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I sat down with Dr. Komal Patil-Sisodia, a Triple Board-Certified Endocrinologist and Women’s Metabolic Health Expert, to unpack one of the most overlooked aspects of PCOS: insulin resistance.

If you’ve been diagnosed with PCOS, chances are you were handed a prescription and little else—no real explanation of why weight management feels like an uphill battle, why cravings and fatigue won’t let up, or how insulin resistance ties into it all.

In this post, we’ll break down what’s really happening in your body and, more importantly, what you can do about it. From movement and nutrition to key supplements, we’ll cover practical strategies that can make a real difference.

What is Insulin Resistance?

At its core, insulin is the hormone that helps move glucose (sugar) from your bloodstream into your cells, where it’s used for energy. But when your body becomes resistant to insulin, this process doesn’t work as efficiently. Your pancreas has to work overtime to produce more insulin, and instead of being used properly, excess glucose gets stored as fat—often around the abdomen.

This creates a frustrating cycle: weight gain contributes to more insulin resistance, and insulin resistance makes it harder to lose weight. But insulin resistance isn’t a permanent sentence. With the right approach, including strategic lifestyle changes and, in some cases, medication, it can be managed and even improved.

Practical Tools for Managing Insulin Resistance

Small, consistent changes can make a big difference when it comes to insulin resistance. Endocrinologist Dr.Patil-Sisodia recommends some practical tools to help improve insulin sensitivity and support overall health:

Intentional Movement

• Any movement is better than none! While walking after meals may provide a slight benefit, the most important thing is simply finding ways to move throughout the day.
  
  
• Just 11 minutes of walking daily can reduce cardiovascular mortality by 33%—it doesn’t have to be complicated.
  
  
• A mix of strength training and cardio is ideal. Even 30 minutes of strength training per week, broken into small chunks, can help maintain muscle mass and improve insulin sensitivity.
• Strength training is one of the best ways to combat insulin resistance. Muscle acts like a sponge for glucose, helping to burn carbs instead of storing them as fat. By building muscle, you increase your basal metabolic rate, burn more calories at rest, and improve body composition. You don’t need to spend hours at the gym—start with 10-minute strength training sessions 2-3 times a week, and gradually increase your intensity as you build strength. Maintaining muscle mass, rather than losing it, is essential for long-term metabolic health. 

Nutrition

When it comes to the best nutrition to support your body, especially in managing insulin resistance, there’s a lot of confusion around carbs and low-carb plans like Keto. While Keto may seem like a quick fix, it's not always the best long-term approach for everyone. Here’s a clearer look at the myths versus facts around Keto and carbs, and how to make healthier choices for your body.

Keto and Carbs Myth vs Fact:

• Keto was developed for epilepsy, not mainstream use. Yes, it can lead to quick weight loss, but it’s hard to sustain long-term, especially for workouts.
  
  
• Muscles need carbs to function properly, and restricting carbs to below 50 grams daily isn’t practical for most people.
  
  
• People often misunderstand carbs in foods like broccoli, and many "keto" diets aren't truly keto.
  
  

Healthy Carbs and Food Pairing:

• Carbs from nature (like vegetables) provide more nutrients, fiber, and antioxidants. Processed carbs, like cookies, don't offer these benefits.
  
  
• Food pairing can help balance blood sugar. For example, eating protein or fat before carbs (like steak before potatoes) can prevent blood sugar spikes.
  
  
• Many people are unknowingly carb-heavy, especially in cultures with vegetarian diets. Substituting lower-carb options, like cauliflower rice for basmati, can make a big difference in how the body processes food.
  
  

Practical Tips:

• Start meals with protein and fiber, then carbs, to stay fuller longer and control cravings.
  
  
• Avoid being too strict—balance is key, and occasionally enjoying carbs is fine.
  
  
• Women may struggle with snacking due to diet culture's emphasis on limiting fats, but choosing the right balance of fats, proteins, and carbs leads to better health outcomes.

Supplementation

There’s a lot of buzz around supplements for conditions like PCOS and insulin resistance—Inositol, Berberine, Magnesium, and more. But, is there real science behind these claims, or is it just expensive urine?

• Inositol seems to have the most data backing it up. However, it’s important to note that its effectiveness can vary from person to person. If you decide to try it, give it 3 to 6 months before deciding if it’s helping. Look for signs like more regular periods or easier weight loss before making a decision to continue.
  
  
• Magnesium is another popular supplement, especially since people with diabetes tend to be magnesium-depleted. For those with insulin resistance, it could be beneficial. But, keep in mind that it can cause side effects like sleepiness or diarrhea. If taken at night, it can support better sleep, which, as we know, is crucial for balancing cortisol and insulin levels. Cortisol, when elevated due to poor sleep, contributes to weight gain, especially visceral fat.
  
  
• Berberine can also be helpful for some, but its effects aren’t always consistent. Some individuals respond well, while others see no changes. It’s not my first line of defense, but if insulin resistance is high and we’re not seeing expected weight loss, it might be worth trying.
  
  

It’s important to keep in mind that supplements are not a one-size-fits-all solution. If you’re thinking about trying something, make sure to:

1. Test it out for a few months.
   
   
2. Use one supplement at a time, so you can track which one works.
   
   
3. Look for high-quality sources, as not all supplements are made the same. Even companies with the best intentions may struggle with sourcing and batch testing.
   
   

Pro Tip: Work with a professional who understands supplementation and can guide you toward safe, effective products. Supplements like Vitamin D, B12, and probiotics are often worth trying, but they should be tested and used thoughtfully.

In the end, it’s about combining science and awareness—try things one at a time, track your results, and reassess after 3-6 months. And remember, no supplement will replace a solid foundation of nutrition, movement, and sleep.

Managing PCOS and insulin resistance involves a holistic approach that includes lifestyle changes such as balanced nutrition, intentional movement, quality sleep, and mindful supplementation. There’s no one-size-fits-all solution, and it's important to experiment, track progress, and work with healthcare professionals to find what works best for your body.