Insulin resistance often develops quietly and gradually, which is why many women don’t realize it’s happening—especially in midlife. In simple terms, insulin resistance means your body’s cells don’t respond to insulin as effectively as they should, so your pancreas may make more insulin to keep blood sugar in a “normal” range. NIDDK+1

That “compensation” is exactly why you can feel stuck (low energy, stubborn weight, cravings) even when a basic glucose lab looks fine.

What Is Insulin Resistance?

Insulin is a hormone that helps move glucose (sugar) from your bloodstream into your cells to be used for energy. With insulin resistance, your cells become less responsive to insulin, so your body may need higher levels of insulin to do the same job. Over time, this can raise risk for prediabetes, type 2 diabetes, and cardiometabolic issues—often before A1C becomes abnormal. NIDDK+1

Common Signs You Might Be Insulin Resistant

You might suspect insulin resistance if you’re experiencing:

• Difficulty losing weight despite eating well and exercising
• Weight gain around the abdomen
• Energy crashes or strong cravings between meals
• Feeling “hangry” or shaky if you don’t eat regularly
• Brain fog or difficulty concentrating
• Fatigue, especially in the afternoon
• Elevated fasting glucose or A1C over time
• A family history of type 2 diabetes, PCOS, or gestational diabetes

Not everyone has obvious symptoms—so it’s also common to find early insulin resistance when someone is looking into fatigue, weight changes, or hormone-transition concerns.

“My Blood Sugar Is Normal”… So Why Do I Still Feel Off?

Many women are told their blood sugar is “normal,” yet still feel stuck. That’s because insulin resistance can be present long before glucose or A1C become abnormal.

In early stages, your pancreas may produce extra insulin to keep blood sugar in the normal range. So the blood sugar number looks okay—while insulin is doing overtime behind the scenes. This “normal glucose with higher insulin” pattern is one reason a single lab value can miss early metabolic dysfunction. NIDDK+1

What Labs And Markers Can Suggest Early Insulin Resistance?

In my practice, I look beyond a single lab value and evaluate patterns that can suggest early metabolic dysfunction. Depending on your history and symptoms, that may include:

Fasting Insulin

Fasting insulin can provide context for what your body is doing to keep glucose stable—especially when fasting glucose still looks “normal.”

HOMA-IR

HOMA-IR is a calculated estimate of insulin resistance based on fasting glucose and fasting insulin. It’s a surrogate marker (not a perfect test), but it can be a useful part of the bigger picture. PMC+1

Triglyceride-To-HDL Ratio

This ratio is sometimes used as a clue for insulin resistance and metabolic risk patterns, particularly when combined with other findings and history. PMC+1

Waist Circumference And Body Composition Changes

Midline weight gain and changes in muscle mass can reflect shifting metabolic physiology (especially during midlife).

Cortisol Rhythm And Stress Physiology

Stress signaling can influence appetite, cravings, sleep quality, and metabolic regulation. A full evaluation often considers whether chronic stress patterns may be amplifying symptoms.

Sleep Quality And Lifestyle Factors

Sleep disruption can worsen insulin sensitivity and hunger signals, and it’s commonly overlooked when people focus only on food and exercise.

Who Is At Higher Risk?

Insulin resistance is influenced by many factors, including:

• Genetics and family history
• Hormone transitions (including perimenopause/menopause)
• Chronic stress load
• Poor or fragmented sleep
• Loss of muscle mass over time
• Inflammation and cardiometabolic patterns
• History of gestational diabetes or PCOS

It’s important to say this clearly: insulin resistance is not a personal failure or a willpower issue. It’s a physiological response shaped by hormones, stress, sleep, muscle, inflammation, and genetics.

Can Insulin Resistance Be Reversed?

The good news is that insulin resistance is often **improvable—and sometimes reversible—**with the right support, especially when identified early. NIDDK+1

When we identify it early, we can intervene with an individualized plan that may include:

• Personalized nutrition strategy (focused on your physiology and sustainability)
• Strength-based movement and muscle support
• Stress regulation and nervous system support
• Targeted supplements when appropriate
• Medications or hormone support when appropriate, as part of a comprehensive plan

The goal is not perfection. The goal is to understand what your metabolism is asking for—and build a plan that helps you feel better and improves long-term health.

How Peace And Calm Health Functional Medicine Can Help

At Peace and Calm Health Functional Medicine in Lakewood, CO, we take an integrative approach to metabolic health—especially for women who feel “stuck” even when they’re doing many things right.

If you’re concerned about insulin resistance, we can help you:

• Connect symptoms (crashes, cravings, fatigue, weight changes) to metabolic patterns
• Look beyond glucose alone using markers like fasting insulin, HOMA-IR, lipid patterns, and body composition clues
• Evaluate the role of stress physiology and sleep quality in your metabolic health
• Create a personalized plan that matches your goals, your lifestyle, and your health history

To explore next steps, book a Clarity Call here:
https://www.drjenniferhorton.com/work-with-me

You can learn more about wellness programs here:
https://www.drjenniferhorton.com/wellness-programs

Science Section

• NIDDK: Prediabetes And Insulin Resistance (Overview + How Insulin Resistance Can Precede Higher Glucose)
• NCBI Bookshelf: Assessing Insulin Sensitivity And Resistance In Humans (Definitions + Clinical/Research Assessment Methods)
• Review (PMC): Surrogate Markers Of Insulin Resistance (Includes Fasting Insulin, HOMA-IR, Lipid-Based Markers)
• Study (PubMed): Triglyceride/HDL Ratio As A Predictor For Insulin Resistance In Euglycemic Adults

Medically reviewed by Dr. Jennifer Horton, DO, ABFM, IFMCP

This content is for educational purposes and does not substitute personalized medical advice.