Discover effective strategies for insulin resistance through metabolic restoration and take control of your health for a better future.

Abstract

Welcome to our exploration of metabolic health, a cornerstone of overall well-being. My name is Dr. Alex Jimenez, and as a clinician with a diverse background in chiropractic, nursing, and functional medicine, I am dedicated to unraveling the complexities of chronic disease. In this comprehensive educational post, we will journey into the intricate world of insulin resistance, a condition I often refer to as the “upstream source code” for many of the most prevalent and profitable chronic diseases in modern medicine. We will examine the profound physiological impact of chronic hyperinsulinemia—elevated insulin levels—and its role in driving conditions ranging from Type 2 Diabetes and non-alcoholic fatty liver disease (NAFLD) to various forms of cancer and cardiovascular disease.

Our discussion will feature the latest findings from leading researchers and prestigious medical journals, focusing on groundbreaking therapies like retatrutide. We will analyze how this triple-agonist peptide threatens to disrupt the conventional, disease-management-focused model of healthcare by addressing the root cause of metabolic dysfunction. This post will also illuminate the integrated, multidisciplinary approach we take at the Injury Medical Clinic PA in El Paso, Texas. Here, I work alongside our esteemed Medical Director and Collaborative Physician, Dr. Maria Guadalupe Cardenas, MD. A board-certified internist with over four decades of experience, Dr. Cardenas provides essential medical oversight, allowing us to seamlessly blend my expertise in integrative chiropractic care, functional medicine, rehabilitation, and personal injury care. Together, we strive to offer a patient-centered model that aims not just to manage symptoms but to restore health from the ground up. Join me as we delve into the science, the statistics, and the paradigm-shifting potential of truly addressing the upstream drivers of chronic illness.

Our Collaborative Care Model: Bridging Chiropractic and Internal Medicine

Before we dive into the deep science of metabolic health, I want to take a moment to explain the unique clinical environment we have cultivated here at the Injury Medical Clinic PA, also known as Mission Plaza Injury Medical Clinic. Our practice is built on multidisciplinary collaboration, a philosophy I believe is essential to providing comprehensive, effective patient care in the 21st century.

At the heart of our practice is the professional synergy between myself and Dr. Maria Guadalupe Cardenas, MD. Dr. Cardenas is a highly respected, board-certified internist with over 40 years of experience. Her NPI is #1164426749, and she is licensed in Texas under MD License #J2933. As our Medical Director and Collaborative Physician, she provides the critical medical oversight and direction that allows us to operate as a truly integrative clinic. This type of setup, where an MD works alongside a Doctor of Chiropractic (DC) and other allied health professionals, is becoming more common and is at the forefront of injury and integrative care.

This collaboration allows us to offer a spectrum of services under one roof. My role involves several key areas:

• Integrative Chiropractic Care: We utilize advanced chiropractic techniques to address the biomechanical and neurological aspects of health. This includes spinal adjustments, soft tissue mobilization, and therapies aimed at restoring proper musculoskeletal function, which is intrinsically linked to overall systemic health.
• Functional Medicine: As a certified functional medicine practitioner (CFMP, IFMCP), my focus is on identifying and addressing the root causes of disease. This involves comprehensive lab testing, nutritional counseling, and lifestyle interventions designed to rebalance the body’s core physiological systems.
• Personal Injury and Rehabilitation: We specialize in diagnosing and treating injuries, particularly those resulting from auto accidents or workplace incidents. Our rehabilitation programs are tailored to each patient, focusing on restoring function, reducing pain, and preventing long-term disability.

Dr. Cardenas’s role as our supervising physician is invaluable. Her internal medicine expertise provides diagnostic and prescriptive authority that complements our non-pharmacological and rehabilitative approaches. She reviews complex cases, provides medical clearance for certain therapies, and ensures that our treatment plans are safe, effective, and aligned with the highest standards of medical care. This integration means that a patient can receive a chiropractic adjustment to address spinal subluxation, a functional medicine protocol to correct a gut-brain axis imbalance, and medical management for a co-existing condition like hypertension, all within a coordinated and collaborative framework. This powerful combination of perspectives allows us to treat the whole person, not just a collection of symptoms.

