermore, a low-calorie diet is known to improve hepatic insulin sensitivity. Medications can also help improve insulin sensitivity; metformin and pioglitazone are good insulin sensitizers.

What, according to you, is the ideal HbA1c level for a diabetes patient?

Guidelines suggests an HbA1c of <7% (ADA); <6.5% (AACE). Keeping the ‘patient-centric’ methodology in mind, treatment must be individualized according to patient characteristics and associated comorbidities. Patients with end-stage renal disease undergoing dialysis can have HbA1c of 7.5%-8%. Similarly, when it comes to older patients or those with complications, long duration of diabetes, and high risk of hypoglycemia, an HbA1c of >7% is acceptable.