Understanding Insulin Resistance
Beyond Diabetes: What’s Happening Before Disease
What insulin is really doing
In metabolically healthy individuals, insulin acts as a precision signaling hormone, coordinating when cells:
take in glucose
store energy
build tissue
repair damage
Insulin pulses rise after meals and fall during fasting or physical activity. This dynamic rise-and-fall is a sign of metabolic flexibility.
Insulin resistance begins when that signaling loses precision.
What is insulin resistance (before diabetes)?
Insulin resistance occurs when cells—especially muscle, liver, and fat—respond less effectively to insulin’s signal. To maintain normal blood glucose, the pancreas compensates by producing more insulin. This leads to hyperinsulinemia, often years before blood sugar becomes abnormal.
Importantly:
You can be insulin resistant with normal glucose and normal A1c
Many people are insulin resistant and don’t know it
This is why insulin resistance is best understood as a systems-level metabolic condition, not a glucose disorder.
Early signs of insulin resistance (often missed)
In non- or pre-diabetic individuals, insulin resistance may show up as:
Elevated fasting insulin
Post-meal fatigue or brain fog
Difficulty losing fat despite calorie control
Central (visceral) fat gain
Reactive hypoglycemia (energy crashes)
Elevated triglycerides / low HDL
Fatty liver patterns
Increased inflammation markers
Hormonal disruptions (PCOS, low testosterone, cortisol dysregulation)
Glucose may remain “normal” while insulin is doing more and more work behind the scenes.
Why insulin resistance matters (even without diabetes)
1. Metabolic aging
Chronically elevated insulin accelerates:
mitochondrial inefficiency
oxidative stress
inflammatory signaling
loss of metabolic flexibility
This contributes to earlier biological aging, even in people who look “healthy.”
2. Fat gain & energy dysregulation
Insulin resistance shifts the body toward:
storing energy more easily
accessing stored fat less efficiently
This is why insulin resistance often presents as “I do everything right but still gain fat.”
3. Hormonal & reproductive effects
Insulin resistance interacts with:
sex hormone balance (estrogen, testosterone)
SHBG levels
ovarian and testicular signaling
This is particularly relevant in PCOS, perimenopause, and andropause.
4. Brain & cognitive implications
Insulin signaling plays a role in:
brain glucose uptake
synaptic function
neuroplasticity
Insulin resistance is associated with increased risk of cognitive decline, sometimes referred to as “type 3 diabetes” in research contexts (a metaphor, not a diagnosis).
5. Cardiometabolic risk
Long before diabetes:
insulin resistance promotes atherogenic lipid patterns
endothelial dysfunction
hypertension
This explains why cardiometabolic risk can rise even when glucose appears normal.
What causes insulin resistance in non-diabetics?
Insulin resistance is rarely about sugar alone. Key drivers include:
Chronic overnutrition (especially ultra-processed foods)
Constant grazing (no insulin “off” periods)
Physical inactivity (especially low muscle mass)
Sleep disruption
Chronic psychological stress
Inflammation
Mitochondrial dysfunction
Circadian misalignment
Environmental toxins
Think of insulin resistance as a mismatch between fuel input and cellular capacity to process it.
How insulin resistance is reversed (evidence-based, non-pharmaceutical)
1. Reduce insulin frequency, not just calories
Insulin resistance improves when insulin gets time to fall.
Strategies include:
structured meals instead of constant snacking
time-restricted eating
avoiding late-night eating
This restores insulin’s natural rhythm.
2. Build muscle (the primary insulin sink)
Skeletal muscle is the largest insulin-responsive tissue.
Resistance training:
increases GLUT4 expression
improves insulin sensitivity independent of weight loss
enhances mitochondrial density
Muscle is not just for strength—it’s metabolic infrastructure.
3. Improve mitochondrial function
Insulin resistance and mitochondrial dysfunction reinforce each other.
Key levers:
regular movement
aerobic + resistance training
nutrient sufficiency (not megadosing)
reducing chronic inflammation
Healthy mitochondria mean cells can actually use the glucose insulin delivers.
4. Normalize circadian signaling
Insulin sensitivity follows a circadian rhythm.
Support includes:
consistent sleep/wake timing
daylight exposure
limiting late-night meals
aligning training earlier in the day when possible
5. Lower inflammatory load
Inflammation interferes with insulin signaling.
This may involve:
gut health optimization
addressing food intolerances
stress regulation
reducing toxic burden
6. Personalization matters
Not all insulin resistance looks the same.
Some people are:
muscle insulin resistant
liver insulin resistant
adipose insulin resistant
Testing (fasting insulin, postprandial responses, lipids, inflammatory markers, CGM data) helps identify which system is driving the resistance—and what to address first. But let’s be specific, a blood test alone will give you indications of insulin resistance, but to drive into what is causing it and how to intervene you need further systemic testing. Looking at the list above: Key factors are Exercise, Mitochondrial function, Gut Health, Stress, Detox Status, Understanding food intolerances and HOW IS INSULIN RESISTANCE MANIFESTING IN YOUR BODY. Here is a list of the tests that can really uncover an action plan:
1) Exercise (Advanced Blood Testing, Metabolic Testing and Genetic Testing). Each reveal a different but important theme.
2) Mitochondrial function (Blood Testing, Metabolic Testing, Glycan Age Testing and Mitochondrial Efficiency Testing)
3) Gut Health (Gut Microbiome Test, Blood Testing, Metabolic Testing)
4) Detox Status (Metabolic Testing, Mitochondrial Efficiency Testing)
5) Stress (Blood Testing, Metabolic Testing, Mitochondrial Testing, GlycanAge Testing)
