In our body, there is only one hormone that can lower blood sugar, namely insulin. It is secreted by islet pancreatic beta cells located in the pancreas. For a long time, it was thought that diabetes was caused by insulin deficiency. However, later studies found that in many people with type 2 diabetes, although the body’s blood glucose level is elevated, the level of insulin secreted in the body is higher than in people without diabetes. Why can’t high insulin secretion lower the high blood sugar? This is because the sensitivity of insulin’s main effector organs, i.e. muscle tissue, adipose tissue, liver, etc., to insulin is reduced, so that the normal amount of insulin produces a lower than normal physiological effect – the hypoglycemic effect cannot be performed normally, a phenomenon we call insulin resistance. Insulin resistance is commonly found in patients with type 2 diabetes. In the early stages of insulin resistance before the onset of diabetes, the body compensates for the lack of its glucose-lowering effect by producing more insulin, producing hyperinsulinemia and maintaining normal blood glucose levels. As time goes on, if the islet cells gradually fail to produce sufficient insulin due to prolonged overwork, it leads to an increase in blood glucose levels in the body and even the development of diabetes. Risk factors for insulin resistance are multiple, including increased caloric intake, reduced physical activity, obesity, hyperlipidemia, hyperglycemia and some medications that affect the action of insulin. Insulin resistance may also be related to genetics. Clinical practice proves that improving insulin resistance (while protecting islet cell function) is important in the prevention and treatment of type 2 diabetes. The treatment of insulin resistance should take a comprehensive approach, including diet control, exercise and medication. First of all, diet therapy is the basic method to improve insulin sensitivity. The type and amount of food consumed affect the effect of insulin. Low-calorie diet can improve insulin sensitivity, especially for obese patients. It is important to pay attention to how much energy is consumed each day to ensure that the body needs nutrition without making weight gain due to excessive intake. Controlling caloric intake in obese people can reduce body weight and thus improve insulin sensitivity. The diet should pay attention to the appropriate ratio of sugar, fat and protein, avoid excessive intake of sugar and sugary foods (especially fructose), reduce the intake of high-fat and high-cholesterol foods, moderate intake of high dietary fiber foods, should eat less and more meals rather than overeating. Reducing the intake of fat in food, especially saturated fat (animal-derived fat) and trans fatty acids (fast food, popcorn, etc. often contain such fatty acids), is beneficial to reduce insulin resistance. Secondly, exercise therapy is also an important approach. In general, fasting insulin levels are positively correlated with insulin resistance. It was found that exercise can will lower insulin levels. It is suggested that exercise can improve the effect of insulin. Exercise not only increases energy consumption, but also makes the body cells use glucose more efficiently, reduces the body fat content, increases the body muscle tissue content and promotes aerobic metabolism, but these effects disappear after a few days of stopping exercise, so exercise should be insisted on. The choice of exercise for diabetic patients should be made under the guidance of a doctor and follow the principles of individualization, safety and effectiveness. Finally, medication. Research shows that many drugs have the effect of improving insulin sensitivity, making insulin “resurrect” and give full play to improve the body’s blood sugar level. At present, the main drugs commonly used to improve insulin sensitivity are biguanides and thiazolidinediones. The application of biguanides, such as metformin, has a long history, especially for obese patients with type 2 diabetes. Metformin can increase the hypoglycemic effect of other hypoglycemic drugs such as sulfonylureas as well as insulin. Thiazolidinediones are relatively new drugs for the treatment of insulin resistance in type 2 diabetes in recent years, and commonly used preparations include rosiglitazone maleate and pioglitazone hydrochloride. In addition, because hyperglycemia can aggravate insulin resistance, other measures to lower blood glucose may also alleviate lower insulin resistance. Sulfonylureas and α-glucosidase inhibitors also have the effect of improving insulin sensitivity by lowering blood glucose. Early application of insulin short-term therapy in patients with first diagnosed type 2 diabetes may also improve insulin resistance. Beta lipid-lowering drugs and niacin can lower blood lipid and fatty acid levels by inhibiting adipose tissue hydrolysis and improve insulin sensitivity of target tissues. Meanwhile, many herbal medicines such as ginsenosides, Tianqi, Platycodon grandis and Liu Wei Dihuang also have the effect of improving insulin resistance. The use of drugs that improve insulin sensitivity, especially when combined with other hypoglycemic drugs, may increase the risk of hypoglycemia, and should be done under the guidance of a physician to master the indications and contraindications for their use. In conclusion, diet and exercise therapy are the basis for the treatment of insulin resistance, and the appropriate addition of insulin sensitizers can obtain a better effect of improving insulin sensitivity, which is more conducive to the control of blood glucose and the protection of pancreatic islet cell function in patients with type 2 diabetes, and improve the quality of survival of diabetic patients.