Insulin resistance

Overview

Insulin resistance is a condition where your body's cells do not respond well to insulin, a hormone that helps sugar (glucose) enter cells for energy. When cells resist insulin, sugar builds up in your blood, which can lead to high blood sugar and eventually type 2 diabetes.

Yes, insulin resistance is very common. It affects millions of people worldwide and is often linked to excess weight and a sedentary lifestyle.

Anyone can develop insulin resistance, but it is more common in people who are overweight, have a family history of diabetes, are physically inactive, or belong to certain ethnic groups (such as South Asian, African Caribbean, or Hispanic). It can affect children, adults, and older adults.

Symptoms

Common symptoms

• Fatigue or low energy
• Increased hunger, even after eating
• Difficulty losing weight or unintended weight gain
• Brain fog or trouble concentrating

Symptoms in children

• Dark, velvety patches of skin (acanthosis nigricans) on the neck, armpits, or groin
• Weight gain, especially around the belly

Symptoms in older adults

• Fatigue and feeling unusually tired
• Brain fog or memory problems
• Increased thirst and frequent urination (if blood sugar is high)

Causes

Main causes

• Excess body fat, especially around the belly
• Physical inactivity
• Genetics and family history of diabetes

Risk factors

• Being overweight or obese
• Having a parent or sibling with type 2 diabetes
• Being over 45 years old
• Having high blood pressure or abnormal cholesterol levels
• Having polycystic ovary syndrome (PCOS)
• Being from certain ethnic backgrounds (South Asian, African Caribbean, Hispanic)

When to see a doctor

See a doctor urgently if:

• If you have symptoms of very high blood sugar (extreme thirst, frequent urination, blurred vision, confusion) or signs of diabetic ketoacidosis (nausea, vomiting, deep breathing, fruity breath).

Book a routine appointment if:

• If you have family history of diabetes, are overweight, or have concerns about your blood sugar
• If you have dark patches on your skin or unexplained fatigue

Diagnosis

A healthcare provider will review your medical history, do a physical exam, and order blood tests to measure your blood sugar levels and how your body handles sugar over time.

Tests that may be done

• Fasting blood sugar test – checks blood sugar after not eating for 8 hours
• Hemoglobin A1c test – shows average blood sugar over the past 2-3 months
• Oral glucose tolerance test – measures blood sugar before and after drinking a sugary drink

What to expect at your appointment

The tests are simple and usually done in a clinic or lab. You may need to fast (no food or drink except water) for several hours before certain tests. Your doctor will explain the results and what they mean for you.

Treatment

Treatment focuses on improving how your body responds to insulin. The most effective way is through lifestyle changes like healthy eating and regular physical activity. Sometimes medications are needed, but only under a doctor's guidance.

Self-care at home

• Eat a balanced diet rich in vegetables, whole grains, lean protein, and healthy fats
• Aim for at least 150 minutes of moderate exercise each week (like brisk walking)
• Reach and maintain a healthy weight – even losing 5-7% of body weight can help
• Get enough sleep (7-9 hours per night)

Medical treatments

If lifestyle changes are not enough, your doctor may prescribe medications that help the body use insulin better or lower blood sugar. Always take medications exactly as prescribed and discuss any side effects with your doctor. Never change your dose without medical advice.

When is surgery considered?

Surgery is not used to treat insulin resistance directly. However, for some people with severe obesity, weight-loss surgery (bariatric surgery) may improve insulin sensitivity and help manage related conditions.

Living with this condition

Living with insulin resistance means making healthy choices every day. It's a manageable condition, and small steps can make a big difference. Check with your healthcare provider regularly to monitor your blood sugar and overall health.

Lifestyle tips

• Plan meals that include plenty of fibre and limit sugary foods and refined carbs
• Stay active – find activities you enjoy, like dancing, swimming, or cycling
• Manage stress with relaxation techniques like deep breathing or meditation
• Avoid smoking and limit alcohol

Diet and exercise

A diet rich in non-starchy vegetables, whole grains, lean proteins, and healthy fats can help control blood sugar. Regular exercise helps your cells use insulin better. Even 30 minutes of walking most days can improve insulin sensitivity.

Mental health and emotional wellbeing

Dealing with a chronic condition can be stressful. You may feel worried or frustrated. It's important to talk about your feelings with family, friends, or a counselor. Many people find support groups helpful.

Prevention

Yes, in many cases insulin resistance can be prevented or delayed by maintaining a healthy weight, being physically active, eating a balanced diet, and avoiding smoking. Even small changes can have a big impact.

Screening programmes

If you have risk factors, such as being overweight or having a family history of diabetes, talk to your doctor about getting a blood sugar test. Early screening can catch problems before symptoms start.

Complications

If left untreated

• Prediabetes and then type 2 diabetes
• Heart disease and stroke
• High blood pressure
• Fatty liver disease
• Kidney damage

Long-term outlook

The outlook is very hopeful. Insulin resistance can often be reversed or improved with lifestyle changes. Many people successfully prevent or delay diabetes and lead healthy, active lives. Working with your healthcare team is the best way to stay on track.

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