What is insulin resistance?
Insulin resistance is a state where cells respond poorly to insulin, so the pancreas secretes more insulin to maintain normal blood glucose. It precedes type-2 diabetes by years and shows up first in fasting insulin, HOMA-IR, triglyceride/HDL ratio, and ApoB before A1C or fasting glucose drift. It is reversible.
Full answer
Insulin resistance is the upstream metabolic state that precedes most cases of type-2 diabetes, metabolic syndrome, and a significant fraction of cardiovascular events. Cells (especially muscle, liver, and adipose) respond less efficiently to insulin, so the pancreas compensates by secreting more insulin to keep blood glucose in range. Glucose looks normal for years while insulin runs high. The earliest signals show up in fasting insulin, HOMA-IR (the fasting insulin × fasting glucose / 405 calculation), triglyceride/HDL ratio, and ApoB — long before A1C or fasting glucose drift out of range. Visceral adiposity, fatty liver, and elevated hs-CRP often appear in the same window. The state is reversible with structured training (resistance + aerobic), nutrition that protects lean mass, sleep regularity, and — where provider-reviewed — pharmacologic and hormonal support.
Educational. Not a substitute for individualized provider review.
- Biomarkers reference — Primary source · oMeds
- Metabolic intelligence — Reference · oMeds Learn
- Weight & metabolism (women's) — Reference · oMeds Learn
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29