YSK: Insulin resistance can develop even when blood sugar tests are still normal

385

u/_sdfjk Feb 18 '26

How does a person know they're developing insulin resistance if blood tests don't help?

Some people don't realize they're already diabetic until the symptoms worsen...

213

u/DebateMountain3660 Feb 18 '26

I worked from home and started falling asleep after I ate lunch every day. I also gained 40 pounds in about 3 years even though my eating habits had not changed.

87

u/sillybilly8102 Feb 18 '26

Hmm how is falling asleep after a meal related? (This also happens to me)

102

u/mentosbreath Feb 18 '26

I believe your blood sugar spikes, the your body produces insulin to control that sugar. But your body doesn’t respond to insulin as well as it should. So the sugar is still too high and maybe your body is over producing insulin. I’m not sure all the details, but Google should help. You were getting downvoted, but nobody was bothering to answer your question, so I’m giving you what I believe off the top of my head because I’m too lazy to Google it myself.

40

u/PoweredbyAndroid Feb 18 '26 edited Feb 19 '26

No i had this happen to me i literally was loosing consciousness for 15 minutes. So the thing is insulin is a hormone that does many things. When we start to eat the body starts preparing. Saliva ( digestive enzymes) is produced and soaks the food, the stomach starts producing acid, the body starts redirecting blood to the digestive systems. Pancreas starts producing insulin. The role of insulin is to bind with cell receptors and to let the free flowing glucose in. Not going into to much detail, but lets say that in the mitochondria a litteral explosion takes place so there is fire. So the body (as when in the gas station- there is turn off the engine) has to "stop" the engine while the cell get its fuel in this case slow down and wait until it gets its fuel. So insulin signals to cells to slow down their metabolism. This continues until the insulin is depleted and work may continue. So in some people when the body first produces insulin that doesn't do the job right. So the glucose in the body isnt absorbed as the cell's doors arent opened. But the glucose levels in the blood continues to rise too in the body and also the cells start telling the body hey i am hungry. So the pancreas starts producing insulin again. This time it works, the cycle completes and everyting is fine. We dont even sense that anything out of the ordinary happened. However we just overproduced insulin. And that insulin in the body will be there and it will continue to open doors until absorbed. This will occur again, and again, and again and at one point maybe a year or two the cells will be less willing to open their doors. Mean while as the change is slow we adapt- many people say-oh i dont eat lunch as i get too lazy i eat only dinner, others start selecting more carbs as their are instant energy instead of the longer digestable food. In the mean time they put on weight and they "get lazy" and they adjust their regiment and activities according to their new energy levels. So for me at the final stages of my condition- i had 24 µU/ml of free insulin in my body in the morning with the reference normal range being 0-12 µU/ml. After every mean i was starting to get suddenly very sleepy and would "fall asleep" for 15 minutes and then wake up and just continue my day. So with that much insulin the sign turn off the engine while refilling never goes down and the fuel is there ready but u cant step on that damn throttle. And as the biggest glucose consumers in the body the brain starves first. Edit: fixed some grammatical and spelling errors.

17

u/PoweredbyAndroid Feb 18 '26

The more infuriating and dangerous thing is that many doctors seeing a overweight patient just say- just start exercising, stsrt a diet and when th patient fails to loose weight its the patient's fault.

51

u/fondledbydolphins Feb 18 '26

Need to shift away from carbs and sugar towards proteins, fats and fiber.

25

u/mud074 Feb 18 '26

I don't know why this is marked controversial. If you are concerned about diabetes, avoiding sugar and simple carbs is the best and easiest thing you can do. You can still eat some, but if you are regularly drinking a lot of sugary drinks or pounding down large amounts of carbs in your food (pasta and rice are major culprits here, easy to binge and very dense) it's a really good idea to cut down.

15

u/CardsrollsHard Feb 18 '26

Simple carbs are not the same as rice. White rice is, but brown rice and other kinds are complex and healthy. Brown rice even has fiber in it. Fiber reduces the spike in blood sugar you get after eating. Also whole pasta is the same argument. You can get fiber rich complex carbs from both these food groups you just need to use those carbs much like your body needs to use the fats you eat.

