Nutrition as the Cornerstone: Re-evaluating the Role of Diet in the Treatment of Insulin Resistance in Polycystic Ovarian Syndrome

Authors

• Meagan Ferguson, University of LynchburgFollow

Specialty

OB/Gyn, Lifestyle Medicine

Advisor

Dr. Elijah Salzer

Abstract

This clinical review evaluates the efficacy of treatment options for insulin resistance (IR) associated with polycystic ovarian syndrome (PCOS), with a focus on the comparison of various dietary strategies and metformin monotherapy. A comprehensive search of electronic databases including PubMed and the Cochrane library was conducted to identify studies published between 2019 and 2025 that compared different dietary interventions and metformin for the management of IR in patients with PCOS. Insulin resistance is a primary driver of PCOS pathophysiology and a surrogate marker used to determine disease severity, therefore optimizing the management of IR is critical for improving clinical outcomes for patients with PCOS. The findings of this study indicate that while both nutrition therapy and metformin are effective interventions, the Dietary Approaches to Stop Hypertension (DASH) diet demonstrated superior efficacy in reducing insulin resistance markers compared to metformin monotherapy. However, relatively small sample sizes and short study durations highlight the need for additional research with large-scale studies to better assess the long-term effects of dietary interventions on insulin resistance and optimize clinical treatment guidelines for PCOS. Additionally, future studies should include a wider variety of dietary patterns plus metformin for better direct comparison of effectiveness. This review underscores the key role nutrition plays in PCOS management and the need for healthcare practitioners to emphasize dietary interventions as a cornerstone of comprehensive PCOS management.

Recommended Citation

Ferguson M. Nutrition as the Cornerstone: Re-evaluating the Role of Diet in the Treatment of Insulin Resistance in Polycystic Ovarian Syndrome. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).