10 subtle signs of insulin resistance

Insulin resistance affects millions of people¹ and often develops long before type 2 diabetes is diagnosed. The challenge is that many people don't realise it's happening because symptoms can be subtle or easily explained away.

While insulin resistance can't be diagnosed based on symptoms alone, there are some common signs that may indicate it's worth having a conversation with your GP.

Understanding these signs can help you take action earlier and potentially reduce your risk of developing type 2 diabetes.

Insulin resistance² occurs when your body’s cells don’t respond to insulin as well as they should.

Insulin is a hormone produced by your pancreas that moves glucose from the blood into your cells to be used as energy. As your cells become resistant to insulin, your body will react by making more insulin. If your cells don’t respond to the higher levels of insulin, glucose can build up in the bloodstream, leading to a condition called hyperglycaemia. This can lead to prediabetes and type 2 diabetes.

Several factors can increase your risk of developing insulin resistance.¹

Factors you can’t do much about include some rare hormonal and genetic disorders, and some medications.

Other risk factors are more closely linked to lifestyle and health. These include carrying excess weight, particularly around the waist, low levels of physical activity, poor sleep and eating patterns that are high in highly processed foods and saturated fats.

You can reduce your risk of developing insulin resistance by maintaining a healthy body weight, staying active and reducing the amount of refined carbohydrates (including sugar) and saturated fat in your diet.

Ask your GP about how you can reduce your risk of developing insulin resistance.

Insulin resistance often develops gradually and may not cause noticeable symptoms. However, some people experience signs that may indicate their bodies are having difficulty responding to insulin properly, resulting in higher blood sugar levels. Some of these signs also overlap with prediabetes or type 2 diabetes.

1. Weight gain around the waist

Carrying excess weight around the abdomen is strongly associated with insulin resistance. Waist circumference can sometimes be a better indicator of risk than weight alone.

2. Difficulty losing weight

Some people with insulin resistance find it harder to lose weight despite making changes to their eating habits and activity levels.

3. Feeling tired after meals

When glucose isn't being used efficiently by the body's cells for energy, some people experience fatigue or sluggishness, particularly after eating.

4. Increased hunger or sugar cravings

You may feel hungry again soon after meals, find it difficult to feel satisfied despite eating enough or crave sweet foods or sugar drinks.

5. Dark patches of skin

A condition called acanthosis nigricans can cause darker, thicker patches of skin, particularly around the neck, armpits or groin. This is one of the more recognisable physical signs associated with insulin resistance.

6. Skin tags

Small skin growths, particularly around the neck, underarms or groin, are more common in people with insulin resistance.

7. High blood pressure

Insulin resistance often co-occurs with other metabolic conditions, including high blood pressure.

8. High cholesterol or triglycerides

Abnormal cholesterol levels can occur alongside insulin resistance, even in the absence of obvious symptoms.

9. Brain fog or difficulty concentrating

Some people report feeling mentally sluggish or having difficulty concentrating. However, many factors can contribute to these symptoms.

10. Energy highs and lows

Fluctuations in energy throughout the day may occur in some people, although this is not specific to insulin resistance and can have many causes.

It's important to remember that these signs don't necessarily mean you have insulin resistance. Many can occur for other reasons. A blood test and assessment by your GP is the best way to understand what's going on.

Insulin resistance often develops years before type 2 diabetes is diagnosed.

Over time, the pancreas may struggle to produce enough insulin to keep blood glucose levels within a healthy range. This can lead to prediabetes and eventually type 2 diabetes.

Insulin resistance is also linked with other health conditions, including high blood pressure, abnormal cholesterol levels, fatty liver disease and an increased risk of cardiovascular disease.

The good news is that insulin resistance can often be improved through lifestyle changes, particularly when it's identified early.

You should consider speaking with your GP if:

• symptoms persist for several weeks
• you notice multiple symptoms occurring together
• you have a family history of type 2 diabetes
• you are overweight or obese
• you have high blood pressure or abnormal cholesterol
• you have previously been told you have high blood sugar levels.

A doctor can arrange appropriate testing to determine whether insulin resistance, prediabetes or another condition may be causing your symptoms.

Insulin resistance is a risk factor for type 2 diabetes, but it’s not the same thing as diabetes. Many people with insulin resistance never develop type 2 diabetes, particularly if they address lifestyle factors early on.

However, untreated insulin resistance can increase the likelihood of progressing to prediabetes and eventually type 2 diabetes. Early detection and intervention provide the best opportunity to improve insulin sensitivity and improve future health outcomes.

If you're concerned about your risk of type 2 diabetes, you can complete a screening tool called AUSDRISK or see your GP for a diabetes health check. AUSDRISK is a questionnaire that considers factors such as age, waist circumference, family history and lifestyle to estimate your five-year risk of developing type 2 diabetes and help guide whether further testing is needed.