Insulin resistance happens when muscle, fat, and liver cells don't respond as strongly to insulin's signal, so glucose has a harder time getting out of the bloodstream and into cells. The pancreas compensates by producing more insulin to keep blood glucose in range - a state that can persist for years before blood sugar itself becomes noticeably abnormal.
What contributes to it
- Excess body fat, particularly around the abdomen
- Physical inactivity
- Genetics and family history
- Chronic stress and poor sleep
- Certain medications and hormonal conditions (e.g., PCOS)
Why it matters
Sustained insulin resistance is a central driver of type 2 diabetes and is linked to conditions like fatty liver disease and cardiovascular risk. It's also why some people with type 2 diabetes need fairly high insulin doses when insulin therapy is eventually added - the medication is working against cells that are resisting its signal.
Improving insulin sensitivity
Regular physical activity (especially strength training and cardio), gradual weight loss where relevant, adequate sleep, and reducing highly processed carbohydrate intake are commonly associated with improved insulin sensitivity. Any changes to medication should go through your care team.