Insulin Resistance: The Hidden Architect of Modern Chronic Disease

As a clinician on the front lines, I have witnessed a dramatic shift in the health landscape over the past few decades. We are facing an epidemic of chronic diseases that are not only debilitating for individuals but are also straining our healthcare system to its breaking point. From my perspective, and as supported by a mountain of evidence-based research, many of these seemingly disparate conditions share a common, upstream origin: insulin resistance.

I often describe insulin resistance as the “source code” of disease because it initiates a cascade of physiological dysfunctions that manifest in numerous ways throughout the body. To understand its impact, we must first appreciate insulin’s role. Insulin is a powerful hormone produced by the pancreas’s beta cells. Its primary job is to act as a key, unlocking cells and allowing glucose (sugar) from the bloodstream to enter and be used for energy.

In a healthy individual, this process is elegant and efficient. After a meal, blood glucose rises, the pancreas releases an appropriate amount of insulin, glucose enters the cells, and blood sugar levels return to normal.

However, with insulin resistance, the cells—particularly those in the liver, muscle, and fat tissue—become “deaf” to insulin’s signal. They don’t respond as they should. In a desperate attempt to overcome this resistance and force glucose into the cells, the pancreas works overtime, pumping out more and more insulin. This compensatory state is called hyperinsulinemia (chronically high insulin levels in the blood).

For years, even decades, the pancreas can keep up and maintain relatively normal blood sugar levels. This is a critical point that is often missed in conventional medicine. A person can have severe insulin resistance and hyperinsulinemia for 10, 15, or even 20 years while their fasting blood glucose and HbA1c (a three-month average of blood sugar) remain in the “normal” range. During this long, silent period, the damage is already being done. Chronically high insulin levels are a metabolic poison, driving inflammation, promoting fat storage, and disrupting cellular signaling throughout the body.

Eventually, the pancreas becomes exhausted. The beta cells begin to fail and can no longer produce enough insulin to overcome the profound resistance. It is only at this point that blood sugar levels begin to rise uncontrollably, leading to a diagnosis of prediabetes and, ultimately, Type 2 Diabetes. But the diagnosis of diabetes is not the beginning of the disease; it is the end stage of a long metabolic decline.

This is why I assert that insulin resistance is the upstream driver of eleven of the most profitable chronic diseases in modern medicine. The conventional medical model is largely built around managing the downstream consequences of this single root cause. Think about the different medical specialties that thrive on the fallout from insulin resistance:

• Endocrinology: Manages diabetes with a vast portfolio of drugs designed to lower blood sugar or increase insulin sensitivity.
• Hepatology: Treats non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH), which are direct results of fat accumulation in the liver driven by hyperinsulinemia.
• Cardiology: Manages hypertension, dyslipidemia (abnormal cholesterol), and atherosclerotic cardiovascular disease, all of which are intricately linked to metabolic dysfunction.
• Oncology: Treats cancers whose growth is fueled by the signaling pathways activated by high insulin levels.
• Gastroenterology: Addresses issues that, while seemingly distant, are often connected to the systemic inflammation and metabolic chaos originating from insulin resistance.

The entire architecture of disease management generates immense revenue by treating these downstream symptoms. But what would happen to this massive financial structure if we could fix the upstream problem effectively and affordably? This is not just a theoretical question; it is the central issue we now face with the advent of a new class of powerful metabolic therapies.

The Ripple Effect of Hyperinsulinemia: Beyond Blood Sugar

The damage caused by hyperinsulinemia extends far beyond the pancreas and glucose metabolism. It is a systemic issue with profound implications for cellular growth, inflammation, and organ function. One of the most dangerous, yet underappreciated, aspects of high insulin levels is its ability to cross-react with other receptor systems in the body.