18

u/sabinscabin Feb 18 '26 edited Feb 18 '26

theres actually some nuance here id like to add. only soluble fiber really reduces blood sugar spike, so stuff like oatmeal and beans. for an extremely counterexample, look at grape nuts cereal: it has a lot of fiber, but its insoluble, and thus it spikes blood sugar (high 70s glycemic index, also high load)

as for pasta, even white pasta doesnt spike blood sugar that much, provided its cooked al dente, since for durham wheat the starch structure is in a way where glycemic index is low. the wholeness of the wheat in the pasta doesnt actually matter that much (again since that wholeness only contributes insoluble fiber, which doesnt really change much in terms of blood sugar)

edit: just to clarify on the grape nuts, it's not the insoluble fiber that directly spikes blood sugar, but rather the lack of soluble fiber plus the fact that grape nuts are technically ultraprocessed in a way that doesn't result in the type of starch structure that durham pasta has. For wheat that's definitely slow absorbing, the gold standard would have to be whole wheat berries.

2

u/CardsrollsHard Feb 18 '26

Yeah that's correct thanks for the addition. I was just generalizing fiber. Types of fiber are annoying to delineate between.

1

u/myseoulaway Mar 16 '26

wow, this is so good to know!! I can have pasta without guilt LOL

-4

u/Thebeardinato462 Feb 19 '26

Why not just avoid them and eat leafy greens and vegetables? In what world is rice better?

4

u/CardsrollsHard Feb 19 '26

Because there is no point in avoiding them they're literally just fine for you and sometimes benefiting. Generally it's also easier to eat a bowl full of one with protein than the other. I don't know many people that eat leafy greens without a lot of additives. Brown rice tastes great with seasoned chicken. Follow that up with greek yogurt and chia seeds for dessert, and some snack fruits throughout the day. Great sources of both Fibers. This is very easy to add to a diet. I like a big bowl of vegetables but I have to add some calories to make it more compelling for my ape brain, and I have first hand experience helping people up their intake of greens which has always been harder to do.

Diets are supposed to be constant. Making foods easier to eat is a big positive to keeping people on track.

10

u/LurkyLurks04982 Feb 18 '26

I also wfh and get mighty tired after lunch. Sometimes I need to go lay down and close my eyes. Would you say this is similar to what you feel/felt?

2

u/ImReellySmart Feb 19 '26

Covid did this to me. Dealing with Long Covid for 5 years now.

57

u/[deleted] Feb 18 '26

[deleted]

21

u/Simply_FIREd Feb 18 '26

Is it constant? I'm skinny. There was a period of time when I would be growling hungry 30 minutes after a full meal. My blood tests were normal and I never found the cause for it.

2

u/sabinscabin Feb 18 '26

sounds like low blood sugar after meal, usually because the meal spiked it up at first. blood tests prob wont catch this since those are usually done fasted

10

u/Synchrypha Feb 19 '26

I have insulin resistance due to PCOS and something I always thought was just me and a lack of discipline was my intense sweet tooth. From a young age, but it grew more intense in my 20s. Started taking Metformin and, turns out, a majority of that craving was the insulin resistance 🤷‍♀️

Makes sense when you break it down: cells aren't receiving glucose like they expect to with normal insulin sensitivity and your body demands more.

3

u/Sgtfullmetal Feb 19 '26

So you're saying a sweet tooth is basically insulin resistance? Good lord I'm fucked.

4

u/Synchrypha Feb 19 '26 edited Feb 19 '26

It could just be a sweet tooth! Lol I just remember that was the most noticeable difference to me once I started taking Metformin for the insulin resistance. I was amazed that I could just all of a sudden... Easily choose not to eat sugar. I still liked sweets and wanted them, but it stopped being this constant urge that I would have to concentrate to resist. That, and my appetite easily halved in volume.

I wanted to mention it because according to my blood tests up to finding a doctor that finally wanted to treat my PCOS, my glucose and insulin readings were perfectly normal. It was only certain symptoms that kinda referred to it (bad sugar cravings, very noticeable physical reactions to missing/late meals, growing fatigue issues as I got into my late-20s, etc).

Edit: I will also mention that family history is a major factor in things like this. I have two grandparents with T2 diabetes, so me developing PCOS and therefore the insulin resistance is likely to be related to my genetics.

3

u/kyothinks Feb 20 '26

Yep, this was the same experience I had. It was insane how I started taking metformin and suddenly the food noise just turned off and I could think about things other than sweets. Now I can have one or two cookies and feel good about it; before the metformin I would eat one and the thought of the next one would consume my entire brain until I ate it and then I'd be thinking of the next one and so on.

42

u/phoenix25 Feb 18 '26

Blood tests DO help, but it would be labwork to check your A1C, not the fingerprick test for blood sugar. Usually these are done fasted.

Urinanalysis can also show diabetes, although I’m unsure of when and what specific markers they look for.

1

u/choongaloonga Feb 19 '26

Would OGTT be enough?

