Understanding insulin resistance

Written by Caitlin Goodwin DNP, CNM, RN

Insulin resistance occurs when muscle, fat, and liver cells do not respond well to insulin and cannot take up glucose from your blood efficiently. As a result, your pancreas makes more insulin to help glucose enter cells. This is called hyperinsulinemia. Over time, this can lead to higher blood glucose levels and prediabetes.

In 2021, about 97.6 million adults in the United States had prediabetes, according to NIDDK.

Insulin resistance is linked with health problems such as hypertension, obesity, unhealthy cholesterol levels, and type 2 diabetes. It is also a major feature of metabolic syndrome.

As there are no routine tests to check for insulin resistance and no visible symptoms until the syndrome turns into prediabetes or type 2 diabetes, it is important to understand this growing condition.

Effects of insulin resistance

The occurrence of insulin resistance leads to an increase in the production of insulin so your body can maintain healthy blood sugar levels. High levels of insulin can result in overweightedness, which worsens insulin resistance.

The following conditions also speak of the presence of hyperinsulinemia:

• Hardening of arteries (atherosclerosis)
• Hypertension
• Higher triglyceride levels

Insulin resistance is the major component of metabolic syndrome, which is a group of features that link excess fat around your waist and insulin resistance to a greater risk of stroke, cardiovascular disease, and type 2 diabetes.

Symptoms of metabolic syndrome can include:

• Elevated triglyceride level
• An increased blood glucose level
• Hypertension
• Low levels of high-density lipoprotein (HDL) cholesterol

Risk factors

Current screening guidance recommends screening adults ages 35 to 70 who have overweight or obesity for prediabetes and type 2 diabetes.

However, if you have the following risk factors, your healthcare provider can suggest testing at a younger age:

• Inactive lifestyle
• Diet high in carbohydrates
• Obesity, especially belly fat
• Gestational diabetes
• Polycystic ovary syndrome
• Nonalcoholic fatty liver disease
• Smoking
• A family history of diabetes
• Latinx, African, or Native American ethnicity.
• Age. It is more likely after 45 years of age
• Hormonal disorders like Crushing’s syndrome and acromegaly
• Sleep problems like sleep apnea
• Medications like steroids, antipsychotics, and HIV medications

Adolescents and children may also benefit from diabetes screening if they’re overweight and have two or more of the above risk factors relating to diabetes.

Symptoms

You would have no symptoms at all if you have insulin resistance, but your pancreas is capable of increasing insulin production to maintain sugar levels at the desired range.

Insulin resistance is feared to get worse in the long run and your pancreas cells that produce insulin can go inactive. As a result, your pancreas is no longer able to produce sufficient insulin to overcome the resistance, which can lead to high blood sugar (hyperglycemia).

High blood sugar can include:

• Frequent urination (peeing)
• Increased thirst
• Increased hunger
• Headaches
• Blurred vision
• Slow-healing cuts and sores
• Vaginal and skin infections

Management and treatment

As all of the factors that lead to insulin resistance can’t be treated, such as age and genetic factors, lifestyle changes are the ideal treatment for insulin resistance. Lifestyle changes can include:

Eating a healthy diet: It is generally recommended to avoid eating excessive amounts of carbohydrates foods (which cause excess insulin production) and eating less unhealthy fat, red meats, sugar, and processed starches. The focus should be on eating a whole food diet that includes more fruits, vegetables, fish, whole grains, and healthy poultry.

Physical activity: Regular moderate physical activity increases glucose usage and improves insulin sensitivity. CDC recommends at least 150 minutes per week of brisk walking or similar activity.

Losing excess weight: Losing excess weight can go a long way toward treating insulin resistance. Losing seven percent of your excess weight can reduce the risk of type 2 diabetes by 58%.

In the long run, these lifestyle changes can produce the following results:

• Lower your blood glucose levels
• Increase insulin sensitivity (reduce insulin resistance)
• Lower hypertension
• Raise HDL (“good”) cholesterol levels
• Lower triglyceride and LDL (“bad”) cholesterol levels

Other healthcare providers, such as an endocrinologist or nutritionist can support a personalized treatment plan that can prove more fruitful for your health.

Works cited

• Insulin resistance & prediabetes, 2025. NIDDK. niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
• Insulin resistance, 2024. Cleveland Clinic. my.clevelandclinic.org/health/diseases/22206-insulin-resistance
• Prediabetes: your chance to prevent type 2 diabetes, 2024. CDC. cdc.gov/diabetes/prevention-type-2/prediabetes-prevent-type-2.html
• Prediabetes and type 2 diabetes: screening, 2021. USPSTF. uspreventiveservicestaskforce.org/uspstf/recommendation/screening-for-prediabetes-and-type-2-diabetes