5 Sneaky Signs You Have Insulin Resistance, According to Dietitians

Four out of 10 adults between the ages of 18 and 44 have an often-overlooked health condition that can lead to type 2 diabetes, according to research published in 2022 in The Journal of Clinical Endocrinology & Metabolism: Insulin resistance. 

When you have insulin resistance, your body doesn’t respond effectively to insulin, a hormone that pushes blood glucose into your cells where it can be used for energy, says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Because of this, the body demands more insulin to help the cells absorb glucose. “This leads to higher levels of both insulin and glucose in the bloodstream,” says Emily Cornelius, RD, a registered dietitian and insulin resistance expert. “Over time, this can lead to various health complications like prediabetes and type 2 diabetes,” she explains.

The catch? Insulin resistance often doesn’t have any signs or symptoms. This can make it difficult to identify before it progresses to prediabetes or type 2 diabetes. But the good news is that insulin resistance can be managed and even reversed when addressed early. That’s why paying attention to the signs of this condition—many of which are sneaky—is so important. Here’s what you need to know.

1.      You Notice Skin Changes

Changes to the skin are one of the lesser-known signs of insulin resistance. In some people, insulin resistance can lead to the development of skin tags or acanthosis nigricans (dark patches of skin on the neck or under the armpits), both of which are thought to be related to excess insulin production, according to the NIDDK. If you have questions about your skin, talk to a dermatologist. 

2.      You May Have Gained Weight

Weight gain may be a sign of insulin resistance, particularly if you have excess abdominal fat called visceral fat,  according to the Journal of Clinical Medicine in 2019. Weight gain alone puts you at risk for developing insulin resistance, but insulin resistance itself can also lead to weight gain resulting in a cycle that can progress over time. That said, it doesn’t have to be a large amount of weight gain, either. Data in The Journal of Clinical Endocrinology & Metabolism in 2022 found that half of adults with insulin resistance did not have weights that were considered obese.

3.      You Experience Brain Fog

Being insulin resistant means that glucose isn’t as readily available to provide energy for cells, including those in the brain. Because of this, you may feel what’s commonly referred to as “brain fog.” Research suggests that people who have insulin resistance may have worse cognitive performance compared to those who don’t have the condition, found a study in Diabetes Research and Clinical Practice in 2020. Insulin resistance may impair important brain processes that affect mental clarity.

4.      You’re Always Hungry

Hunger is influenced by a combination of hormones, one being insulin. With insulin resistance, you may experience frequent hunger. Why? Insulin resistance causes high blood sugar, a symptom of which is increased hunger.

5.      You Have Low Energy Levels

Because the cells don’t get the energy they need from glucose, you may also feel fatigued. It’s important to note that many other health conditions can affect energy levels. Be sure to talk to your doctor about persistent fatigue.

How Is Insulin Resistance Diagnosed?

Many of the tests to diagnose insulin resistance are time-consuming and expensive. For this reason, they’re often only used in research studies and not in medical offices, according to the NIDDK. Prediabetes is a condition that is diagnosed, which is done through blood testing like a fasting plasma glucose test or A1C test. The Centers for Disease Control and Prevention points out that having a combination of high blood sugar, high triglycerides, high “bad” LDL cholesterol and low “good” HDL cholesterol can alert you to the fact that you probably have insulin resistance.

Strategies to Improve and Prevent Insulin Resistance

Balance Meals 

The foods you eat have a significant effect on blood glucose and can help to stabilize levels throughout the day. “When working on reversing insulin resistance, it’s critical to look at it from a holistic perspective, but the diet plays a foundational role,” says Cornelius. “Eating a balanced diet that includes protein, fat and fiber helps to lessen spikes during meals,” she says.

Focus on Minimally Processed Foods 

Many processed foods—fast food, packaged desserts, snack mixes, sodas, chicken nuggets, hot dogs and more—are rich in saturated fat or sugar or both, and are calorically dense, making them easy to overeat, something that can lead to weight gain and the development of visceral fat.

“Prioritizing whole-nutrient dense foods such as fresh fruits, vegetables, whole grains and lean proteins along with controlling portion sizes and consistent and spaced meal timings can help improve insulin sensitivity,” says registered dietitian nutritionist Cari Riker. Eating this way can also help with weight management. 

Don’t Fear Carbohydrates

Fiber-rich carbs are the way to go. “Carbohydrates often get a bad reputation when it comes to blood sugar discussions; however, fiber is a type of carb that doesn't get fully digested and absorbed. So its impact on your blood sugar levels is significantly different than that of added sugars,” says registered dietitian Alyssa Pacheco. Choose high-fiber foods often as part of a balanced diet. Foods like whole grains, beans, vegetables and fruits, nuts and seeds can all contribute to the recommended 25 to 38 grams of daily fiber.

Eat Magnesium-Rich Foods

Foods that are a good source of fiber are also often a good source of magnesium, a nutrient that plays a critical role in glucose metabolism. “Magnesium is another nutrient to make sure you're getting enough of, since a deficiency can worsen insulin resistance. Good food sources of magnesium include beans, spinach, almonds, pumpkin seeds, cashews and avocados,” says Pacheco.

Fit in Physical Activity 

It’s time to get on the move. “Another important strategy is moving your body throughout the day, since it lowers blood sugar,” says Cornelius. Physical activity improves insulin sensitivity, according to the American Diabetes Association, helping to manage or reverse insulin resistance. Find an activity you enjoy and do it regularly to combat insulin resistance.

Frequently Asked Questions

How do I know if I’m insulin resistant?

According to the CDC, no single test can determine if you have insulin resistance. Having health conditions like high blood sugar levels, high LDL (“bad”) cholesterol, low HDL (“good”) cholesterol and high triglycerides may indicate insulin resistance. 

What is the main cause of insulin resistance?

A family history of type 2 diabetes, being overweight or having obesity and a sedentary lifestyle can all increase the risk of developing insulin resistance. 

How do you fix insulin resistance?

Strategies like increasing activity, weight loss, a healthy diet, improving sleep quality and reducing stress can all help improve insulin resistance. 

The Bottom Line

Maintaining a healthy blood sugar range is essential for longevity and the prevention of chronic disease. Regular physical activity and eating a balanced diet can help with preventing insulin resistance, but because many other factors are at play in the development of this condition, it’s equally as important to know the signs and symptoms for early detection. If you suspect you have insulin resistance, reach out to your doctor or registered dietitian to help you develop a plan to manage or reverse it over time.