IR Prevalence By Condition – For Radiant Health

IR Prevalence by Condition — UK & US Estimates | For Radiant Health

How to read this data: These tables address two clinically important questions. First: within each patient population, what share of sufferers appears to have a condition driven by causes other than insulin resistance? A low "Without IR" figure (e.g. T2DM at 10%) confirms how dominant IR is as a root driver. A higher figure (e.g. OCD at ~60%) reflects multi-causality. Second: of the IR-positive patients, what proportion could expect significant improvement or remission through a sustained very low carbohydrate diet (VLC) and intermittent fasting (IF) protocol? All figures are research-based estimates; individual clinical variation applies.

Remission column — methodology note: "Est. % remission / major improvement" refers to the proportion of IR-positive patients with each condition who, in published clinical trials and prospective cohort studies, achieved either full remission (e.g. T2DM — no longer meeting diagnostic criteria without medication) or a major, clinically significant improvement (e.g. blood pressure normalisation, ≥50% symptom reduction, or measurable structural change) on sustained VLC diet and/or intermittent fasting. Where RCT data is sparse, figures draw on mechanistic evidence and published case series. Stroke denotes recurrence-risk reduction rather than neurological reversal.

🇬🇧 United Kingdom

Estimated IR-Free Patients & Remission Potential — UK

Condition	Total UK Patients	Est. % With IR	IR Strength	% Without IR	Number Without IR	Est. % Remission / Major Improvement (VLC + IF, IR-positive patients)
Type 2 Diabetes Diagnosed; ~850,000 additional undiagnosed	4,800,000	~90%	Critical	~10%	480,000	~45–60%
Hypertension Diagnosed; ~5M additional undiagnosed	14,000,000	~65%	High	~35%	4,900,000	~50–65%
MASLD / Fatty Liver Non-alcoholic; substantial under-diagnosis	6,000,000	~95%	Critical	~5%	300,000	~65–80%
Arthritis OA ~9M; RA ~400,000 — Versus Arthritis UK	10,000,000	~50%	Moderate	~50%	5,000,000	~35–50%
Alzheimer's Disease Dementia UK 2024; ~950,000 total dementia	1,000,000	~65%	High	~35%	350,000	~20–35%
Multiple Sclerosis MS Society UK; highest prevalence in north	130,000	~55%	Moderate	~45%	58,500	~25–40%
Stroke Stroke Association UK — living with stroke effects	1,300,000	~65%	High	~35%	455,000	~40–55% *
IBS NHS est. ~1 in 10; includes all adult ages	8,000,000	~45%	Moderate–Low	~55%	4,400,000	~45–60%
Asthma Asthma UK; ~1 in 8 adults actively managed	5,400,000	~50%	Moderate	~50%	2,700,000	~30–45%
ADHD Diagnosed adults; significant under-diagnosis	2,500,000	~50%	Moderate	~50%	1,250,000	~25–40%
AMD Macular Society UK; predominantly age-related	700,000	~55%	Moderate	~45%	315,000	~25–40%
OCD OCD-UK estimate; 1 in 50 population	1,000,000	~40%	Emerging	~60%	600,000	~15–25%
Autism NAS UK figure; ~1.1% prevalence all ages	750,000	~40%	Emerging	~60%	450,000	~20–35%
Combined across 13 conditions	55,580,000	—	—	~39% weighted avg	21,260,000	—

IR Link: Critical (>85%) High (60–85%) Moderate (45–60%) Moderate–Low (40–45%) Emerging (<45%) Remission (VLC+IF): Strong (65%+) Good (45–64%) Moderate (30–44%) Limited / Emerging (<30%)

* Stroke remission figure refers to metabolic recurrence-risk reduction, not neurological reversal of prior stroke damage.