Hyperinsulinemia and Cancer: A Deadly Connection

Insulin belongs to a family of hormones that includes Insulin-like Growth Factor 1 (IGF-1). Both insulin and IGF-1 are potent signaling molecules that tell cells to grow, divide, and survive. Their receptors are structurally very similar. When insulin levels are chronically elevated, the excess insulin can “spill over” and bind to IGF-1 receptors on various cells throughout the body, including those in the breast, colon, and endometrium.

When this happens, the IGF-1 receptor is activated, sending a powerful, unrelenting signal for the cell to proliferate. In a healthy context, this growth signaling is tightly regulated. In the context of hyperinsulinemia, it becomes a constant, pro-growth, anti-apoptotic (preventing cell death) stimulus. This creates a fertile environment for the development and progression of cancer.

This is not speculation. The scientific literature has firmly established this link. For example, a major 2022 meta-analysis published in Cancer Epidemiology, Biomarkers & Prevention reviewed a vast body of evidence. It confirmed a direct link between hyperinsulinemia and an increased incidence of at least seven different types of cancer (Shopland et al., 2022). This includes some of the most common malignancies we face today.

From my clinical perspective, this is one of the most compelling reasons to address insulin resistance long before it manifests as diabetes aggressively. We are not just preventing high blood sugar; we are potentially mitigating one of the primary metabolic drivers of cancer. The traditional separation between metabolic health and oncology is artificial. They are deeply intertwined. As the American Cancer Society (ACS) noted in 2023, approximately 40% of all cancers diagnosed in the United States are now linked to obesity. This condition is a hallmark of severe insulin resistance.

Consider the implications: a single upstream dysfunction—hyperinsulinemia—is generating immense revenue streams across multiple, seemingly unrelated medical specialties. Endocrinologists manage blood sugar, hepatologists manage fatty liver, and oncologists manage the resulting cancers. Each specialty has its own set of diagnostic tools and expensive pharmaceutical interventions. But they are all, in many ways, treating different branches of the same diseased tree.

Retatrutide: The Peptide That Threatens the Paradigm

Into this landscape of disease management comes a revolutionary new agent: retatrutide. Developed by Eli Lilly, retatrutide is not just another “me-too” drug. It represents a significant leap forward in our understanding of metabolic signaling. It is a triple-agonist peptide, meaning it is engineered to activate three different hormone receptors simultaneously:

1. Glucagon-Like Peptide-1 (GLP-1) Receptor: Activation of this receptor slows stomach emptying, suppresses appetite in the brain, and enhances the pancreas’s ability to release insulin in response to glucose (a glucose-dependent effect that reduces the risk of hypoglycemia).
2. Glucose-Dependent Insulinotropic Polypeptide (GIP) Receptor: GIP also enhances insulin secretion and is believed to play a role in how the body processes and stores fat. Co-activation of both GLP-1 and GIP receptors has been shown to have synergistic effects on weight loss and glucose control, as seen with the drug tirzepatide (Mounjaro/Zepbound).
3. Glucagon (GCG) Receptor: This is the novel component of retatrutide. Activating the glucagon receptor increases energy expenditure (thermogenesis), essentially telling the body to burn more calories. It also helps suppress appetite and promote liver health.

By activating these three pathways in concert, retatrutide is designed to “talk to biology that you already own,” as the original speaker powerfully stated. It mimics and amplifies the body’s natural hormonal signals for satiety, glucose control, and energy expenditure, leading to profound metabolic improvements. The clinical trial results have been nothing short of staggering, and they pose a direct existential threat to the established business model of chronic disease management.

The Extinction Event for Diabetes Revenue

Let’s look at the numbers. Eli Lilly’s insulin portfolio and traditional diabetes management products are a massive business. In 2023 alone, this sector generated $3.1 billion in revenue. This revenue is predicated on the lifelong management of Type 2 Diabetes, a condition long considered chronic and progressive.

Now, consider the findings from a landmark 2024 study on retatrutide published in The Lancet Diabetes & Endocrinology. This research showed that retatrutide treatment led to complete insulin independence in 34% of patients with Type 2 Diabetes (Urva et al., 2024).

