Insulin Resistance: Causes, Symptoms, and Management

insulin resistance
Medically reviewed by Dr. Mandy Liedeman


Insulin resistance is a condition when your body becomes resistant to insulin or unable to recognize its presence. Insulin resistance has several genetic and lifestyle factors.

In order to know all aspects of insulin resistance, please read the article thoroughly. 

What is Insulin Resistance?

Insulin is a regulatory hormone that plays a vital role in multiple metabolic processes, including blood sugar regulation on the top. Whenever the sugar level (Glucose Level) in the blood increases, pancreas B-cells release insulin and transport the glucose into the cells. Once the glucose is up-taken by cells with the help of an insulin transporter, this glucose is converted into the energy molecule ATP, which is further used to perform different body functions.

In case of insulin resistance, cells cannot recognize the presence of insulin or may become insulin tolerant and ultimately cannot uptake glucose resulting in the unavailability of energy, making the patient feel tired and lethargic and causing fat accumulation around the fat around the waist area. A high blood sugar result occurs when your cells do not respond adequately to insulin’s signal. As a result, it can lead to prediabetes type 2 diabetes.

It is estimated that one out of three Americans suffer from insulin resistance, and half of them are age 60 or older. Insulin resistance may lead to certain medical conditions including prediabetes and type 2 diabetes, heart attacks, strokes, and cancer.

Causes of Insulin Resistance

Following are some causes that increase the risk of insulin resistance

  • Fat around the belly or  obesity
  • A sedentary lifestyle
  • Stress and trauma 
  • Tobacco or alcohol abuse
  • Gestational diabetes
  • Sleep apnea and other sleep problems
  • Diabetes in the family
  • If your age is more than 45
  • Drugs like steroids, antipsychotics, and HIV medication
  • PCOS and nonalcoholic fatty liver disease
  • Hormonal disorders, including Cushing’s syndrome and acromegaly
  • If you are African, Latino, or have Native American ancestry, you may have more chances of getting insulin resistance.
  • An unhealthy dietary pattern like excessive consumption of carbohydrates or high glycemic index foods.

Children and teens of age 10 to 18 who are overweight and have two or more of the above diabetes risk factors undergo diabetes screening. It is recommended that diabetes screening if your age is 40 or above. In addition to diabetes screening, other including cholesterol, and blood pressure, are also indicators of insulin resistance. In most cases, your doctor will recommend testing as part of an annual physical examination or preventive screening.

  • There may be a need for testing at a younger age if you have these risk factors:
  • low Triglycerides or HDL levels
  • Diabetes runs in the family.
  • Blood pressure of 140/90 mmHg or higher
  • Prediabetic symptoms
  • Diabetes during pregnancy (a temporary condition) was diagnosed.
  • Have  stroke in history 

Above are the most possible risk factors that can cause insulin resistance and ultimately lead to prediabetes or diabetes.

Other causes of insulin resistance :

Stress and Inflammation: You may develop insulin resistance if you suffer from high oxidative stress and inflammation.

Gut microbiota problems: There is evidence that disruptions in the bacterial environment of your gut can lead to inflammation, which may worsen insulin resistance and other metabolic disorders

Overconsumption of fructose: High fructose intake, which comes from added sugars and not fruits, is linked to insulin resistance.

Unaware of the Cause Making you Insulin Resistant? Chat with our Doctor Today!

Symptoms of Insulin Resistance

Insulin resistance is a complex disorder that affects body weight, age, genetics, ethnicity, being sedentary, smoking, and poor sleep. Specific signs that may indicate that you have or are likely to develop insulin resistance include:

A large waist

Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and a moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women and 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese, or Japanese descent) increases the odds of insulin resistance and metabolic syndrome which is also linked to insulin resistance.

Metabolic syndromes

You are likely to have metabolic syndrome, which causes insulin resistance, if you have two or more of the following (or any three of the following without a large waist circumference) in addition to excess abdominal fat (measured by waist circumference):

  • An insufficient level of high-density lipoprotein (“good”) cholesterol – or medication taken to raise HDL 
  • Hypertension 
  • A blood pressure reading of 130/85 mmHg or more and taking medication to control it.
  • A high level of triglycerides
  • Blood fat levels of 150 or more or taking medication to treat them.
  • Hyperglycemia after fasting 
  • Having blood sugar levels between 100 and 125 mg/dl (prediabetes) 
  • Over 125 mg/dL (diabetes) or taking diabetes medication.

