Insulin Resistance: The Hidden Risk Factor You Should Test For (and How to Do it)

Insulin Resistance: What It Is, How It Develops, and Why It Matters

In today’s world, insulin resistance (IR) is becoming increasingly common, often lurking beneath the surface for years before being detected. It’s a key player in a variety metabolic disorders, including type 2 diabetes, infertility, obesity, osteoporosis, low testosterone, decreased libido, and more. Insulin resistance extends far beyond just blood sugar levels, and can have a global impact on health and recovery. Let’s break down what insulin resistance is, how it develops, and why it’s important to address it early.

What Is Insulin Resistance?

Insulin is a hormone produced by the pancreas that plays a crucial role in metabolism. Its primary job is to help cells absorb glucose (sugar) from the bloodstream to use for energy or store for later. When the body becomes resistant to insulin, the cells—especially in muscles, fat, and the liver—fail to respond properly to its signals. As a result, glucose remains in the bloodstream, and the pancreas compensates by producing more insulin to try to force glucose into the cells.

This state of elevated insulin and blood sugar levels can persist for years before blood sugar becomes high enough to diagnose diabetes. However, even before diabetes develops, insulin resistance can contribute to a wide range of health issues.

How Does Insulin Resistance Develop?

Insulin resistance doesn’t happen overnight. It typically develops over time due to a combination of genetic, lifestyle, and environmental factors. Some of the most common contributors include:

Excessive Sugar and Processed Carbohydrates – Diets high in refined sugars and processed carbs lead to frequent spikes in blood sugar and insulin levels, which over time can make cells less responsive to insulin’s effects.
Chronic Inflammation – Low-grade inflammation, often caused by poor diet, stress, and environmental toxins, interferes with insulin signaling.
Physical Inactivity – Muscle tissue is one of the main consumers of glucose. A sedentary lifestyle reduces glucose uptake by muscles, making the body more resistant to insulin.
Visceral Fat Accumulation – Fat stored around the organs (visceral fat) releases inflammatory compounds and hormones that disrupt insulin’s action.
Hormonal Imbalances – Conditions like polycystic ovary syndrome (PCOS) and chronic stress (which increases cortisol) can worsen insulin resistance.
Sleep Deprivation – Poor sleep affects hormone regulation, increasing insulin resistance and hunger hormones that drive cravings for sugary foods.

Complications of Insulin Resistance

Even before blood sugar levels reach diabetic levels, insulin resistance can cause significant health problems. Some of the most common complications include:

Type 2 Diabetes – When insulin resistance becomes severe, the pancreas can no longer produce enough insulin to keep up, leading to persistently high blood sugar and a diabetes diagnosis.
Heart Disease – Insulin resistance contributes to high blood pressure, elevated triglycerides, and increased LDL (“bad”) cholesterol, all of which raise the risk of cardiovascular disease.
Non-Alcoholic Fatty Liver Disease (NAFLD) – Excess glucose and insulin promote fat storage in the liver, leading to inflammation and potential liver damage.
Polycystic Ovary Syndrome (PCOS) – In women, insulin resistance is a major driver of PCOS, a hormonal disorder linked to irregular menstrual cycles, infertility, and increased androgen levels.
Cognitive Decline and Alzheimer’s Disease – Some researchers refer to Alzheimer’s as “Type 3 Diabetes” because insulin resistance is linked to brain inflammation and impaired glucose metabolism in neurons.
Weight Gain and Obesity – Elevated insulin levels promote fat storage, especially around the abdomen, making weight loss more difficult.

The Link Between Insulin Resistance and Metabolic Health Testing

Recognizing the widespread impact of insulin resistance is just the first step. The next crucial part is identifying it early—before it progresses to more serious conditions like type 2 diabetes, cardiovascular disease, or cognitive decline. While symptoms may not always be obvious, lab testing can reveal hidden metabolic dysfunction.

One of the most effective ways to assess insulin resistance is through fasting insulin levels and the HOMA-IR ratio. These tests provide a more accurate picture of how efficiently your body is responding to insulin—far earlier than a standard fasting glucose test alone. By incorporating these markers into routine health assessments, you can take proactive steps to improve insulin sensitivity and prevent long-term complications.

The Importance of Testing Fasting Insulin and HOMA-IR Ratio for Metabolic Health

Understanding how the body processes insulin is essential for maintaining long-term metabolic health. While many routine tests focus on fasting glucose levels, this alone does not provide the full picture. A fasting insulin test with HOMA-IR ratio calculation is a more insightful way to assess insulin sensitivity and detect metabolic dysfunction before it progresses into serious conditions like type 2 diabetes or cardiovascular disease.

Why Test Fasting Insulin and HOMA-IR?

Fasting glucose levels can remain in the normal range for years, even when insulin resistance is already developing. The body compensates by producing more insulin to keep blood sugar stable. By measuring fasting insulin alongside fasting glucose, the HOMA-IR ratio can be calculated, offering a more precise assessment of how efficiently the body is using insulin.

A high HOMA-IR ratio indicates insulin resistance, meaning the body’s cells are not responding effectively to insulin. Over time, this leads to higher insulin demands, increased pancreatic stress, and a higher risk of blood sugar dysregulation and chronic disease.

How to Calculate HOMA-IR (Click for calculator)

The formula for HOMA-IR is: HOMA-IR Score = (Fasting insulin, uIU/mL)*(Fasting glucose, mg/dL) / 405

***A result above 2 suggests some degree of insulin resistance, while a result under 1 is generally considered optimal.

Improving Insulin Sensitivity

If your HOMA-IR score is elevated, lifestyle adjustments can help improve insulin sensitivity:

Diet – Focus on whole foods, reduce processed carbohydrates, and increase fiber intake.
Exercise – Strength training and aerobic activities improve glucose metabolism.
Stress Management – Chronic stress contributes to insulin resistance, so mindfulness and relaxation techniques are beneficial.
Sleep – Poor sleep disrupts metabolic processes and increases insulin resistance.
Supplements and Herbs – A variety of supplements and herbs can support a healthy diet in order to assist in reversing insulin resistance.

Other Essential Labs to Check Yearly

For a more complete picture of metabolic health, consider testing:

Hemoglobin A1c (HbA1c) – Reflects a three-month average of blood glucose levels and helps detect prediabetes and diabetes risk.
High-Sensitivity C-Reactive Protein (hs-CRP) – Measures systemic inflammation, a key driver of metabolic dysfunction and chronic disease.
Omega-3 Index – Evaluates the balance of omega-3 to omega-6 fatty acids, which plays a role in inflammation and heart health.
Vitamin D Levels – Essential for immune function, hormone regulation, and metabolic balance.
Lipoprotein(a) (Lp(a)) – A genetic risk factor for cardiovascular disease that offers more insight than traditional cholesterol tests.

Take Charge of Your Metabolic Health

By making fasting insulin and HOMA-IR a part of your routine health assessments, you can catch early signs of insulin resistance and take action before more serious conditions develop. Understanding and tracking these markers allows you to make informed choices that support long-term vitality, energy, and disease prevention.