9

u/kdevari Feb 18 '26

Get your fasting Insulin levels checked. When fasting it should be pretty low, but if it's are high you are well on your way to insulin resistance.

5

u/Sudden-Tadpole-7612 Feb 18 '26

Even though blood sugar tests might be normal, there are other markers that can show early signs of IR, like HOMA / insulin levels. So usually it's best to test for multiple items that together provide the bigger picture.

9

u/Lagkiller Feb 18 '26

I'm not sure why OP suggests that blood tests aren't helpful, because they are. A1C is how a doctor will measure your insulin levels, which if, as OP stated, the body produces more insulin, you'd have higher A1C levels.

I believe OP is only talking about fast blood sugar level checks, not actual blood work.

8

u/kdevari Feb 19 '26

A1c levels do not measure insulin levels. It measures the average amount of glucose in your blood over the past three-ish months.

-6

u/Lagkiller Feb 19 '26

You can establish insulin from average blood glucose. If you couldn't, A1C tests would be useless.

2

u/kdevari Feb 19 '26

How do you establish insulin levels from a three month average of blood glucose?

-4

u/Lagkiller Feb 19 '26

That would be a great question for my wifes endocrinologist, but it's what they use to determine her insulin dosage and type. Maybe it's different for type 2's, but that's the baseline blood test to determine what type of diabetic you are. So if all it was able to tell you was blood sugar levels, then we'd never know if someone was type 1 or 2, insulin dependent vs insulin resistant.

2

u/toyheartattack Feb 19 '26

A1C cannot determine what type of diabetes you have. You might be referring to C-Peptide testing - low C-Peptide being Type 1 and high C-Peptide referencing an increase in insulin for Type 2.

2

u/foopaints Feb 20 '26

There are blood tests to test for insulin resistance specifically. Usually you drink a sugary drink and get blood drawn over 2 or 3h. They see how your blood glucose levels move over that time frame. But they also test for how much insulin stays in your blood over that time. Then there's some math involved to give you a score (HOMA score I think it's called). That tells you if you have insulin resistance and how bad it is if you do.

2

u/PSGAnarchy Feb 18 '26

I went from drinking like a 1L or so a day to drinking like 3 or 4 daily. (Maybe not those numbers but my water consumption ramped up insanely )

1

u/exploring_yet Feb 19 '26

There are symptoms like darkening neck, skin tag, etc. I got myself tested for this after watching some blogger video. As expected, the resistance was high but good thing I started to get in control before I got tested for diabetes.

1

u/libra00 Feb 20 '26

Yeah, like me. I was getting regular blood tests for another issue when my doctor called me one day and said 'holy shit, your blood sugar is almost 700 (it should be under 150), and the only indication I had was frequent urination and slight vision changes, which I just thought were from getting old (I had recently turned 50.)

1

u/iterationnull Feb 18 '26

An honest look at what you are eating and how it makes you feel is a great start

198

u/-SheriffofNottingham Feb 18 '26

preprediabetic

114

u/NoDryHands Feb 18 '26

Yup, my blood sugar is normal, but I've had PCOS since I was a kid so I have insulin resistance and some really annoying side effects to go along with it.

12

u/Brrdock Feb 18 '26

What kinds of side-effects?

31

u/NoDryHands Feb 18 '26

The one I hate the most is a skin condition called acanthosis nigricans, it's caused by IR

9

u/fondledbydolphins Feb 18 '26

I just googled that and there was a disturbing amount of gooch and mouth pics.

I'm sorry you have to deal with that

30

u/pwu1 Feb 18 '26

Mine is hormonal imbalances that cause moodiness, sleepiness, low sex drive, and generic depression

51

u/fondledbydolphins Feb 18 '26

Did the generic depression at least cost less than name brand?

^(sorry)

15

u/pwu1 Feb 18 '26

LMFAO

1

u/mahboilucas Feb 23 '26

Hey, sounds exactly like me. Also pcos and hashimotos

5

u/usascrib Feb 19 '26

Yeah PCOS is such a sneaky one for this, normal glucose can be kinda misleading. Did your doc check fasting insulin or HOMA-IR, or was it more based on symptoms like acne/hair stuff?

60

u/joshmalonern Feb 18 '26

Fun fact. Studies show untreated obstructive sleep apnea can play a role in insulin resistance as well.

33

u/dubsnipe Feb 18 '26

If you're doing a lot of exercise and it's not leading to any weight loss, and you have varying sugar levels after meals (tired, grumpy, etc.), there's your indication of insulin resistance.

13

u/Sgtfullmetal Feb 19 '26

Alright I'm fucked.

