5 Signs You May Be Insulin Resistant

When you are insulin resistant, your body requires more and more insulin to deliver glucose into your cells, and over time, you will officially have type 2 diabetes

Photo by Towfiqu Barbhuiya

Diabetes, pre-diabetes, and metabolic syndrome are all synonymous with insulin resistance. But insulin resistance also leads to other chronic conditions like heart disease and may be related to Alzheimer’s disease and inflammatory problems.

Unfortunately, the signs of insulin resistance are there for months, and sometimes years, before you or your doctors recognize them. Identifying the key indicators of insulin resistance and the problems it causes can help you make the needed changes so it doesn’t result in debilitating chronic diseases. 

1. Central obesity

Fat stored around your waistline and stomach, or central obesity, is associated explicitly with insulin resistance. Your body produces insulin in response to raised blood sugar, and insulin’s job is to help sugar get from the blood and into your cells to produce energy. When you have sugar circulating through your blood that your body doesn’t need, it gets stored as fat.

If your waist circumference is more than half your height, it’s a good indicator that you’re building this central obesity. Another name for this is visceral fat because it lines our internal organs. 

In the old days, when humans had less food available during winter, fat would be a storage place for when food wasn’t available, and we needed energy. We no longer have that problem, so we eat food, particularly sugar, and carbohydrates, and store fat but do not use it, mainly because food is excessively available now.

Once we reach the capacity to store fat under our skin, we start accumulating this visceral fat in and around the organs in our abdomen, like our liver and pancreas.

High insulin levels that continue causing fatty deposits around our organs lead to higher insulin production and more fat storage. The vicious cycle continues and causes damage over the long term with clear links to Type 2 diabetes, cardiovascular disease, and high blood pressure.

A good indicator of whether you are building visceral fat and central obesity is whether your waist circumference is more than half your height. 

Doctors still like to use the Body Mass Index (BMI) to assess obesity, but it doesn’t gauge whether your fat stores are harmful.

2.  Elevated blood glucose levels

An average fasting blood glucose level of 70-99 mg/dl should be maintained within this narrow range. When insulin production works normally, your pancreas makes insulin to keep these blood glucose levels stable regardless of what you’ve eaten. Insulin moves glucose out of your blood and into your cells, providing energy for your body. 

Elevated blood glucose levels cause your pancreas to secrete insulin. When glucose levels are high for extended periods because of excessive carbohydrate and sugar intake, insulin secretion ramps up to try and drive glucose into your cells to lower levels in the blood.  Eventually, cells become resistant to insulin, and your blood glucose is always high, which causes a vicious cycle that results in insulin resistance.

Your doctor can do a hemoglobin A1C (HgA1C) blood test that gives an average glucose level over three months. It’s a valuable test for diagnosing pre-diabetes and diabetes. 

• Normal HgA1C is below 5.7%

• Prediabetes is between 5.7% and 6.4%

• Diabetes is above 6.5%

You should have a HgA1C test twice per year. You can also test your blood glucose at home using a glucometer. If your blood glucose is not back to 70-99 mg/dl within two hours after eating, it may indicate you are insulin resistant.

3. Cholesterol levels

When your doctor orders a fasting lipid panel, it will show your blood cholesterol levels. Unfortunately, many doctors still measure everything by your LDL (bad cholesterol) level. But insulin resistance and metabolic disease should be measured by the ratio between triglyceride and HDL (good cholesterol) levels.

Low HDL and high triglyceride levels mean you are at higher risk for cardiovascular disease, diabetes, and metabolic disease. Doctors often judge cholesterol levels solely from LDL because they can lower this number with statins, and a medication to raise HDL would be much more helpful. Unfortunately, no one has come up with that one yet.

Make sure the next time your doctor orders a lipid panel, you ask him to check your HDL and triglyceride levels to understand your insulin resistance risk.

4. Fatty liver disease

Having a fatty liver is often associated with excessive intake of alcohol. Unfortunately, non-alcoholic fatty liver disease (NAFLD) has become more prevalent and, as the name implies, has nothing to do with drinking too much alcohol. Signs of NAFLD are obesity, diabetes, high lipids, and insulin resistance. The liver converts carbohydrates and sugars into fat with the help of insulin. When you have excessive amounts of insulin, your liver makes more fat. Excessive amounts of insulin production cause insulin resistance, resulting in type 2 diabetes and cardiovascular disease.

There aren’t any symptoms of NAFLD until the liver is 90% destroyed, and the only real physical sign of the disease is a fat roll around your waistline, in other words, central obesity.

5. High blood pressure

Besides helping glucose enter cells for energy, insulin also plays a role in retaining sodium in the kidneys. Sodium retention in the kidneys sets off a cascade effect that causes blood vessels to constrict, raising blood pressure.

Insulin also stimulates the sympathetic nervous system, or the “fight or flight” mechanism, which raises blood pressure.

Too much insulin and insulin resistance cause many problems in different ways. In some cases, as with NAFLD, there are no real symptoms. 

If you recognize these symptoms, it’s time to take action before your metabolic health deteriorates and you develop chronic conditions like type 2 diabetes and cardiovascular disease.

Talk with your doctor

Your doctor can advise you on how to avoid becoming insulin resistant. But you know your body better than anyone. Ask about having your HDL and triglyceride levels checked during your next physical. A fasting blood test to measure insulin in your blood rather than simply fasting blood glucose is another excellent way to determine if you are at risk for insulin resistance.

Lifestyle and dietary changes can prevent or reverse insulin resistance before you go on to develop type 2 diabetes.