In the outpatient clinic, we often encounter such diabetic patients, who have been transferred to many hospitals for consultation and have used insulin, even dozens or hundreds of units of insulin, but their blood sugar still cannot reach the ideal level, and their persistent high blood sugar makes them worry and even lose confidence in the treatment. Why is insulin not effective in lowering blood sugar, or even ineffective? In fact, insulin resistance is one of the important reasons. The reason is that the body is no longer sensitive to insulin (i.e. insulin resistance), and the function of insulin has been “devalued”. What are the causes of insulin resistance? In type 2 diabetes, the main cause is a decrease in the affinity between insulin and insulin receptors on cells or a decrease in the number of insulin receptors; in type 1 diabetes, the main cause is the body’s spontaneous production of antibodies. Researchers believe that insulin resistance is closely related to a poor lifestyle, in addition to a genetic relationship. It is prone to occur in the following conditions: reduced intake of complex carbohydrates and dietary fiber; excessive consumption of foods rich in animal fats; excessive consumption of refined grains; sedentary and less active, smoking can also aggravate insulin resistance. In addition, endocrine hormone imbalance can also lead to insulin resistance. For example, polycystic ovary syndrome, excessive glucocorticoids, glucagon, catecholamines and growth hormone can counteract the effect of insulin. Some special groups of people are prone to insulin resistance. First, the elderly; second, obese people; third, patients with hypertension, central obesity, lipid metabolism disorders and other diseases. When insulin resistance occurs, the first thing to do is to use drugs that can improve insulin resistance and activate insulin sensitivity, such as GLP-1 such as exenatide, DPPP-4 inhibitors such as selegiline, insulin sensitizers such as rosiglitazone (Ventia), etc. Also, diet control must be adhered to. Diabetic patients should avoid sugar and sugary foods, reduce the consumption of high-fat and high-cholesterol foods, eat high-fiber and starchy foods in moderation, and eat small and frequent meals. At the same time, to do more whole-body exercise, including walking and jogging, etc.. Particular attention should be paid to the combination of high blood pressure diabetic patients to use less beta-blockers and thiazide diuretics and other antihypertensive drugs, these drugs can interfere with the body’s glucose metabolism, aggravate insulin resistance, and even induce diabetes. Of course, Chinese medicine plays an important role in improving insulin resistance and enhancing insulin sensitivity, which can greatly reduce the dosage of insulin and obtain better blood sugar control. Patients are advised to add Chinese herbal medicine for this type of insulin ineffectiveness.