How To Check Insulin Resistance

The Types Of Insulin Resistance Tests

Insulin resistance is not something that is commonly tested for. However, if prediabetes or type 2 diabetes is suspected, a doctor will perform an insulin resistance test.

The most commonly used insulin resistance tests are:

Fasting plasma glucose test

An FPG test is used to diagnose prediabetes and diabetes by testing a persons blood sugar level after they have not eaten for 8 to 12 hours usually overnight. When you have an annual physical, the standard blood panel includes an FPG test, which makes it the most common type of insulin resistance test.

Oral glucose tolerance test

An OGTT is performed after an overnight fast. A healthcare professional starts by taking a blood sample, and then you are instructed to drink a high-glucose beverage. Additional blood samples are taken at specific intervals for two to three hours, and the results are compared to analyze how your body processes glucose over time. This test is not used as often as others.

Random blood glucose test

An RBG test measures your blood sugar at any time throughout the day, without the need for fasting. This test is performed when a quick diagnosis is necessary.

A1C test

The CDC classifies the following results for each blood test:

If you are diagnosed with prediabetes, the ADA recommends being checked for type 2 diabetes every 1-2 years.

What Do The Results Mean

If your insulin levels were too high, it may mean you have:

• Type 2 diabetes

If insulin levels were too low, it may mean you have:

• Hyperglycemia
• Pancreatitis, an inflammation of the pancreas

If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

What Are The Complications Of Insulin Resistance

The majority of the complications that can result from insulin resistance are related to the development of vascular complications due to elevated blood sugar levels and elevated insulin levels .

Not everyone who has insulin resistance will have complications. If youve been diagnosed with insulin resistance, Type 2 diabetes or metabolic syndrome, its important to see your healthcare provider regularly and follow your treatment plan to try to prevent these complications.

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How Is It Used

Insulin testing may be used to help:

Insulin testing may be ordered with glucose and C-peptide tests. Insulin levels are also sometimes used in conjunction with the glucose tolerance test . In this situation, blood glucose and insulin levels are measured at pre-established time intervals to evaluate insulin resistance.

How To Reverse Insulin Resistance

If you have insulin resistance, you want to become the oppositemore insulin sensitive .

Physical activity makes you more sensitive to insulin, one reason why its a cornerstone of diabetes management . Dont wait until youre diagnosed with diabetes to start moving more. The earlier you take action , the better off youll be.

Weight loss is important too, as is avoiding high blood sugar, reducing stress, and getting enough sleep .

These lifestyle changes really work. Talk with your health care provider about how to get started.

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Why Are Tests For Insulin Resistance Important

Knowing this information very important to your overall health and wellbeing. If prevention is your goal then these tests can be life-saving. If you have a condition aggravated by hyperinsulinemia such as reactive hypoglycemia, PCOS, or type two diabetes, these tests are key to managing your condition and reaching optimal health.

Consider that the very first effect of hyperinsulinemia is pathology of the arterial wall.As the arterial wall is an insulin-sensitive tissue, it has long been known that chronic exposure to high levels of insulin results in the development of lipid-filled lesions like those of early atherosclerosis.

It is also well-known that in patients with diabetes, atherosclerosis is found in the vast majority of cases. It has been found that insulin has the capacity to stimulate the arterial muscle cell proliferation and lipid synthesis in the arterial wall, which is known as endothelial dysfunction). Since arteries are present in all tissues in the body, we can see why diabetes causes such widespread changes to health, affecting almost every organ in the body. In fact, up to 80% of type two diabetics die from cardiovascular complications . It is also known that retinopathy, which involves changes to the blood vessels in the eye develops at least 7 years before diabetes is clinically diagnosed.

Pilaf: How To Measure Insulin Resistance

Insulin resistance is the root cause of many chronic diseases. Often, being diagnosed with diabetes precedes the diagnosis of other chronic conditions, including coronary artery disease, high cholesterol, hypertension, Alzheimers disease, cancer, stroke, and chronic inflammation.

When reversing insulin resistance using your diet, the goal is to become as insulin sensitive as possible, to prevent against the development of these chronic diseases.

In order to help you understand your level of insulin resistance, weve developed a convenient checklist to help you understand how to become as insulin sensitive as possible.

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How Common Is Insulin Resistance

Since there arent any common tests to check for insulin resistance and there arent any symptoms until it turns into prediabetes or Type 2 diabetes, the best way to measure the prevalence of insulin resistance is through the number of prediabetes cases. More than 84 million adults in the United States have prediabetes. Thats about 1 out of every 3 adults.

