You eat no differently than you used to, you move reasonably, and yet the belly fat slowly creeps in and losing weight no longer works the way it once did. Not a single isolated value on your blood result stands out. That is exactly the treacherous part of insulin resistance: it can stay under the radar for years while your glucose is still perfectly fine.
Honestly: this is one of the reasons I sometimes find fasting insulin just as interesting as glucose. Insulin shows something earlier. It is your body working harder to keep things in balance, and you do not see that as long as you only look at your sugar.
What exactly is insulin resistance?
Insulin resistance means your cells respond less well to insulin, the hormone that helps move sugar from your blood into your cells. To keep your blood sugar normal anyway, your pancreas makes more insulin. For a while this works fine. Your glucose stays within range while your insulin is already raised in the background. Only when the pancreas can no longer keep up does your glucose start to rise. The Diabetes Fonds (Dutch Diabetes Foundation) therefore describes insulin resistance as an early link on the road towards prediabetes and eventually type 2 diabetes.
Which signals can fit insulin resistance?
Insulin resistance gives no clear symptom of its own. There are signals that occur with it more often, though. They prove nothing on their own, but together they can form a pattern worth examining.
- Increasing belly fat: waist size is strongly linked to insulin sensitivity.
- Energy dips after meals: especially after carbohydrate-rich meals, often with hunger soon after.
- Difficulty losing weight: despite genuine attention to food and movement.
- Dark, velvety skin patches: for example on the neck, armpits or groin (acanthosis nigricans).
- A family history of type 2 diabetes: heredity plays a clear role.
If you recognise several of these, it can be useful to look at your sugar metabolism. Read also our pillar on blood sugar and preventing type 2 diabetes for the bigger picture.
Which blood values say something about insulin resistance?
A combination of values gives the most insight. Your fasting glucose and your fasting insulin together say more than each alone. From both, labs sometimes calculate the HOMA-IR, an estimate of insulin sensitivity. The table shows what each value adds.
| Blood value | What it adds | Where to have it checked |
|---|---|---|
| Fasting insulin | Can be raised while glucose is still normal, so often the earliest signal | Fasting insulin |
| Fasting glucose | A snapshot of your blood sugar at that moment | Fasting glucose |
| HbA1c | Your average blood sugar over the past 2 to 3 months | HbA1c |
A complete metabolic panel measures these values together, alongside your lipids and liver and kidney function. If you want to look specifically at your blood sugar, a diabetes blood test fits. Important: measuring fasting insulin is only useful if you are genuinely fasted, usually 8 to 12 hours without food.
What does raised insulin with normal glucose mean?
That is exactly the scenario this whole piece is about. A normal glucose with raised insulin can suggest that your body is working extra hard to keep your blood sugar tidy. It is not a diagnosis, but it can be a starting point to address lifestyle earlier, before your glucose starts to climb. The NHG (Dutch College of General Practitioners) type 2 diabetes guideline relies on glucose and HbA1c for the diagnosis, so insulin and HOMA-IR are mainly context, not a replacement. Always discuss the outcome with your GP.
Can you improve insulin resistance?
In many people, lifestyle can favourably affect insulin sensitivity, and that is the encouraging part. You do not have to wait until your glucose is too high.
- Movement: both strength and endurance help your muscles take up glucose, even independent of weight loss.
- Fibre and protein: these keep your blood sugar steadier than fast sugars.
- Reducing belly fat: even a modest drop can improve your insulin sensitivity.
- Sleep: structurally short sleep is linked to a less favourable sugar metabolism.
The effect varies from person to person, so treat this as direction and not a guarantee. Read on in our explainer on reversing prediabetes and on metabolic syndrome, because insulin resistance is often hidden in both stories.
Frequently asked questions
Can I have insulin resistance with a normal glucose?
Yes. Especially at an early stage your glucose can still be normal while your insulin is already raised. That is why measuring insulin as well can give extra context you would miss with glucose alone.
What is HOMA-IR?
HOMA-IR is a calculation based on fasting glucose and insulin. It gives an estimate of insulin sensitivity. It is a tool, not a diagnosis, so discuss the outcome with your GP.
Do I need to be fasted for this test?
For fasting glucose and insulin yes, usually 8 to 12 hours without food. For HbA1c you do not need to be fasted. Your appointment details tell you what applies to your test.
My advice: look at the pattern, not at one number. If you recognise several signals, discuss with your GP which values are useful in your situation. Every blood test result at Vitalcheck includes a professional assessment by a doctor registered in the Dutch BIG register. A blood value is not a diagnosis: always discuss treatment decisions with your GP.
Sources
- NHG guideline Diabetes mellitus type 2. Dutch College of General Practitioners. 2021.
- Diabetes Fonds (Dutch Diabetes Foundation). Insulin resistance and type 2 diabetes. Accessed 2026.
- World Health Organization. Diabetes: key facts. 2023.
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