Nutritional Science has exploded in the past couple of years as more and more people are becoming interested in living a healthier, fuller life. If you’re here with us today, it might be that you’ve noticed one or more of these telltale warning signs that all is not right with your body – such as high blood pressure, increased inflammation, sugar cravings and an expanding waist circumference you can’t seem to check. 

All of these might be signs of insulin resistance, a metabolic storm of sorts, that we have delved into here. How is this diagnosed, though, and is there a missing link in the standard physical examination? 

Here’s a quick recap: insulin, our fat storage hormone, calls the shots in our physiology as it is required to even out blood glucose levels. Years of leading an unhealthy life with erratic eating habits can lead to insulin resistance, wherein our cells become less sensitive to insulin. The pancreas then has to pump out more and more insulin to do the same job, and we end up practically marinating in the hormone. This self-reinforcing cycle, over a period of years, causes Insulin Resistance Syndrome – the so-called medical condition of the day.

What are the signs of insulin resistance? 

According to the National Institutes of Health(1), if three out of five of these traits are present, you can be diagnosed with metabolic syndrome(2) also known as Insulin Resistance Syndrome: 

  • Large waist — A waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men
  • High triglyceride level — 150 milligrams per deciliter (mg/dL), or 1.7 millimoles per liter (mmol/L), or higher of this type of fat found in blood
  • Reduced “good” or HDL cholesterol — Less than 40 mg/dL (1.04 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women of high-density lipoprotein (HDL) cholesterol
  • Increased blood pressure — 130/85 millimeters of mercury (mm Hg) or higher
  • Elevated fasting blood sugar — 100 mg/dL (5.6 mmol/L) or higher 
  • PCOS (polycystic ovarian syndrome)
  • Hypertension and insulin resistance often co-exist, and as per clinical trials(3), 50% of hypertensive patients have hyperinsulinemia.

Most people understand blood glucose levels and are generally quite concerned in knowing if those levels are within limits. What we’re kind of missing is the elephant in the room here. Metabolic Syndrome is also known as Insulin Resistance Syndrome(4) – but why on earth aren’t insulin levels being measured at all in the official diagnostic criteria? 

If you have any of the above insulin resistance symptoms, go ahead and get your insulin levels checked. 

What is the test to check for insulin levels and how can we interpret the results?

While tests for fasting Blood Glucose, HbA1c(5), and the OGTT (oral glucose tolerance test) are all measures solely of blood glucose, the HOMA-IR or the homeostatic model assessment of insulin resistance considers, in its calculation, the relationship between blood glucose and insulin levels. Finally a test that has nailed the crux of the issue!

Homeostasis is nothing but the physical equilibrium that your body strikes with respect to various functions, and the processes through which this equilibrium is maintained. It keeps our internal environment in check, and it does this with several functions such as blood pressure, core body temperature and blood pH (acidity levels), to name a few. If you’d like to dig a little deeper, read up on glucose homeostasis here(6). 

So what HOMA-IR measures is how hard your body has to work in order to maintain that physiological equilibrium. The key question it aims to answer is – how much insulin needs to be produced in order to maintain blood glucose at a certain level?

Here are guidelines on acceptable levels from Richard Maurer, ND, creator of The Blood Code(7):

Optimal insulin sensitivity:  < 1
Early insulin resistance:  > 1.9
Significant insulin resistance:  > 2.9 Early insulin resistance:  > 1.9Significant insulin resistance:  > 2.9

The bottom line is – the higher your HOMA-IR, the more insulin resistant you are. All is not lost even if you fall into the last bracket, though. There are changes you can make to raise your insulin sensitivity and work towards a healthier life.

What are the lifestyle and dietary changes that can increase insulin sensitivity?

Once the spiked insulin levels have been detected and you’ve been diagnosed as someone who is at risk for diabetes in the future (or diagnosed as having insulin resistance) – don’t panic! – it’s time to strategise and plan a lifestyle intervention. 

Simply put-

Let’s focus on reducing the long, continuous exposure to insulin and do everything in our power to increase insulin sensitivity. Low-carb high-fat diets, ketogenic diets, and intermittent fasting / time-restricted eating (not caloric restriction), are emerging to be effective insulin-reducing strategies, as they cause stored food energy or fat to be broken down to power the body. This prevents the metabolic slowdown that constantly soaring insulin levels cause, and results in a decrease in appetite and, eventually, weight loss.

Other lifestyle changes such as reducing stress levels through practising yoga and meditation, better quality and quantity of sleep and regular physical exercise will also take you far. 

As far as our diet goes, should we do away with carbohydrates altogether? Hold your horses! Here’s a look at why the Carbohydrate-Insulin Hypothesis is incomplete.