What does insulin resistance mean?
Insulin is a hormone produced by the body in the pancreas. It ensures that sugar (glucose) is taken up from the blood into the body's cells, where it serves as a source of energy. In insulin resistance, muscle, liver and fat cells respond less effectively to the hormone. As a result, the body has to release increasing amounts of insulin to keep blood sugar levels within the normal range.
This silent adaptation can go unnoticed for years. If it persists, it is considered a key risk factor for the development of type 2 diabetes, metabolic syndrome, cardiovascular disease and fatty liver. Early recognition is therefore worthwhile in order to influence the further course favourably.
Symptoms of insulin resistance: what to look out for
The complaints are often non-specific, which is why they are frequently only linked to the metabolism at a late stage. Possible indications include:
- Tiredness after carbohydrate-rich meals: A pronounced midday slump or drop in concentration after eating may suggest fluctuations in blood sugar and insulin levels.
- Food cravings: Particularly for sweet or starchy foods.
- Increasing waist circumference: An increase in visceral fat tissue (abdominal fat) is considered a typical accompanying phenomenon.
- Difficulty losing weight despite mindful nutrition and exercise.
- Skin changes: Dark, velvety discolouration in skin folds (acanthosis nigricans), often on the neck, armpits or groin area. Small skin tags (fibromas) may also appear more frequently.
- Elevated blood pressure or borderline readings.
- Menstrual cycle irregularities or difficulty conceiving: Insulin resistance often plays a role in polycystic ovary syndrome (PCOS).
- Restlessness, irritability or trembling between meals as signs of reactive hypoglycaemia.
Important: These signs are non-specific and can have many other causes. They do not replace a medical assessment but may serve as a reason to discuss the topic with your doctor.
Risk factors: who is particularly affected?
The development of insulin resistance is multifactorial. Contributing factors include:
- Being overweight, particularly with abdominal fat accumulation
- Lack of physical activity
- A low-fibre, highly processed diet with a high proportion of sugar and refined carbohydrates
- Chronic sleep deprivation and sleep disorders
- Ongoing stress
- Genetic predisposition and a family history of type 2 diabetes
- Certain medications (e.g. long-term corticosteroids)
- Hormonal conditions such as PCOS
Diagnosing insulin resistance: which examinations are useful
The diagnosis is based on a combination of a detailed medical history, physical examination and laboratory values. A metabolic assessment with your general practitioner or an internist may include the following components:
Medical history and physical examination
- Recording of symptoms, eating and exercise habits, sleep and family history
- Measurement of body weight, height, body mass index and waist circumference
- Blood pressure measurement
- Inspection of the skin for signs such as acanthosis nigricans
Laboratory values
- Fasting blood glucose: A standard parameter, which, however, does not reliably detect early insulin resistance.
- HbA1c: Reflects average blood sugar over the past two to three months.
- Fasting insulin: Elevated values may indicate insulin resistance.
- HOMA index: Calculated from fasting blood glucose and fasting insulin. An elevated value suggests reduced insulin action.
- Oral glucose tolerance test (OGTT): After drinking a defined sugar solution, blood sugar (and optionally insulin) is measured repeatedly. This also allows early disturbances in glucose metabolism to be detected.
- Blood lipids: Elevated triglycerides and low HDL cholesterol often occur in the context of impaired insulin action.
- Liver values and, if appropriate, uric acid.
Further diagnostic workup
Depending on the findings, additional examinations such as an ultrasound of the liver (to look for fatty liver), hormonal assessments or cardiological check-ups may be useful. The selection is made on an individual basis.
Lifestyle factors: what can relieve the metabolism
The scientific evidence shows that changes in everyday life can contribute significantly to improving insulin action. The following areas are considered well established:
Nutrition
- Preference for minimally processed foods: vegetables, pulses, wholegrain products, fruit in moderate amounts, high-quality vegetable oils, nuts and fish.
- Reduction of sugary drinks, sweets and highly processed products.
- Sufficient dietary fibre, which can moderate the blood sugar response after eating.
- Moderate portion sizes and a regular meal structure.
Exercise
- Regular endurance activity such as brisk walking, cycling or swimming.
- Complementary strength training: muscle tissue is a central site of glucose uptake.
- Even everyday movement – such as short walks after meals – can support blood sugar utilisation.
Weight
- A moderate weight reduction in cases of overweight – even in the range of around five to ten per cent of the initial body weight – can have a favourable effect on the metabolism.
Sleep and stress
- Seven to eight hours of restful sleep are associated with improved insulin action.
- Stress management, for example through breathing exercises, mindfulness or regular breaks, can additionally relieve the metabolism.
Avoiding tobacco, moderate alcohol consumption
- Giving up smoking and a mindful, moderate consumption of alcoholic beverages are considered important components of a metabolism-friendly lifestyle.
When a medical assessment is advisable
A consultation at the surgery is particularly recommended if:
- several of the symptoms mentioned persist over a longer period,
- risk factors such as a family history, overweight or PCOS are present,
- blood pressure, blood lipid values or blood sugar have already been borderline on occasion,
- there is a desire to have children and menstrual irregularities occur.
An early metabolic assessment makes it possible to identify individual risks and, together with the treating doctor, to develop an appropriate plan. Medication-based therapies may be used additionally in certain cases, but do not replace fundamental lifestyle changes.
Conclusion
Insulin resistance develops gradually, but can be favourably influenced through attentive self-observation, targeted laboratory tests and sustainable adjustments in everyday life. Taking symptoms such as persistent tiredness, food cravings, weight gain in the abdominal area or skin changes seriously creates the basis for early diagnosis and thus for better long-term prospects.
This article does not replace medical advice.