🇺🇸 United States

Estimated IR-Free Patients & Remission Potential — US

Condition	Total US Patients	Est. % With IR	IR Strength	% Without IR	Number Without IR	Est. % Remission / Major Improvement (VLC + IF, IR-positive patients)
Type 2 Diabetes CDC 2023 — diagnosed + undiagnosed combined	38,000,000	~90%	Critical	~10%	3,800,000	~45–60%
Hypertension CDC 2023 — 47% of US adults; ~122M total	120,000,000	~65%	High	~35%	42,000,000	~50–65%
MASLD / Fatty Liver AGA — ~30% of US adults; rapid increase	30,000,000	~95%	Critical	~5%	1,500,000	~65–80%
Arthritis CDC — all types; predominantly OA (~32M)	58,000,000	~50%	Moderate	~50%	29,000,000	~35–50%
Alzheimer's Disease Alzheimer's Association 2024 — 6.7M aged 65+	6,700,000	~65%	High	~35%	2,345,000	~20–35%
Multiple Sclerosis National MS Society 2023 est.	1,000,000	~55%	Moderate	~45%	450,000	~25–40%
Stroke CDC — adults living with stroke effects	7,800,000	~65%	High	~35%	2,730,000	~40–55% *
IBS AGA/CDC est. — 25–45M range; mid-range used	35,000,000	~45%	Moderate–Low	~55%	19,250,000	~45–60%
Asthma CDC 2023 — ~8% of US adults	27,000,000	~50%	Moderate	~50%	13,500,000	~30–45%
ADHD NIMH diagnosed adults; significant under-diagnosis	10,000,000	~50%	Moderate	~50%	5,000,000	~25–40%
AMD NEI/BrightFocus — predominantly dry AMD	3,000,000	~55%	Moderate	~45%	1,350,000	~25–40%
OCD NIMH — ~1.2% adults; some estimates up to 3M	3,000,000	~40%	Emerging	~60%	1,800,000	~15–25%
Autism CDC 2023 — 1 in 36 children; all-age est. ~5M	5,000,000	~40%	Emerging	~60%	3,000,000	~20–35%
Combined across 13 conditions	344,500,000	—	—	~38% weighted avg	125,725,000	—

IR Link: Critical (>85%) High (60–85%) Moderate (45–60%) Moderate–Low (40–45%) Emerging (<45%) Remission (VLC+IF): Strong (65%+) Good (45–64%) Moderate (30–44%) Limited / Emerging (<30%)

* Stroke remission figure refers to metabolic recurrence-risk reduction, not neurological reversal of prior stroke damage.

Methodology & Data Sources

IR co-occurrence estimates are derived from peer-reviewed population studies rather than from direct HOMA-IR measurement in each condition cohort. Remission/improvement figures draw on published RCTs, prospective cohort studies, and mechanistic evidence where RCT data is limited. All are research-based mid-range estimates; individual clinical populations will vary. Prevalence figures are current as of 2023–2024 data releases.

IR Prevalence Estimates

T2DM — 90% IR IR is mechanistically central to T2DM pathogenesis (ADA, 2023). ~5–10% may represent MODY/LADA phenotypes with predominantly insulin-secretory defects.

Hypertension — 65% IR Reaven (1988); Ferrannini et al.: sodium retention, RAAS activation, and sympathetic overactivity are IR-mediated in ~50–75% of essential hypertension cases.

MASLD — 95% IR IR is essentially universal in MASLD. De novo lipogenesis driven by hyperinsulinaemia is the primary hepatic fat-accumulation mechanism (Targher et al., 2021).

Arthritis — 50% IR OA metabolic phenotype (Courties et al., 2019): adipokines, synovial inflammation, and IR co-present in ~55–60% of OA; RA systemic inflammation-driven IR ~45%.

Alzheimer's — 65% IR "Type 3 diabetes" framing (de la Monte, 2012); impaired cerebral insulin signalling present in 60–70% of AD cases. ApoE4 carriers have higher IR-overlap.

MS — 55% IR IR and metabolic syndrome co-prevalence in MS cohorts (Mähler et al., 2020). IR accelerates neuroinflammation and demyelination via IL-6 and TNF-α pathways.

Stroke — 65% IR Hyperinsulinaemia-driven endothelial dysfunction and atherogenesis account for majority of ischaemic stroke risk. Shares pathophysiology with hypertension.

IBS — 45% IR Gut dysbiosis, elevated LPS, and impaired gut-brain axis overlap with IR (Mihai et al., 2021). Metabolic dysregulation estimated in ~40–50% of IBS patients.

Asthma — 50% IR IR-driven adipose inflammation, elevated leptin, and impaired bronchodilator responsiveness documented in obese and metabolically impaired asthma cohorts (Shore, 2014).

ADHD — 50% IR Insulin-dopamine receptor interactions (Coccurello & Maccarrone); elevated IR in ADHD cohorts; shared genetic loci with metabolic syndrome.

