Insulin resistance do we have a solutions other than diet and exercise to the receptor or post receptor defects causing the problem

Insulin resistance is a serious condition, despite over 40-50 years of investigation a definitive mechanism or defect has not been elucidated.in the post receptor signalling network. This implicates a defect closer to the insulin binding event. hyperinsulinemia is an initiating component of insulin resistance and is responsible for an affinity change and a reduction in the number of insulin receptors a the cell surface. In the high fat fed mouse model we initiated an exercise program at the start of the high fat feeding and did not see any hyperinsulinemia or insulin resistance.Finding a therapy that can reduce insulin in the circulation maintain blood glucose and restore insulin receptor affinity and numbers would seem to be the silver bullet to prevent the hyperinsulinemia induced insulin resistance, to date there has not been a mechanism or therapy described that can achieve this. The new GLP-1 A's reduce weight but not insulin initially but have the best prospect so far for an effective means of combating the effect of excess caloric consumption. Diet and exercise alone after the onset of insulin resistance does not seem to be a permanent or suitable solution, but remains the aminstay for preventing the prediabetic state to progress to Diabetes. Unless the constant stimuli that produce hyperinsulinemia is able to be tamed the self perpetuating process of continual reduction in insulin receptor affinity and number will along with the metabolic consequences of impaired insulin action that is a result of the receptor changes, we will still have a poor prognosis for the future treatment and prevention of obesity and Type 2 diabetes.