Dark Skin Patches 

You may notice visible skin changes if you have severe insulin resistance. Dark spots may appear on your elbows, knees, armpits, or on the back of your neck. In medical terms, this pigmentation is known as acanthosis nigricans.

The Medical Condition Associated with Insulin Resistance

Health issues linked to insulin resistance include:

Insulin resistance and diabetes 

The symptoms of insulin resistance usually do not appear until diabetes develops. 

According to the CDC, more than 85% of prediabetics are unaware that they have the disease.

Insulin resistance can develop in anyone – either temporarily or chronically. 

Chronic insulin resistance has the ability to lead to prediabetes, type 2 diabetes, and heart disease if untreated for a long period of time.


Insulin resistance is linked to PCOS. Women with PCOS often suffer from irregular periods, infertility, and painful periods.

Chronic Heart Diseases(CVDs): 

International Diabetes Federation research shows that insulin resistance doubles your risk of heart attacks and strokes and triples your risk of fatal heart attacks and brain attacks. 

According to a study a study insulin resistance is a strong predictor of cardiovascular disease in over 28,000 women.

Major depressive disorder (MDD):

Major depressive disorder is also associated with high insulin levels in the blood even in the absence of diabetes.

Researchers found that the prevalence of insulin resistance (IR) is significantly higher among individuals who are actively battling major depressive disorder ( MDD ). Compared with patients without MDD, patients with MDD had a higher rate of IR.

Unaware of the Cause Making you Insulin Resistant? Chat with our Doctor Today!

Diagnosis of Insulin Resistance

Diagnosing diabetes or prediabetes can be done with an A1C test. An average blood sugar level over the past two or three months is measured in this test.

  • It is considered normal to have an A1C below 5.7 percent.
  • The A1C level is diagnostic for prediabetes when it is between 5.7 and 6.4 percent.
  • The A1C must equal or above 6.5 percent for diabetes to be diagnosed.

It is possible that these numbers could vary by 0.1 to 0.2 percent depending on where your blood is drawn. The test results may need to be reconfirmed by your doctor later.

Fasting blood glucose test

Fasting blood glucose level can be determined by a fasting blood glucose test. A minimum of eight hours should have passed since you last ate or drank.

To confirm a high level, a second test may be required a few days later. Your doctor may diagnose you with prediabetes or diabetes if both tests show high levels of blood glucose.

  • Normal: 100 milligrams/deciliter (mg/dL) 
  • Prediabetes: 100 and 125 mg/dL.
  • Diabetic: equal to 126 mg/dL.
  • Depending on the lab, these numbers may vary by 3 mg/dL points.
  • Glucose tolerance testing

Prediabetes or diabetes can also be diagnosed with a 2-hour glucose tolerance test. This test begins with a blood glucose measurement. In two hours, you’ll be given a sugary drink, and your blood glucose level will be rechecked.

  • The normal blood sugar level after 2 hours is less than 140 mg/dL.
  • The amount of glucose in the blood between 140 mg/dL and 199 mg/dL is considered prediabetes. 
  • In diabetes, blood sugar levels of 200mg/dL or higher are considered high.
  • Random blood draws

If you experience significant diabetes symptoms, you should test your blood sugar at random. For routine diabetes screening and identifying prediabetes, the American Diabetes Association (ADA) does not recommend random blood glucose testing.

Treatment  for Insulin Resistance

You can take steps to treat insulin resistance and prevent type 2 diabetes:


Following are some medications that are used sometimes in combination or individually to improve insulin sensitivity and management of diabetes.


Metformin is the most commonly prescribed medication that lowers the amount of glucose absorbed from the intestines, reduces the amount of glucose made by the liver, and improves insulin sensitivity.

In patients with type 2 diabetes, it is recommended to use metformin along with a diet to lower high blood sugar levels.


Pioglitazone is most helpful when you have exercise too. It Improves blood sugar control and insulin sensitivity in adults with type 2 diabetes mellitus. In the treatment of type 1 diabetes, pioglitazone is not recommended. If you have a heart disorder, please consult with your doctor first.