How Do Doctors Diagnose Insulin Resistance And Prediabetes

Doctors use blood tests to find out if someone has prediabetes, but they dont usually test for insulin resistance. The most accurate test for insulin resistance is complicated and used mostly for research.

Doctors most often use the fasting plasma glucose test or the A1C test to diagnose prediabetes. Less often, doctors use the oral glucose tolerance test , which is more expensive and not as easy to give.

The A1C test reflects your average blood glucose over the past 3 months. The FPG and OGTT show your blood glucose level at the time of the test. The A1C test is not as sensitive as the other tests. In some people, it may miss prediabetes that the OGTT could catch. The OGTT can identify how your body handles glucose after a mealoften before your fasting blood glucose level becomes abnormal. Often doctors use the OGTT to check for gestational diabetes, a type of diabetes that develops during pregnancy.

People with prediabetes have up to a 50 percent chance of developing diabetes over the next 5 to 10 years. You can take steps to manage your prediabetes and prevent type 2 diabetes.

The following test results show Prediabetes2

• A1C5.7 to 6.4 percent
• FPG100 to 125 mg/dL
• OGTT140 to 199 mg/dL

You should be tested for prediabetes if you are overweight or have obesity and have one or more other risk factors for diabetes, or if your parents, siblings, or children have type 2 diabetes. Even if you dont have risk factors, you should start getting tested once you reach age 45.

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Waist To Height Ratio

A completely free yet accurate marker of insulin resistance is the waist to height ratio. This is incredibly simple to calculate as it is the waist circumference divided by height in the same units. A 2010 study following 11,000 subjects for 8 years found that WHtR was a better measure of the risk of heart attack, stroke or death. Another study in 2016 followed 754 reproductive age women found that Waist to Height Ratio was a good predictor of Insulin Resistance and metabolic syndrome in women with and without PCOS.

Waist to height ratios over 0.5 are considered to be exceptionally risky when it comes to metabolic health. We encourage all patients to measure this ratio, as it is completely non-invasive and can be done at home.

I hope that this guide has been helpful for you in clarifying the difference between testing for insulin resistance and diabetes, two conditions that although are linked, require different testing to be done to detect. Have you ever been told that you were not insulin resistant even though you have clear signs and which tests have you had done so far?

Please share your experiences and cases below in the comments!

What Actions Might You Consider5

• Counsel patients on lifestyle changes, such as increasing physical activity, losing weight, and adhering to a healthy diet
• Employ pharmaceutical interventions that increase insulin sensitivity or induce weight loss

Risk score report: the Cardio IQ® Insulin Resistance Panel with Score gives you an effective counseling tool for patients who need to make lifestyle changes.

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What Are The Long

When insulin resistance is left unmanaged, it can lead to a host of health complications, such as metabolic syndrome. This is a cluster of conditions including high blood sugar, high blood pressure, high cholesterol and excess abdominal fat. If you have metabolic syndrome, youre also a lot more likely to develop type 2 diabetes, which is linked to further complications. Find more on metabolic syndrome and diabetes here.

What Questions Should I Ask My Doctor

If youve been diagnosed with insulin resistance, it may be helpful to ask your healthcare provider the following questions:

• Whats causing my insulin resistance?
• What can I do to increase my insulin sensitivity?
• Whats my risk of developing prediabetes or Type 2 diabetes?
• Is there any medication I can take?
• Should I see a specialist for insulin resistance?

A note from Cleveland Clinic

Insulin resistance is a complex condition that can affect your health in several ways. Since it doesnt have any symptoms until it turns into prediabetes or Type 2 diabetes, the best thing you can do is try to prevent and reverse insulin resistance by maintaining a healthy weight, exercising regularly and eating a healthy diet. Unfortunately, though, not all causes of insulin resistance can be prevented or treated. If you have any questions about your risk of developing insulin resistance or conditions associated with it, talk you your healthcare provider. Theyre there to help you.

Last reviewed by a Cleveland Clinic medical professional on 12/16/2021.

References

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Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.

What Tests Will Be Done To Evaluate Insulin Resistance

Your healthcare provider may order the following blood tests to diagnose insulin resistance and/or prediabetes or diabetes:

• Glucose: A fasting plasma glucose or a glucose tolerance test may be used to screen for, diagnose and/or monitor prediabetes, type 2 diabetes or gestational diabetes.
• Glycated hemoglobin A1c : This test reveals your average blood glucose levels over the past three months.
• Lipid panel: This is a group of tests that measure specific lipids in your blood, such as total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.

Your healthcare provider may also order tests that can help diagnose other conditions that are associated with insulin resistance, such as metabolic syndrome, cardiovascular disease and polycystic ovary syndrome .

