What is insulin resistance and how to manage it?
Insulin resistance is a metabolic disorder in which the body’s cells become less responsive to the hormone insulin, which is responsible for regulating blood sugar levels. One of the biggest challenges of insulin resistance is that it often shows no clear symptoms until it progresses into a condition such as prediabetes or type 2 diabetes. It is estimated that around 500 million people worldwide are living with diabetes, and this number is expected to increase in the coming years (WHO, 2024). In this article, you will learn what insulin resistance is, its causes, early warning signs, diagnostic methods, and effective prevention strategies.
Table of Contents
- What is insulin resistance?
- Causes of insulin resistance
- How do I know if I have an insulin sensitivity disorder?
- How is insulin resistance diagnosed?
- What conditions are associated with insulin sensitivity disorder?
- How can I prevent or improve insulin resistance?
- Is medical treatment necessary for insulin sensitivity disorders?
What is insulin resistance?
Insulin resistance describes a condition in which the body’s cells no longer respond properly to the hormone insulin and is also referred to as insulin sensitivity disorder. Insulin is produced by the pancreas, and its main function is to transport glucose (sugar) from the bloodstream into the cells, where it is used for energy production. When cells become less sensitive to insulin, this process becomes less efficient and the body has to produce more insulin to get the sugar into the cells. An insulin sensitivity disorder can be temporary, for example during pregnancy, or it can become a chronic condition. Over time, it often develops gradually and, if left untreated, can lead to health issues such as prediabetes or type 2 diabetes (NIDDK, 2018).
What is the difference between insulin resistance and prediabetes?
Unlike insulin resistance, prediabetes refers to a state in which blood sugar levels are already higher than normal but not yet high enough to be classified as diabetes. Insulin sensitivity disorders can be a cause of prediabetes, but not everyone with insulin resistance is immediately prediabetic. As long as the pancreas is able to produce enough insulin to meet the increased demand, blood sugar levels can remain in the normal range. Prediabetes often follows prolonged insulin resistance, during which the body is no longer able to compensate for the effects of insulin sensitivity disorder by producing more insulin (Cleveland Clinic, 2021).
What is the difference between insulin resistance and type 1 and 2 diabetes?
Insulin sensitivity disorders play a central role in type 2 diabetes, as they are one of the first abnormalities observed in the development of the condition. Long-term insulin resistance can lead to prediabetes, and prediabetes can develop into type 2 diabetes if no action is taken to lower blood sugar levels.
Type 1 diabetes, on the other hand, is an autoimmune disease in which the body’s immune system attacks and destroys the insulin-producing cells of the pancreas. Insulin resistance plays a lesser role in type 1 diabetes, as the body is unable to produce insulin at all in this condition, although it may still occur (Cleveland Clinic, 2021).
Causes of insulin resistance
- Acquired causes: Overweight and obesity play a major role in acquired insulin resistance. Abdominal fat in particular releases inflammatory substances that reduce the cells’ sensitivity to insulin. A diet high in fast-digesting carbohydrates and saturated fats is another contributing factor. A lack of physical activity also leads to less glucose being burned in the muscles, which promotes fat accumulation and insulin resistance.
- Genetic causes: People with a family history of type 2 diabetes are often predisposed to developing insulin resistance themselves. This is due to certain genes that can affect how sensitive cells are to insulin.
- Hormonal causes:Conditions such as polycystic ovary syndrome (PCOS) and hypothyroidism are known hormonal causes of insulin resistance. PCOS often results in elevated androgen levels, which impair the cells’ response to insulin. Cushing's syndrome, which is characterized by excessive cortisol production, can also promote insulin resistance by disrupting normal glucose metabolism.
Source: Cleveland Clinici, 2021
How do I know if I have an insulin sensitivity disorder?
Insulin resistance is a condition that often develops without obvious symptoms and can therefore be difficult to detect. However, early detection is important to prevent more serious health issues. Below are warning signs that may indicate something is wrong with your blood sugar metabolism:
Warning signs of insulin resistance:
- Increased hunger: Feeling hungry again shortly after eating or not feeling full after a meal.
- Unusual fatigue: Tiredness and exhaustion even after a good night's sleep.
- Weight gain: Especially an increase in abdominal fat.
- Dark skin changes: Darkening of the skin in body folds.
Source: Mayo Clinic, 2022
After the first warning signs of problems with blood sugar metabolism, additional symptoms such as increased thirst, more frequent urination, or blurred vision may indicate that the condition is progressing. If you notice one or more of these symptoms, you should see a doctor and have your blood sugar levels tested.
How is insulin resistance diagnosed?
The diagnosis of insulin sensitivity disorder is made through a combination of medical history, physical examination, and specific blood tests. The doctor will first ask about symptoms and any family history. The blood tests include:
- Fasting blood sugar test: This test measures the blood glucose level after an overnight fasting period to determine how effectively the body produces and uses insulin.
- Oral glucose tolerance test (OGTT): In this test, blood sugar levels are measured before and after drinking a sugary solution to assess how quickly the body processes glucose.
- HbA1c test: This test measures the average blood sugar level over the past two to three months and helps evaluate glucose control over a longer period.
Source: Cleveland Clinic, 2021
Want to check for yourself?
The Homed-IQ Blood Sugar Test (HbA1c) offers a simple and reliable way to check your blood sugar levels at home. This test is especially useful for people showing signs of insulin sensitivity disorder or who have risk factors for diabetes. The test measures the HbA1c level in your blood, which reflects your average blood sugar levels over the past three months. If your value is too high, it may indicate prediabetes or diabetes, and you should consult a doctor for further evaluation.