AMD — 55% IR IR-driven VEGF overproduction, oxidative stress, and RPE cell dysfunction (Rozing et al., 2020). Particularly strong signal in wet AMD subtype.

OCD — 40% IR Emerging hypothalamic-pituitary-IR-serotonin axis interactions. IR prevalence in OCD estimated at or marginally above population base rate (~38–42%).

Autism — 40% IR Metabolic and mitochondrial dysfunction in ASD; GI co-morbidity via IR-gut axis; elevated IR markers (Napoli et al., 2014). Prevalence range ~35–45%.

Remission / Major Improvement Estimates — Key Trial Evidence

T2DM — 45–60% DiRECT trial (Lean et al., Lancet 2019): 49% remission at 1 year with intensive dietary intervention. Virta Health ketogenic cohort: ~54% remission at 1 year, 26% at 5 years. Westman et al. VLC trials: consistent 40–60% range.

Hypertension — 50–65% NEWSTART program (Zahnd & Hunninghake, 2019): 67% no longer hypertensive within 18 days on whole-food low-sodium diet. Multiple VLC cohort studies: 50–60% achieve ≥10 mmHg SBP reduction. Phinney & Volek clinical series.

MASLD — 65–80% Most responsive condition to VLC diet. Haufe et al. (2011): liver fat reduced by 30–50% within 8 weeks. Dramatic fatty liver resolution consistently documented across VLC trials. Full early-MASLD remission achievable at 3–6 months.

Arthritis — 35–50% Metabolic OA phenotype responds to IR reversal: adipokine reduction, synovial inflammation dampening. Weight loss ≥5% reduces knee OA pain 50%+ (Christensen et al., 2007). VLC anti-inflammatory effect in RA (Sköldstam et al.).

Alzheimer's — 20–35% Ketogenic diet intervention in early-stage AD shows cognitive improvement in RCTs (Henderson et al.; Reger et al.). Bredesen ReCODE protocol: multi-factorial reversal in MCI/early AD. Limited to early stages; structural damage limits ceiling.

MS — 25–40% Wahls Protocol (ketogenic tier): fatigue improvement, reduced relapse frequency in open-label trial (Wahls et al., 2018). IF reduces CNS inflammation and supports myelin repair precursors. Modest but consistent signal across studies.

Stroke — 40–55%* Figures represent metabolic recurrence-risk reduction. VLC + IF reverses major modifiable stroke risk factors (hypertension, IR, dyslipidaemia, atrial fibrillation risk). Not neurological reversal of prior damage.

IBS — 45–60% VLC diet removes fermentable substrates (FODMAPs overlap). Gibson et al.: significant symptom reduction in IBS-D on low-carbohydrate protocols. IF reduces gut permeability and LPS-driven visceral hypersensitivity.

Asthma — 30–45% Weight loss and IR reversal reduce airway hyperresponsiveness in cohort studies (Eneli et al., 2008). VLC reduces systemic inflammation and leptin-driven bronchoconstriction. Effect size greater in obese/metabolic asthma subtype.

ADHD — 25–40% Emerging evidence: gut microbiome restoration and dopamine-insulin axis normalisation. Limited RCT data; case series and mechanistic studies suggest clinically meaningful improvement in subset of IR-positive ADHD patients.

AMD — 25–40% VLC diet reduces VEGF overproduction and retinal oxidative stress. IR reversal may slow progression of dry AMD; wet AMD has additional pathology. Evidence base growing but RCT data limited (Rozing et al., 2020; Chiu et al.).

OCD — 15–25% Very limited trial data. Case series of ketogenic diet in OCD report reduced compulsive symptom severity. Serotonin-insulin axis and gut microbiome normalisation proposed as mechanisms. Research in early stage.

Autism — 20–35% GI symptom improvement well documented on VLC/elimination diets (Pennesi & Klein, 2012). Behavioural improvements reported in ketogenic diet case series. IR-gut-brain axis effect. RCT evidence limited.

Important caveat: Patient totals across conditions cannot simply be summed as individuals frequently carry multiple diagnoses simultaneously (e.g. hypertension + T2DM + MASLD). The combined totals reflect condition-diagnosis counts, not unique individuals. True unique counts would be substantially lower due to multi-morbidity overlap.