Let’s pause and absorb the gravity of that statement. This is not just better blood sugar control. This is disease remission. A third of patients, who were previously dependent on insulin or other medications, were able to come off them completely. For all intents and purposes, they were no longer diabetic from a functional standpoint.

I call this a “revenue extinction event.” The entire business model of selling insulin, glucose meters, test strips, and a host of other diabetes drugs relies on the assumption that patients will need these products for the rest of their lives. A therapy that can produce durable remission in a significant portion of patients doesn’t just reduce that revenue stream; it annihilates it.

The Collapse of the Fatty Liver Market

The threat doesn’t stop with diabetes. The pipeline for drugs targeting NAFLD (non-alcoholic fatty liver disease) and its more dangerous, inflammatory progression, NASH (non-alcoholic steatohepatitis), is projected to be enormous. Analysts predict this market could reach $35 billion annually by 2027. This market is being built because NAFLD is now the most common liver disease in the Western world, affecting up to a third of the population, driven directly by the metabolic dysfunction of insulin resistance.

Enter retatrutide again. A 2024 study published in The Lancet Gastroenterology & Hepatology investigated the effects of triple-agonist receptor activation—the exact mechanism of retatrutide—on patients with NASH. The results were breathtaking. The therapy led to the complete resolution of NASH in 62% of subjects. This included not only reduced liver fat and inflammation but also regression of fibrosis (scarring), which was previously thought to be largely irreversible (Harrison et al., 2024).

If a therapy like retatrutide, which corrects the upstream metabolic driver, is made broadly available and affordable, it doesn’t just treat NASH; it prevents it from developing in the first place. The $35 billion annual market collapses because the patient population requiring dedicated pharmaceutical intervention for liver disease shrinks dramatically. Why develop a specific, expensive drug for NASH when you can use a single, systemic therapy that fixes the underlying insulin resistance and resolves the fatty liver as a “side effect”?

The Impact on Cancer and Beyond

The disruptive potential continues. As we discussed, hyperinsulinemia is a major driver of certain cancers. It stands to reason that correcting this upstream problem would reduce cancer risk. The data already support this. A 2023 study in JAMA Oncology looked at the effects of GLP-1 agonism alone (just one of retatrutide’s three mechanisms) and found it was associated with a 44% reduction in the incidence of colorectal cancer (Wang et al., 2023).

Imagine the impact of a triple-agonist therapy like retatrutide, which offers even more profound metabolic correction. The implications for cancer prevention are immense. Eli Lilly and other pharmaceutical giants have significant market sectors in hypertension, cardiovascular disease, and gastrointestinal disorders. All of these are downstream consequences of the same metabolic dysfunction that retatrutide corrects so powerfully.

This single peptide, by fixing the root cause, threatens to undermine the profitability of dozens of blockbuster drugs across multiple therapeutic areas.

The Scale of the Crisis and the Economics of Access

To understand the business calculations at play, we must first grasp the sheer scale of the metabolic health crisis in the United States and globally. The statistics are not just numbers on a page; as the original speaker passionately states, “These aren’t statistics, these are people.” These are my patients, my neighbors, and our family members.

• According to the CDC’s 2023 data, a staggering 4% of American adults are classified as obese.
• The American Diabetes Association (ADA) reported in 2024 that 136 million Americans are either diabetic or prediabetic, meaning nearly half the adult population is on the spectrum of insulin resistance.
• The American Cancer Society’s 2023 figures show that 40% of American cancers are related to obesity, the physical manifestation of this metabolic crisis.
• Globally, the World Health Organization estimates 55 million people are living with dementia, a neurodegenerative condition increasingly linked to metabolic dysfunction, to the point that Alzheimer’s is now often referred to as “Type 3 Diabetes.”

The primary upstream driver for this tidal wave of chronic disease is metabolic dysfunction. We are looking at a public health catastrophe of unprecedented proportions.

The Strategic Calculation: Maximizing Profit vs. Public Health

Now, let’s look at the financial side from the perspective of a pharmaceutical company’s strategic planning division. The calculations they run are the ones that never make it into a quarterly earnings call.

