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A randomized open-label trial evaluated the orlistat effect on insulin resistance (IR) and compared with metformin and pioglitazone in obese women, treatment with orlistat has significantly reduced the IR compared to metformin and pioglitazone (17)

Efforts to alleviate IIRI by modulating the microbiota, such as with probiotic Bifidobacterium and Lactobacillus plantarum transplantation in animal models, have already been reported [13, 14]

The article pairs that with slowed gastric emptying, which it says raises the risk further

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