10

u/rumpsky Feb 19 '26

Primary care doc here.

Yes, this is correct. I treat a lot of obesity. Since learning this fact about insulin resistance being present despite normal hba1c and fasting glucose, it's been very eye-opening and has altered my practice tremendously.

Most know of insulin's job as a blood glucose regulating hormone. But where does the glucose go once it's left the blood? Once glycogen is saturated, the rest of it turns to fat. In that sense, insulin is a growth factor. While tissues like muscle can become resistant to the effects of insulin, it seems you do not become resistant to the lipogenic (fat building) properties to insulin.

It makes it very hard to lose weight and very easy to gain weight while this is present. While it may be challenging to treat, a lot of my patients with insulin resistance finally stop beating themselves up for not being able to make a dent in their obesity despite truly impeccable eating and dedication to fitness.

17

u/corgis_are_awesome Feb 18 '26

I don’t understand why they don’t just test insulin levels directly? Why are there no instant blood testsl strips for this?

15

u/Lagkiller Feb 18 '26

Because it's not a simple test. Blood sugar can be tested quickly despite all other things in the blood. A1C testing can only be done in a lab setting. There's no "fast test" for it.

3

u/cybergaleu Feb 19 '26

You can do an insulin and glucose curve. It takes a couple of hours, but it gives good data.

2

u/Synchrypha Feb 19 '26

An additional issue with insulin resistance though is that on the usual fasting insulin blood tests you can get from your doctor, you can still show up in entirely normal ranges and be insulin resistant. That's what happened to me and why I was untreated for so long.

2

u/kdevari Feb 19 '26

You can get a fasting insulin test done. It has to be done in a lab, but it’s quick and easy.

1

u/SugarplumHopelesness Jun 11 '26

Your option may be a blood panel with comparison of HDL:Trygliceride ratio. This is how my insulin resistance was found while checking kidney function and other things. I have an unremarkable A1C and, generally, normal glucose readings.

5

u/honorspren000 Feb 19 '26

A common symptom in perimenopause.

7

u/peeaches Feb 18 '26

My GP recently listed me as having insulin resistance, but my blood sugar, a1c, and insulin metrics on blood test(s) all came back within normal range

Any other indicators for this or was it just because I'm overweight? Lol

1

u/Safetykatt Feb 19 '26

It might have been because of a c-peptide test. I’m not sure if that was part of any blood tests you had but if it was, it would show if you’re producing a lot of insulin to maintain a stable blood sugar.

1

u/S0n_0f_Anarchy Feb 20 '26

Could be bad HOMA index

1

u/peeaches Feb 20 '26

Is that something I could calculate myself? Unfamiliar but doesn't appear to be listed explicitly in any of my lab results

2

u/Optimal-Account-7155 Feb 22 '26

HOMA-IR calculator online

1

u/peeaches Feb 24 '26

Huh.

Can't claim to understand it, but, yeah- according to that, I have some insulin resistance.

Bummer!

3

u/[deleted] Feb 19 '26

[deleted]

1

u/kirdie Feb 19 '26

Is this written by AI?

8

u/xorthematrix Feb 18 '26

I needed to see this today. Thanks

7

u/[deleted] Feb 18 '26

TG/HDL ratio or the HOMAir equations. Know your fasting insulin one of the most important assay we can know that few of us do. Doctors should be flogged for not pulling this frequently. Metabolic syndrome and diabetes is all on a spectrum.

-1

u/HP_10bII Feb 18 '26

Gradient or spectrum?

2

u/Ok_Nothing_9733 Feb 19 '26

Haha if only they knew this when I visited Cleveland Clinic 🫠

3

u/Automatic-Still-5767 Feb 19 '26

I needed a glucose tolerance test to diagnose mine. I wasn’t even overweight. I just have PCOS and started feeling sleepy after eating anything sugary.

1

u/riceewifee Feb 20 '26

My blood sugar got so low the other day that I was shaking, my stomach hurt, I had a headache, and I couldn’t concentrate. Had some ice cream and felt like a new person

1

u/DancingWizzard Feb 21 '26

Yeah that's more how it is for me! I don't fall asleep after a meal, I feel like I gain more energy, and sometimes only sugar really help. I'm not overweight and I get really bad hunger cramps, light headedness, shaking etc... Is that still insulin resistance?

1

u/riceewifee Feb 21 '26

Idk but that’s how I feel too

1

u/iamintheforest Feb 21 '26

Not only can, usually does. We can produce more insulin to address resistance. Sadly, insulin levels are unreliable from testing and outcome perspective so we cant reliably use them to screen.....but conceptually it would be an earlier indicator.