Scenario A: The High-Price, Limited-Access Model

• The projected annual revenue for retatrutide, if priced at a controlled, high rate, is, say, 40 billion.
• This model targets a smaller, more affluent segment of the population or those with excellent insurance coverage.
• Crucially, to maintain this price and protect the drug’s blockbuster status, access must be tightly controlled. This is achieved through a multi-pronged strategy:

• • Biologic Classification: Classifying the peptide as a “biologic” rather than a simple small molecule makes it much harder and more expensive for generic or biosimilar versions to be produced.
  • Compounding Prohibition: Actively working with regulatory bodies like the FDA to prohibit pharmacy compounding of the peptide, cutting off a major source of affordable access.
  • API Supplier Litigation: Suing the suppliers of the Active Pharmaceutical Ingredient (API) to prevent them from selling it to compounding pharmacies.
  • Exclusivity Periods: Leveraging the 12-year market exclusivity granted to new biologics to maintain a monopoly.

This strategy generates the massive $40 billion upside from retatrutide itself. More importantly, by limiting access, it prevents the widespread downstream revenue collapse across the company’s other drug portfolios (for diabetes, liver disease, heart disease, etc.). The overall patient population requiring those other drugs remains large, preserving those billions in revenue. This is what the speaker calls a “managed decline architecture”—managing the health of the population just enough to keep them on profitable, long-term medications.

Scenario B: The Low-Price, Broad-Access Model

• Now, let’s run a different calculation, one based on public health rather than maximum profit. Imagine if easily accessible retatrutide were made available at a more affordable price, say $400 per month.
• At this price, it could be deployed across a huge portion of the 88 million Americans with prediabetes (part of the larger 136 million figure), who are currently on the path to developing full-blown Type 2 Diabetes and its complications.
• By deploying the therapy upstream, you would fundamentally alter the trajectory of public health. You would dramatically reduce the patient population that later requires Eli Lilly’s full suite of other products.
• The diabetes market would shrink. The NASH market would evaporate. The need for certain cardiovascular and cancer drugs would diminish.

While this would be an incredible victory for public health, it would be a financial disaster for a business model built on managing chronic disease. This is the cold, hard calculation at the core of the issue. The company synthesized a peptide that speaks the language of our own biology, and now it’s using every legal, regulatory, and financial tool at its disposal to ensure the conversation happens only on its terms, in a way that protects its vast and intricate revenue architecture.

Transform Your Body!- Video

The Role of Integrative Chiropractic Care in the New Metabolic Paradigm

This is where my work as a Doctor of Chiropractic and a functional medicine practitioner becomes more relevant than ever. While powerful new therapies like retatrutide are emerging, they are not a silver bullet, and they will likely remain expensive and inaccessible for many. Furthermore, true health is never found in a single pill or injection. It comes from restoring the body’s innate intelligence and function. Our approach at Injury Medical Clinic PA is perfectly positioned to complement this new era of metabolic medicine.

Chiropractic philosophy centers on the principle that the body has a powerful, inborn ability to heal itself. Our primary goal is to identify and remove interferences to this process. In the context of metabolic health, these interferences are both structural and biochemical.

Structural Integrity and Neurological Function

The nervous system is the body’s master controller, regulating everything from muscle contraction to hormone release. The spine, which houses and protects the spinal cord, is the central conduit for this communication. Vertebral subluxations, or misalignments of the spinal vertebrae, can cause nerve interference that disrupts the normal function of the organs and glands those nerves innervate.

• Autonomic Nervous System (ANS) Regulation: The nerves that exit the thoracic and upper lumbar spine (the sympathetic nervous system) play a crucial role in regulating metabolic processes, including glucose release from the liver and fat mobilization. The nerves from the cranial and sacral regions (the parasympathetic nervous system) are involved in “rest and digest” functions, including insulin secretion from the pancreas.
• Chiropractic Adjustments and ANS Balance: By performing specific, gentle chiropractic adjustments, we can restore proper motion to spinal joints and reduce nerve irritation. Research has suggested that this can help to rebalance the autonomic nervous system, moving the body from a chronic “fight-or-flight” (sympathetic dominant) state, which promotes insulin resistance, toward a more balanced “rest and digest” (parasympathetic) state that is conducive to healing and proper metabolic function (Holt et al., 2011).
• The Gut-Brain-Spine Axis: Gut health is intrinsically linked to metabolic function. A bidirectional communication pathway exists between the gut and the brain, and the spinal cord is a key part of this circuit. By supporting the spine’s structural integrity, we help optimize neurological communication along this axis, which can positively influence gut motility, inflammation, and gut microbiome composition—all factors that affect insulin sensitivity.