Sodium-Glucose Cotransporter 2 Inhibitors

An SGLT2 inhibitor increases urinary glucose excretion, thus reducing plasma glucose levels without insulin. Studies done in obese patients treated with insulin have shown that these medications reduce body weight.

DPP-4 inhibitors

DPP-4 inhibitors lower high blood glucose levels and may be used to treat type 2 diabetes. Glucose-removing hormone GLP-1 is inactivated and degraded by DPP-4 inhibitors. 

DPP-4 inhibitors improve glucose regulation, which lower fasting and postprandial blood glucose levels without causing weight gain. 


Self-medication leads you one step closer to death. Please do not use any of the above medications without having a consultation. A doctor can prescribe you the best medication choice by considering your medical history and condition.

Unaware of the Cause Making you Insulin Resistant? Chat with our Doctor Today!

Lifestyle Changes 

  • 5 to 7 days a week, exercise for 30 minutes of moderate activity (like brisk walking). Get active if you aren’t already.
  • Maintain a healthy weight. Consult your dietician if you’re unsure what weight you should weigh or how to lose weight. 
  • Maintain a healthy diet: You should eat a healthy diet of fruits, vegetables, grains, nuts, beans, fish, legumes and lean proteins.
  • Avoid smoking and limit alcohol intake.

Insulin therapy

Insulin therapy is a critical part of treatment for people with insulin resistance and also type 1 and type 2 diabetes. Insulin therapy aims to maintain blood sugar levels within a healthy range. With a syringe, insulin pen, or insulin pump, insulin is usually administered to the fat under your skin.

Management and Prevention of Insulin Resistance

It is often possible to completely reverse insulin resistance by making the following lifestyle changes:

Right nutrition: Consume whole, unprocessed foods and plenty of nuts and fatty fish.  Omega-3 fatty acids in nuts and fish reduce inflammation and oxidative stress that, ultimately, improve insulin sensitivity. Avoid sugar-sweetened drinks and reduce your sugar intake.

Losing belly fat: Exercise and other methods are essential for targeting fat that accumulates around your main organs.

Avoid smoking: Smoking is known to cause insulin resistance, and quitting can help in the improvement of insulin sensitivity.

Exercising: One of the easiest ways to improve insulin sensitivity is through physical activity. There is a rapid onset of its effects.

Supplements: Though more research is needed, some studies suggest that berberine may enhance insulin sensitivity and regulate blood sugar. Magnesium supplements may be helpful for some people as well.

Quality sleep: Improving sleep quality may help reduce insulin resistance, which is associated with poor sleep.

Stress management: It has been suggested that chronic stress contributes to insulin resistance. As a result, yoga and meditation may be useful for stress reduction.

Intermittent Fasting: You can improve insulin sensitivity by following an intermittent fasting diet. Make sure you consult your dietician/doctor first before trying it to ensure that it is safe for you.

When to Consult a Doctor

If you have insulin resistance or conditions related to insulin resistance, you should talk to your doctor frequently so your blood sugar levels stay within a healthy range and your treatment is effective.

Contact your healthcare provider if you are experiencing symptoms of high blood sugar or prediabetes. A simple blood sugar test can be performed by them.

Talk to Your Doctor about Insulin Resistance if you have a Family History of Diabetes or Conditions that can Cause it.

FAQs About Insulin Resistance Answered By Your Doctors Online Team 

Can you be insulin resistant without being diabetic?

Insulin resistance has many other underlying causes instead of diabetes.
But the insulin resistance stage is considered the prediabetes stage; moreover, if it is left untreated, then it will surely lead to diabetes.

What can I eat for breakfast if I am insulin resistant?

High-fiber foods should be the best option. Add nuts and low-GI fruits to your breakfast.
Avoid added sugar as much as you can.

What organ produces insulin?

Pancreas contains specialized cells called islets of Langerhans. The most common islets type Beta cells produce insulin, which regulates carbohydrate, fat, and protein metabolism.

Can you live without a pancreas?

It is possible to live without a pancreas. There will be some adjustments you’ll need to make in your life.
In addition to controlling blood sugar, your pancreas helps you digest food. To maintain these functions after surgery, you will need to take medicines. 

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