A friend mentions insulin resistance. An online video lists a dozen supposed signs. At your last appointment, nobody said you had diabetes. Can all of those things be true at once?
Yes. Insulin resistance and diabetes are related, but they are not the same diagnosis. Here's a practical way to understand the difference and start a conversation about your own health.
First, what does insulin do?
Insulin is a hormone that helps the body manage glucose, also called blood sugar. When cells in the muscles, liver and fat don't respond as well to insulin, that's called insulin resistance.
The body may make more insulin to help keep glucose levels in range. If it can no longer keep up, blood glucose can rise. Depending on the results of appropriate testing, someone may have prediabetes or diabetes. That progression is not inevitable for every person, and an individual test result needs context.
Where prediabetes fits
Prediabetes describes glucose levels that are above the usual range but not high enough for a diabetes diagnosis. It is identified using blood tests, such as A1C or fasting glucose, rather than by counting symptoms.
Insulin resistance can be part of that story, but the terms aren't interchangeable. A person can discuss insulin resistance without having diabetes, and a normal-looking result on one test isn't a complete assessment of every future risk.
If you've been told you have prediabetes, our guide to GLP-1 medicines and prediabetes offers questions for a follow-up appointment.
Can you tell from how you feel?
Insulin resistance and prediabetes often have no obvious symptoms. Tiredness, changes in appetite or other common experiences can have many explanations. An online checklist can't establish the cause or tell you which tests you need.
That doesn't mean you should ignore a symptom. Describe what you've noticed, when it started and how it affects your day. Your health professional can consider the rest of your history and decide what to check.
You might say, “I've seen information about insulin resistance and I'm not sure whether it applies to me. Can we review my recent results and risk factors?” You don't need to arrive with a diagnosis already figured out.
What about an insulin test?
Specialized tests of insulin resistance are used mainly in research and aren't routinely needed for every person. A care team may instead discuss your health history and use appropriate glucose tests when assessing diabetes or prediabetes.
An A1C reflects a longer-term glucose picture, while a fasting glucose result represents a particular point in time. Neither result by itself tells you exactly how insulin-sensitive every tissue is. Ask what each ordered test is meant to answer and when you'll discuss the result.
What can you do with the information?
Start with changes that fit your circumstances. That could mean making a regular lunch easier to pack, adding a comfortable walk or finding an activity you enjoy. Sleep, other health conditions and medicines are also worth discussing when they affect your routine.
Weight-management treatment may be part of an individual plan, but a social-media claim about insulin resistance isn't a reason to borrow a medication or change a dose. Ask your care team what options make sense for your history and what follow-up they recommend.
If you're already taking a GLP-1 and eating has become difficult, say so. A plan that accounts for nourishment and your daily life is more useful than a list of foods to fear.
The goal is a clear explanation and a next step you understand. You can leave the internet's symptom quizzes behind and bring your actual questions to the visit.