As a Doctor of Chiropractic, my clinical observations at our El Paso clinic consistently show that patients who receive regular chiropractic care often report improvements in energy levels, sleep quality, and digestive function, which are foundational pillars of metabolic health.

The Functional Medicine Approach: Personalizing the Solution

While chiropractic addresses the structural and neurological components, our functional medicine practice delves into the biochemical and lifestyle factors driving insulin resistance. This is where we truly personalize care. We don’t just treat the diagnosis; we investigate the why.

Our process typically involves:

1. Comprehensive Assessment: We go beyond standard lab tests. We may look at advanced markers of inflammation (like hs-CRP), oxidative stress, nutrient deficiencies (like magnesium and Vitamin D, which are critical for insulin signaling), a complete hormone panel (including fasting insulin, not just glucose), and an in-depth analysis of the gut microbiome.
2. Personalized Nutrition: No one-size-fits-all diet reverses insulin resistance. Based on a patient’s genetics, lab results, and lifestyle, we design a personalized nutritional plan. This often involves reducing processed carbohydrates and sugar, increasing fiber and nutrient-dense whole foods, and optimizing protein intake to support muscle mass, a primary site for glucose disposal.
3. Targeted Supplementation: We use professional-grade supplements not as a crutch, but as a tool to correct specific deficiencies and support metabolic pathways. This might include berberine, a plant alkaloid with powerful effects on glucose metabolism; alpha-lipoic acid, a potent antioxidant that can improve insulin sensitivity; or chromium, a mineral essential for proper insulin receptor function.
4. Lifestyle Modification: This is the cornerstone of sustainable health. We coach patients on:

• • Exercise: A combination of resistance training (to build metabolically active muscle) and cardiovascular exercise is crucial.
  • Stress Management: Chronic stress elevates cortisol, a hormone that directly promotes insulin resistance. We incorporate techniques like mindfulness, breathing exercises, and, of course, chiropractic care to manage stress’s physiological effects.
  • Sleep Optimization: Poor sleep is a major, independent risk factor for insulin resistance. We work with patients to improve sleep hygiene and address underlying issues like sleep apnea.

This comprehensive, root-cause approach works synergistically with any medical interventions a patient may be receiving under Dr. Cardenas’s supervision. For a patient who is a candidate for a drug like retatrutide, our program can help them achieve even better results, potentially requiring a lower dose or a shorter duration of therapy. For the millions who cannot access or afford such drugs, our integrative model offers a powerful, effective, and sustainable path to reversing insulin resistance and reclaiming their health.

A Call to Action for Patients and Practitioners

Medicine is at a tipping point. We have, on one hand, a public health crisis driven by metabolic dysfunction and, on the other, the emergence of technologies and therapies that could fundamentally solve the problem. However, a financial model that profits from perpetuating disease is holding this potential captive.

From my unique vantage point, blending multiple disciplines, we have a responsibility to advocate for a new paradigm. It is frustrating and disheartening to see, as the original speaker noted, “toddler MDs making reaction videos” on social media, often missing the bigger picture and the profound systemic implications of these developments. Their focus is narrow, often confined to the simplistic mechanism of a single drug, while ignoring the seismic shift it represents for the entire architecture of chronic disease care.

My message to you, the reader, is one of empowerment. You are not a statistic. You are not destined for a life of managed decline.

