Insulin Resistance and Prediabetes in Women... The Early Warning Signs Doctors Miss

Most women are told they will know when diabetes becomes a problem. The idea seems simple. If fasting glucose is normal, everything is fine. If it is high, then it is a problem.

But glucose is only the smoke. Insulin is the fire.

This is why so many women with fatigue, stubborn weight, feeling puffy, brain fog, or cravings are told everything looks fine. Glucose still looks normal, so their doctor reassures them that everything is stable. They are sent home with the same symptoms. Nothing changes.

What most women are never told is that insulin rises long before blood sugar changes. Years before. Sometimes a full decade before glucose shifts.

That early stage is insulin resistance. It sits quietly in the background and drives almost every chronic health issue I see in practice.

This article will help you understand what insulin resistance actually is, why it is so often missed, and why every woman with diabetes or prediabetes needs their insulin tested.

What Insulin Resistance Really Means

Your body uses insulin to move glucose into your cells for fuel. When the cells respond well, you feel steady. Hunger is predictable. Energy is stable. Weight is manageable.

Insulin resistance develops when those same cells stop responding. The pancreas pumps out extra insulin to compensate. Glucose stays normal on blood work because insulin is working overtime behind the scenes.

This is why glucose alone is misleading. You can have normal glucose for years with insulin three to five times higher than it should be. Many women go from normal labs to sudden prediabetes without any warning because the real problem was never measured.

Signs your body is pushing against insulin

• Fatigue that feels heavy

• Difficulty losing weight

• Belly weight gain

• Afternoon crashes

• Cravings for carbs or sweets

• Brain fog

• Skin tags

• Darkened skin on the neck or underarms

• Irregular periods or signs of PCOS

• High triglycerides

• Low HDL

• High blood pressure

• Elevated inflammation markers

Why Most Doctors Miss It

Your medical doctor is trained to diagnose diabetes, not insulin resistance. That distinction matters.

Diabetes is diagnosed based on glucose. The problem is that glucose changes late.

Most routine blood work includes fasting glucose. Occasionally an A1c.

Fasting insulin is almost never ordered. HOMA IR is rarely calculated.

So women with years of symptoms are told their labs are normal. They hear nothing is wrong. They are advised to eat better, exercise more, reduce stress.

If insulin is not tested you cannot diagnose insulin resistance. If you cannot see it, you cannot treat it.

Prediabetes Is Not a Mild Diagnosis

Many women are told prediabetes is just a warning. Something to watch. Nothing urgent. The truth is very different.

Prediabetes means insulin resistance has been present for years. The cells are struggling. The metabolic system is under strain. The pancreas is still producing insulin, but at a higher cost.

Without testing insulin, you cannot know whether your plan is helping or if the problem is progressing.

If You Already Have Diabetes, Insulin Still Matters

Blood sugar becomes the focus once diabetes is diagnosed. But insulin remains a major part of the picture. Even after glucose rises, insulin often stays high. This continues to drive inflammation, weight gain, cholesterol changes, and complications.

Testing insulin helps you understand how hard the pancreas is working. Some people are in burnout. Others still have strong insulin production but severe resistance. These patterns need different approaches.

You cannot customize treatment if you only see glucose.

What Happens When Insulin Resistance Is Not Treated

Insulin resistance does not remain stable. Once insulin rises, the body experiences continuous metabolic strain. Symptoms may come and go, but the damage continues underneath.

Here is what happens when insulin resistance or prediabetes is ignored.

Faster progression to diabetes

Most people do not realize how quickly this can happen.

• Up to 70 percent of people with prediabetes develop diabetes

• The shift from normal glucose to diabetes often happens suddenly

• This can be prevented when insulin is addressed early

Prediabetes is not a soft diagnosis. It is the midpoint of a long metabolic process.

Damage to blood vessels long before diabetes

High insulin affects the lining of your blood vessels. Even with normal glucose, this can cause:

• Stiffer arteries

• Higher blood pressure

• Earlier plaque formation

• Poor oxygen delivery to tissues

This is why many women with insulin resistance also have high blood pressure, high triglycerides, or low HDL before glucose changes.

Higher inflammation everywhere

Insulin resistance increases inflammatory cytokines. Chronic inflammation:

• Slows metabolism

• Affects mood and brain function

• Raises joint pain

• Worsens autoimmune tendencies

• Increases heart disease risk

• Raises risk of certain cancers

Fatty liver development

Fatty liver is now one of the most common liver conditions. The main cause is insulin resistance. It can develop silently for years.

It contributes to:

• Elevated liver enzymes

• Impaired detoxification

• Increased metabolic strain

• Higher risk of cirrhosis later

Hormone disruption and fertility issues

High insulin increases ovarian androgen production. This creates:

• Irregular cycles

• Acne

• Hair thinning

• Facial hair growth

• PCOS patterns

Insulin resistance also lowers progesterone. This leads to PMS, cycle instability, and difficulty conceiving.

If trying to conceive, untreated insulin resistance increases risk of:

• Miscarriage

• Poor egg quality

• Implantation issues

• Gestational diabetes

Thyroid function declines

Insulin resistance interferes with thyroid conversion from T4 to T3. This slows metabolism and contributes to:

• Fatigue

• Brain fog

• Weight gain

• Low mood

• Cold intolerance

Weight gain becomes more difficult to reverse

High insulin blocks fat burning. The body remains in storage mode. This increases:

• Visceral fat

• Inflammation

• Hunger and cravings

• Cortisol levels

Increased risk of cognitive decline

Elevated insulin affects the brain. Over time this can cause:

• Memory changes

• Mood changes

• Difficulty concentrating

• Higher risk of cognitive decline

Higher risk of heart attack and stroke

Insulin resistance is a cardiovascular condition. It increases:

• Plaque formation

• Blood pressure

• Oxidative stress

• Blood clotting risk

Faster progression of diabetes complications

Once diabetes develops, untreated insulin resistance accelerates complications like:

• Nerve damage

• Kidney changes

• Vision problems

• Poor wound healing

• Higher infection risk

How to Test for Insulin Resistance

Testing is simple.

The most useful markers are:

• Fasting glucose & Fasting insulin & HOMA IR

• Other helpful tests:

  • A1C

  • Triglycerides, HDL

  • ALT

  • hsCRP

How to Reverse Insulin Resistance

Nutrition:

• Focus on protein and fiber at meals

• Lower sugar fruits, fewer refined carbs

• Earlier evening eating

Movement

• Walking after meals, strength training, Daily movement

  
  

Sleep

• Short sleep increases insulin resistance. One night of four to five hours can spike insulin the next day.

Stress

• cortisol and insulin rise together. Lowering stress helps lower insulin.

Supplements

• there are a variety of supplements that can help, but first you need to test how severe your insulin resistance is. This will help to determine what supplements will help you.

Why Early Testing Changes Everything

Most women do not wake up with diabetes. It is a long process that starts with insulin resistance. When you test early, you can protect your metabolism, fertility, thyroid, and long term health.

Insulin is one of the most responsive hormones in the body. When insulin improves, everything else becomes easier.

Next steps

If you want to understand your own insulin picture, start with proper testing.

I help women across Ontario get the right labs, interpret them for optimal levels, and follow a step by step plan to reverse insulin resistance and stabilize metabolism.

You can book a discovery call to see if you are a good fit. This is the first step to working together.