Modulation of Insulin Receptor gene expression through diet and lifestyle modifications in a prediabetic subject: An observation

Prediabetes affects nearly 1.1 billion adults globally and often leads to Type 2 Diabetes, primarily because of insulin resistance. Although research on the Insulin Receptor (INSR) gene is limited, evidence suggests that this gene plays a pivotal role in the development of insulin resistance and the subsequent progression of the disease. A 55-year-old male with a 20-year history of prediabetes, presented with complaints of burning palms and soles along with increased glycemic parameters, i.e. Fasting Blood Sugar (FBS): 110 mg/dL, Post Prandial 2-h Blood Sugar (PP2BS): 166 mg/dL, and Glycated Hemoglobin (HbA1c): 6.3%. Based on clinical features such as Pada daha and Supti (~burning and numbness in soles), Alasya (~laziness), Gurugatrata (~heaviness in body), the case was diagnosed as Prameha purvarupa (~prodromes of Diabetes mellitus). After re-evaluation of Nidana (~causative factors), diet and lifestyle modifications were implemented for three months. Subsequently, significant improvements were observed in glycemic parameters (FBS: 100 mg/dL, PP2BS: 129 mg/dL, HbA1c: 5.9%). Notably, INSR gene expression analysis revealed 16-fold up-regulation as compared with control gene, Glyceraldehyde-3-phosphate dehydrogenase (GAPDH). This case suggests that tailormade Ayurveda diet and lifestyle modifications, guided by precise evaluation of Nidana and its avoidance, may effectively manage prediabetes, resulting in better glycemic control, improved glucose metabolism and enhanced INSR gene expression, thereby, reducing the risk of progression to diabetes.