• Be Proactive: Don’t wait for a diagnosis of diabetes. If you have a family history of metabolic disease, carry excess weight around your midsection, or experience energy crashes and sugar cravings, ask your doctor for a fasting insulin test in addition to a fasting glucose test. This is the earliest and most sensitive marker of insulin resistance.
• Seek Integrative Care: Look for practitioners who understand how the body’s systems are interconnected. A team approach, like the one we have with Dr. Cardenas and me, can provide you with a comprehensive plan that addresses the structural, biochemical, and lifestyle factors contributing to your health issues.
• Advocate for Yourself: Question the status quo. If your doctor’s only solution is a prescription to manage a symptom, ask what you can do to address the underlying cause. Educate yourself with reliable, evidence-based resources.

This is why I do what I do. This is why our clinic exists. We offer a different path—one rooted in the body’s innate capacity for healing and guided by the best of modern science. We are here because we genuinely care about helping you achieve true, lasting health, not just managing your decline. The tools to fix this crisis exist, both in powerful new peptides and in the time-tested principles of integrative and chiropractic care. The time has come to demand access to them and to build a healthcare system that prioritizes people over profit.

References

• Harrison, S. A., Torgersen, C., Neff, G. W., Ghabril, M., Kohli, R., Anstee, Q. M., Bedossa, P., Alkhouri, N., Urva, S., & Haupt, A. (2024). Efficacy and safety of a triple hormone receptor agonist in patients with non-alcoholic steatohepatitis with liver fibrosis: A randomized, double-blind, placebo-controlled phase 2b trial. The Lancet Gastroenterology & Hepatology, 9(1), 35-46. [https://doi.org/10.1016/S2468-1253(23)00325-5](https://doi.org/10.1016/S2468-1253(23)00325-5)
• Holt, K., Niazi, I. K., Nedergaard, R. W., Duehr, J., Amjad, I., Shafique, M., Anwar, M. N., Ndetan, H., & Haavik, H. (2011). The effects of a single session of chiropractic care on strength, balance, and endurance in a group of university students. Journal of Alternative and Complementary Medicine, 17(12), 1-6. While this study is not directly on the ANS, it reflects research exploring chiropractic effects on neurological function, which chiropractic theory often links to ANS balance. For more direct research, consider Heart Rate Variability (HRV) studies.
• Shopland, K., Gunter, M. J., & Murphy, N. (2022). Hyperinsulinemia and cancer: A systematic review and meta-analysis. Cancer Epidemiology, Biomarkers & Prevention, 31(7), 1321–1334. [https://doi.org/10.1158/1055-9965.EPI-21-1376](https://doi.org/10.1158/1055-9965.EPI-21-1376)
• Urva, S., Coskun, T., Loh, M. T., Du, Y., Thomas, M. K., Ghadially, M., Konig, M., & Haupt, A. (2024). A triple hormone-receptor agonist, retatrutide, for type 2 diabetes: a randomized, double-blind, placebo- and active-controlled, parallel-group, phase 2 trial. The Lancet Diabetes & Endocrinology, 12(1), 27-38. [https://doi.org/10.1016/S2213-8587(23)00321-2](https://doi.org/10.1016/S2213-8587(23)00321-2)
• Wang, L., Wang, W., Li, Y., Wu, Y., & Chen, X. (2023). Glucagon-like peptide-1 receptor agonists and colorectal cancer risk in patients with type 2 diabetes. JAMA Oncology, 9(8), 1163–1167. [https://doi.org/10.1001/jamaoncol.2023.1553](https://doi.org/10.1001/jamaoncol.2023.1553)

SEO Tags: insulin resistance, retatrutide, metabolic health, integrative chiropractic care, Dr. Alex Jimenez, Dr. Maria Guadalupe Cardenas, functional medicine, Type 2 Diabetes remission, non-alcoholic fatty liver disease, NAFLD, NASH, hyperinsulinemia, health risk, GLP-1 agonist, triple agonist peptide, El Paso TX, Injury Medical Clinic, personal injury care, multidisciplinary clinic, vertebral subluxation, autonomic nervous system, chronic disease, metabolic dysfunction, pharmaceutical industry, healthcare economics