What conditions are associated with insulin sensitivity disorder?
People with insulin sensitivity disorders often experience increased fatigue and struggle to manage their weight, which can affect their daily performance and overall quality of life. Additionally, uncontrolled insulin resistance can lead to the development of type 2 diabetes. Type 2 diabetes occurs when blood sugar levels remain chronically elevated. This can lead to serious health complications, including cardiovascular disease, kidney damage, and vision problems. The following table provides a brief overview of other conditions associated with progressing insulin sensitivity disorder:
| Condition | Description |
|---|---|
| Metabolic syndrome | This is a combination of various health issues such as high blood pressure, high blood sugar, excess abdominal fat, and abnormal cholesterol levels. Metabolic syndrome increases the risk of heart disease, stroke, and diabetes. |
| Polycystic ovary syndrome (PCOS) | PCOS is a hormonal disorder in women that often coexists with insulin resistance and leads to symptoms such as irregular menstrual cycles, excessive body hair, and difficulties with conception. |
| Cardiovascular disease | Insulin resistance is associated with risk factors such as high blood pressure and elevated triglyceride levels that can damage blood vessels and lead to atherosclerosis. This hardens and narrows the arteries, increasing the risk of heart attacks and strokes. Insulin resistance also promotes inflammatory processes that further damage blood vessels. |
| Non-alcoholic fatty liver disease (NAFLD) | In insulin sensitivity disorders, the body is unable to efficiently convert glucose into energy, leading to increased fat storage. This excess fat in liver cells can trigger inflammation and lead to severe liver disease. |
Sources: Mayo Clinic, 2022; NHS, 2023
To proactively monitor your health and detect risk factors early, Homed-IQ offers additional convenient at-home tests. With the Heart Disease Blood Test and Cholesterol and Lipids Test, you can monitor key cardiovascular markers and your cholesterol levels from the comfort of your home.
How can I prevent or improve insulin resistance?
When it comes to preventing insulin sensitivity disorders, certain factors—such as genetic predisposition and specific hormonal conditions—are more difficult to influence. Nevertheless, it is possible to counteract many acquired causes of insulin resistance through targeted lifestyle changes. Below are five practical tips that can help prevent or improve insulin resistance:
Tip 1: Dietary changes
A diet rich in fiber (25–30 g per day), healthy fats, and moderate amounts of protein can help stabilize blood sugar levels. Combine carbohydrates with protein and fiber to avoid blood sugar spikes. Foods containing complex carbohydrates, such as whole grains, are beneficial as they are digested more slowly and cause less fluctuation in blood sugar levels. Omega-3 fatty acids from fish, unsaturated fats from nuts and seeds, and antioxidants (e.g. from berries) are also important to reduce inflammation. It's essential to read food labels carefully, as sugar is often listed under various names like fructose, glucose, sucrose, or maltose. As a general rule, less than 5 grams of sugar per 100 grams is considered low.
The table below shows food alternatives that can help you improve your diet for better insulin sensitivity:
| Swap this... | For this... |
|---|---|
| White bread | Whole grain bread or other whole grain options |
| Regular pasta | Whole grain pasta, lentil or chickpea pasta |
| White rice | Brown rice, quinoa, or wild rice |
| High-sugar breakfast cereals | Oatmeal or low-sugar whole grain muesli |
| Flavored yogurts | Greek yogurt with fresh berries |
| Potato chips | Raw vegetables with hummus or unsalted nuts |
| Soft drinks and sugary beverages | Water, herbal teas, or fresh juice without added sugar |
| Canned fruits in syrup | Fresh fruits (in moderation) or unsweetened frozen fruits |
| Fried foods | Oven-baked or steamed dishes |
Source: John Hopkins, 2024
Tip 2: Regular physical activity
Regular activities such as aerobic exercise, strength training, or even light activities like walking can stimulate the muscles to use more glucose from the bloodstream and improve insulin sensitivity. Experts recommend at least 150 minutes of moderate aerobic exercise or 75 minutes of vigorous exercise per week.
Tip 3: Weight management
Obesity, particularly the accumulation of belly fat, is closely associated with insulin resistance. Losing just 5–10% of body weight can significantly improve insulin sensitivity and reduce the risk of developing diabetes.
Tip 4: Stress management
Cortisol, a hormone released in response to stress, can impair insulin sensitivity by stimulating glucose production in the liver, which raises blood sugar levels. As a result, more insulin is needed, which can worsen insulin resistance over time. Chronic stress also often leads to unhealthy habits such as overeating or lack of exercise. Effective stress management through regular physical activity, meditation, and sufficient sleep can help lower cortisol levels, promote healthy behaviors, and reduce the risk of insulin resistance.
Tip 5: Regular medical check-ups
It’s important to be aware of your risk factors and monitor early signs of insulin resistance. Regular monitoring through at-home blood tests or medical check-ups can be essential in preventing long-term complications.
Sources: Gunnars, 2022; ADA, 2024
Is medical treatment necessary for insulin sensitivity disorders?
Whether insulin resistance requires medical treatment depends on the severity, the associated symptoms, and the presence of related conditions such as prediabetes or type 2 diabetes. Often, a combination of lifestyle changes—such as a healthier diet and increased physical activity—is sufficient to improve insulin sensitivity. If these measures are not effective enough, a doctor may recommend additional treatment with medication, such as metformin, to help regulate blood sugar levels.
