Insulin resistance means cells respond less effectively to insulin, the hormone that helps glucose enter cells. The pancreas may compensate by making more insulin. If that response no longer keeps glucose in the usual range, prediabetes or diabetes can develop.[1]
Insulin resistance and prediabetes are related, but they are not interchangeable labels.
Glucose tests answer defined questions
NIDDK notes that direct testing for insulin resistance is mainly used in research. Clinicians commonly evaluate prediabetes with established glucose tests instead:[1]
- A1c estimates average blood glucose over about three months.
- Fasting plasma glucose measures blood glucose at one point after fasting.
- An oral glucose tolerance test measures the response after a glucose drink.
The tests provide different views. The choice and interpretation depend on the clinical question and circumstances.
Weight does not establish the diagnosis
Excess weight and other factors can raise the risk of insulin resistance, but difficulty losing weight does not prove it is present. Some people with insulin resistance or prediabetes have no obvious symptoms.[1]
A fasting insulin result is also not a universal explanation for stalled weight loss.
A result needs a next step
A1c can be affected by certain conditions involving red blood cells or hemoglobin. If results do not fit the rest of the picture, another test may be needed.[2]
A useful review explains what was measured, whether a finding needs confirmation, and what follow-up is appropriate.
