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Now for those of you who'd like to take advantage of insulin and the benefits of being sensitive through drug use, I've compiled the following list.
Acetohexamide
This is a derivative of sulfonylureas. Sulfonylureas are compounds that stimulate the islet tissue on the pancreas to synthesize and release endogenous insulin. In general, for those who are insulin resistant, these aren't very beneficial, as they only increase insulin levels to a higher degree. Acetohexamide, however, is unique in the sense that it can increase insulin sensitivity on insulin receptors and improve peripheral utilization of insulin.
Acarbose
This is an alpha-glucosidase inhibitor. This means that it's able to prevent sugars such as maltose and sucrose from being broken down. It works by prolonging the absorption of carbohydrates. It's been shown to decrease somatostatin levels, which theoretically, could lead to an increase in GH. It's also been shown to decrease triglycerides as well as improve the ratio of LDL to HDL.
Benfluorex
This is a derivative of the anoretic drug, Fenfluramine. It works similarly to metformin by increasing insulin sensitivity in peripheral tissues. It also has a slight appetite suppressant effect and can decrease cholesterol while increasing HDL levels.
Glyburide
This drug differs from others in that it may increase the number of insulin receptors resulting in increased insulin sensitivity.
Clofibrate
While the new compounds being used to treat insulin resistance (called glitazones) have proven to be quite effective, another class referred to as fibrates (currently used for their antilipidemic properties) may prove to be just as effective in terms of increasing sensitivity while not resulting in a gain of body fat, and possibly even reducing it. Clofibrate, also known as Atromid-S, could prove to be a rival to metformin. However, to my knowledge, this has only been found in animal models. So, stay tuned and be on the look out!
Metformin
This drug is my personal favorite. Why? Well, the problem with most other insulin sensitizing drugs is that they don't work selectively to sensitize only muscle tissue. Their increased insulin sensitivity occurs in peripheral tissue, meaning both adipocytes and myocytes. However, metformin works by increasing sensitivity in muscle tissue only.
Unlike sulfonylureas, it doesn't cause an increase in fat. In terms of dropping body fat and maintaining insulin sensitivity while using insulin, this is the superior drug. Dosages range between 500-2500 mg per day with meals. They typically come in 500 and 850 mg tabs.
Insulin
In terms of staying absolutely insulin sensitive, avoiding exogenous insulin is important. However, for those of you who choose to use insulin in order to increase muscle mass, it's important to use metformin along with it and even afterward. Be careful though. Every time you inject a fast acting insulin, you run the risk of going into a hypoglycemic shock and dying, which would really mess up your sex life. You can come up with your own ideas on how to avoid this, or you can do what my large friend (6'3", 285 lbs at 8% body fat) does: sit down with a container of dextrose or maltose and drink it until you no longer feel like passing out. Needless to say, this is scary stuff!
In terms of reducing insulin resistance, one type of insulin actually does the job. It's called insulin lispro. It's made with recombinant DNA technology by altering the pharmaceutical profile. This insulin is also known as Humalog, and it's the only form of insulin to which patients with severe insulin resistance responded.
It has a shorter and more consistent duration of action than most other types of insulin, which makes it safer and less likely to increase body fat. As a side note, if you're using any type of insulin, make sure to supplement with magnesium and potassium, as they're both depleted while using it.
Anabolic Steroids
While anabolic steroids have many affects on the human body, one of interest to us may be their ability to increase glucose disposal, possibly leading to an increase in insulin sensitivity. In one study, healthy males were given 300 mg/week of either Testosterone enanthate or nandrolone decanoate for six weeks. At the end of the study, it was found that while TE had no detrimental effect on glucose disposal, ND had increased glucose disposal to a significant degree. These findings were in conflict with what was found in the use of 17-alpha alkylated steroids. So, according to this, the best anabolic to use while trying to improve insulin sensitivity may be Deca! The benefits of this 'roid never seem to end.