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What Are The Symptoms Of Insulin Resistance

If you have insulin resistance, but your pancreas can increase insulin production to keep your blood sugar levels in range, you wont have any symptoms.

However, over time, insulin resistance can get worse, and the cells in your pancreas that make insulin can wear out. Eventually, your pancreas is no longer able to produce enough insulin to overcome the resistance, leading to elevated blood sugar , which does cause symptoms.

Symptoms of high blood sugar include:

• Increased thirst.
• Vaginal and skin infections.
• Slow-healing cuts and sores.

Many people have no symptoms of prediabetes, often for years. Prediabetes may be invisible until it develops into Type 2 diabetes. Some people with prediabetes may experience the following symptoms:

• Darkened skin in your armpit or back and sides of your neck, called acanthosis nigricans.
• Skin tags .
• Eye changes that can lead to diabetes-related retinopathy.

If youre experiencing any of these symptoms, its important to see your healthcare provider.

Who Should Be Tested For Insulin Resistance

Insulin resistance tests may be ordered for people with certain genetic and lifestyle risk factors. According to the National Institute of Diabetes and Digestive and Kidney Diseases , the following factors can make people more likely to develop insulin resistance and possibly prediabetes:

• Being overweight or obese.
• Having a history of polycystic ovary syndrome , gestational diabetes, heart disease, or stroke.
• Health issues like high blood pressure and/or abnormal cholesterol levels.
• Physical inactivity.
• A history of diabetes in the immediate family.
• Ethnicities such as African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American.
• Hormonal disorders like Cushings syndrome or acromegaly.
• Taking certain medications like glucocorticoids, certain antipsychotics, and certain HIV medications.
• Sleep problems, such as sleep apnea.

The NIDDK also notes that excess fat in the abdomen and around the organs can be a cause of insulin resistance. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance, even if their body mass index is within a normal range.

If weight loss goals are not currently a realistic option, there are still ways to improve your blood sugar levels through diet and activity. Consult with your doctor to learn about the best options for your health.

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Symptoms Of Insulin Resistance

You can’t tell that you have insulin resistance by how you feel. You’ll need to get a blood test that checks your blood sugar levels.

Likewise, you wonât know if you have most of the other conditions that are part of insulin resistance syndrome without seeing your doctor.

Some signs of insulin resistance include:

• A waistline over 40 inches in men and 35 inches in women

How Is Insulin Resistance Diagnosed

Insulin resistance is difficult to diagnose because there isnt routine testing for it, and as long as your pancreas is producing enough insulin to overcome the resistance, you wont have any symptoms.

As theres no single test that can directly diagnose insulin resistance, your healthcare provider will consider several factors when assessing insulin resistance, including your:

• Medical history.
• Test results.

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Why A Fasting Glucose Test Isnt Enough

Most people who are insulin resistant â a whopping 90% â donât realize it. Thatâs because most doctors donât routinely check glucose levels, and if they do, they only test fasting glucose, which doesnât show the full picture.

As a doctor with insulin resistance myself, and as someone who has helped hundreds of patients lower their blood glucose and insulin levels, I recommend doing a fasting glucose test, an oral glucose tolerance test, and an insulin test.

Let me share an example to illustrate my point. A patient of mine was concerned about diabetes. Why? He was slightly overweight, he had family members with diabetes, and his father had died of a heart attack. He told me his family doctor checked his fasting glucose once a year and it always came back normal.

So I ran the tests. His fasting glucose indeed came back normal, at 88mg/DL. But when we did an oral glucose tolerance test, his sugar levels were through the roof: at 291mg/Dl at the two-hour mark. . As you can see, fasting glucose doesnât tell the whole story. Some people can bring their sugars down to normal levels over time but the worrying part is that it takes them too long to do so. The sugar in their bloodstream can still cause damage. This is especially common in prediabetes and early diabetes.

Diagnosis And Tests For Insulin Resistance

Your doctor will use these things to diagnose insulin resistance:

• Questions. Theyâll want to know about your family’s medical history.
• Physical exam. Theyâll weigh you and check your blood pressure.
• Blood tests. You might get:

• Fasting plasma glucose test. This test measures your blood sugar after you havenât eaten for at least 8 hours.
• Oral glucose tolerance test. First, you’ll take the fasting glucose test. Then you’ll drink a sugary solution. Two hours after that, you’ll take another blood test.
• Hemoglobin A1c test. This blood test shows your average blood sugar level for the past 2 to 3 months. Doctors use it to diagnose prediabetes or diabetes. If you have diabetes, it helps show whether it’s under control. You may need to take the test again to confirm the results.

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