The problem PIR solves
Every cell in your body relies on insulin to pull glucose across its membrane and convert it to energy. In insulin resistance, that signal breaks down: cells go 'deaf' to insulin, glucose stays in the bloodstream, and tissues — nerves, kidneys, eyes, blood vessels — slowly starve. Conventional diabetes care manages the blood sugar number but rarely fixes the broken signaling.
PIR is built around a different idea: restore insulin sensitivity, and the body can begin to repair the damage on its own.
How PIR works
A healthy pancreas releases insulin in pulses every few minutes, not in one continuous stream. PIR mimics this physiologic rhythm: a programmed IV pump delivers precise insulin pulses while you receive a carbohydrate substrate, triggering the cellular machinery to respond and re-sensitize.
Over weeks of treatment, cells regain their ability to take up and use glucose. A1C falls, energy returns, nerve pain quiets, kidney function stabilizes, and many patients reduce or eliminate their diabetes medications under their physician's supervision.
What a treatment program looks like
A standard PIR protocol runs 2–3 sessions per week for 8–12 weeks, with each session lasting about an hour. We pair PIR with complementary therapies — Class IV laser, shockwave, red light, vibration, and targeted nutraceuticals — to amplify nerve regeneration, circulation, and tissue healing.
Every program begins with comprehensive lab work and a full medical evaluation. We re-test at regular intervals so you can see your progress in real numbers, not just how you feel.
The evidence behind PIR
PIR is supported by peer-reviewed case series documenting reversal of diabetic neuropathy, improvement in chronic kidney disease, reduction in A1C, and improvement in wound healing. Citations from the American Journal of Biomedical Science & Research, MDPI's International Journal of Molecular Sciences, and Opast Publishers are linked in the research archive on our home page.
Is PIR right for you?
The best way to know is a consultation. We review your full medical history, run baseline labs, and tell you honestly whether PIR is a fit. If it's not, we'll point you toward what is.
Frequently asked questions
What is Physiologic Insulin Resensitization (PIR)?+
PIR is a physician-supervised IV infusion therapy that delivers insulin in carefully timed, physiologic pulses — mimicking the way a healthy pancreas releases it. Over a course of treatments, this re-trains insulin-resistant cells to absorb and use glucose properly again.
How is PIR different from insulin injections?+
Injected or pumped insulin keeps blood sugar in range but does not correct insulin resistance — the cells stay 'deaf' to the hormone. PIR uses physiologic pulse dosing through an IV to restore the cells' insulin sensitivity, addressing the root cause of metabolic disease.
What conditions does PIR treat?+
PIR is used to treat Type 1 and Type 2 diabetes, diabetic neuropathy, diabetic nephropathy (chronic kidney disease), diabetic retinopathy, non-healing wounds, peripheral artery disease, chronic fatigue, and other complications of insulin resistance.
How does a PIR session work?+
Each session takes about an hour. A small IV is placed and a programmed pump delivers insulin in physiologic pulses while you receive carbohydrate to support the infusion. You can read, work, or relax during the session. Most patients treat 2–3 times per week for 8–12 weeks.
Is PIR safe?+
PIR is performed under direct physician supervision with continuous monitoring of blood glucose and vitals. It has been used in clinics across the U.S. for over a decade with an excellent safety profile. Hypoglycemia is rare because dosing is matched to your response in real time.
Is PIR FDA-approved?+
Insulin itself is FDA-approved. PIR uses FDA-approved insulin in a physician-directed protocol. The therapy is supported by peer-reviewed case series, including publications in the American Journal of Biomedical Science & Research and other medical journals.
Does insurance or Medicare cover PIR?+
Medicare and most major commercial insurance plans cover PIR when it is medically necessary. Our team verifies your benefits before treatment so you know your exact cost upfront — including any deductible, copay, or coinsurance.
How long until I see results?+
Energy and mental clarity often improve within the first 2–3 weeks. Nerve pain, numbness, and tingling typically begin to fade between weeks 4 and 8. Lab markers — A1C, eGFR, lipid panel — show measurable change between 8 and 16 weeks.
Can I stop my diabetes medications during PIR?+
Many patients are able to reduce or eliminate oral diabetes medications and lower their insulin doses during the protocol. Any medication change is made by your physician based on your labs and glucose readings — never on your own.
Who is NOT a candidate for PIR?+
PIR is not appropriate for pregnant patients, patients with active malignancy under chemotherapy, severe untreated heart failure, or anyone unable to tolerate IV infusions. Our team performs a thorough evaluation before recommending treatment.
Is PIR the same as 'IV insulin therapy' I've seen online?+
No. PIR is a specific, physician-supervised protocol with precise pulse dosing, continuous monitoring, and structured complementary therapies. Generic 'IV insulin' offerings without proper protocol design or physician oversight are not the same and can be unsafe.
Where is PIR available in Delaware?+
The Diabetes Center of Wilmington is the leading PIR provider in Delaware, serving patients from Wilmington, Newark, Middletown, Dover, the Brandywine Valley, and southeastern Pennsylvania. Schedule a consultation to see if PIR is right for you.