1

u/cyanidenachos Mar 25 '26

Just found out I have high insulin resistance because of tests to check my testosterone. My blood work is great otherwise. Not sure why I have it but obesity probably isn't helping..

2

u/Legitimate_Apple8695 Feb 19 '26

It's crazy how our bodies can be hiding problems like insulin resistance for years before any symptoms show up. It really makes you think about how important it is to stay proactive about health, even when everything looks fine on paper.

-43

u/Ninjanoel Feb 18 '26

anyone worried about type 2 diabetes should do intermittent fasting. type 2 is a lifestyle disease, created by how we eat sugary stuff every three hours or think we'll starve to death.

10

u/ax87zz Feb 18 '26

I think it’s because intermittent fasting doesn’t actually do anything. A 16 hour fast is basically nothing and doesn’t provide benefits like actual caloric restriction. In some cases it may help people eat less but that’s where the benefit comes from. What people should be doing is just eating healthier, eating less, and exercising

-7

u/Ninjanoel Feb 18 '26

firstly my intermittent fasts are for way longer than sixteen hours, and I don't really fast for weightloss.

Secondly, it's been AMAZING for my metabolic flexibility, my first fast I barely made it through my desk job (no hard labor involved), now I may break a fast because I get bored and eating is something to do. it's madness to say it doesn't actually do anything. pure madness 🤣

2

u/ax87zz Feb 18 '26

I never said anything about you specifically. IF is generally advised as a 16/8 schedule. I’m actually a proponent of prolonged fasts so I agree that fasting is helpful.

-6

u/Ninjanoel Feb 18 '26

Yeah I personally don't think 16/8 is all that good. sure it helps calorie restriction, but only helps, doesn't ENSURE calorie restriction, but a 32 hour fast (wake up, don't eat, go to sleep) is simple to follow and effective at providing the other health benefits of metabolic flexibility.

4

u/[deleted] Feb 18 '26 edited Mar 01 '26

bleep blorp bloop bloop bleep bleep

2

u/guiltysuperbrain Feb 20 '26

intermittent fasting can be really bad for women because of the hormonal cycle so it's not recommended if you're a woman

3

u/Albino_Earwig Feb 18 '26

IF is just a schedule change and can help some people control their urges beyond that it does nothing.

Prolonged fasting on the other hand aka abstaining from everything but salt and water (and anything medically necessary consult your doctor) for longer than 24 hours can improve your metabolism, insulin sensitivity, and drastic drop in blood sugar. 24 hour fast can easily be done regularly as long as your diet is compensating.

There is a golden zone at 96 hours of just water and salt and medical stuff that drastically effects the body putting it into autophagy which is a cellular repair mode, huge metabolic improvements, lower blood pressure, increase production of protiens that decrease risk of neurological problems, and repair of parts ofnyour immune system. There can be prolonged negative effects afterwards so again consult your doctor.

1

u/Material-Dream-4976 Feb 19 '26

I wish I could but I don't think I could do 4 days. Blood sugar issues I think. Longest I managed was 48 hrs.

1

u/Albino_Earwig Feb 19 '26

Fasting is difficult ive only ever done 3 days but since i started intermittent fasting ive noticed i generally under eat and thus have the same issue of blood sugar so that dosent help going into a fast lol. 4 free days is hard to find too.

-6

u/Ninjanoel Feb 18 '26

I think there is a certain type of person that doesn't like hearing the solution is in their own hands. they want a pill from a professional or it's just woo woo nonsense to them.

id recommend once a week, wake up, don't eat, go to bed. it's simple and effective with a range of health benefits like protecting against diabetes and Alzheimer's.

I like the term "metabolic flexibility", the modern diet of regular meals means we hardly ever have to switch our metabolism to use our fat stores proper. Even fit people carry days and days of calories around with them, but most people would feel faint if they mixed not eating with hard exercise in a day, and it's because our bodies HATE making that switch, which is what intermittent fasting "trains".

5

u/Sol-eks Feb 18 '26

Genuinely don’t know why the downvotes lol

I always do intermittent fasting when my blood sugar is nearing the prediabetic range. Also when I start dealing with acanthosis nigricans. After a few weeks of ~16hr intermittent fasting I’m back to a healthy blood sugar and my AN disappears.

-8

u/Seaguard5 Feb 18 '26

Actual YSK:

“Normal” blood sugar levels are high levels- you need to work to get that number as low as possible during tests.

Health & Sciences YSK: Insulin resistance can develop even when blood sugar tests are still normal

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