Insulin Resistance: Signs, Tests and Treatment

Insulin resistance means muscle, liver and fat cells respond poorly to insulin, so the pancreas must produce more to keep glucose normal. Over time this can lead to prediabetes and type 2 diabetes.

Causes

Abdominal (visceral) fat, inactivity, refined carbohydrates, genetics, poor sleep and sleep apnoea, PCOS, some hormonal disorders and medications such as steroids.

Signs

Increased waist size, dark velvety skin on the neck or armpits (acanthosis nigricans), skin tags, irregular periods, high triglycerides, low HDL and fatty liver.

Testing

HOMA-IR is commonly used but has no universal cut-off, so it is interpreted alongside waist, glucose, HbA1c, lipids and blood pressure. Dr. Demirci has published on the triglyceride-glucose (TyG) index as a simple marker of insulin resistance.

Improving Insulin Sensitivity

Losing 5–10% of body weight, at least 150 minutes of weekly activity plus resistance training, reducing sugary drinks and refined carbohydrates, good sleep and, in selected cases such as prediabetes or PCOS, metformin.