Insulin Resistance

The basics of understanding blood glucose, body fat, and metabolic health

What is insulin resistance?

Key summary

Insulin resistance is a state in which muscle, liver, and fat cells do not respond well to insulin even though the pancreas releases it, making blood glucose harder to control. It is closely linked to abdominal obesity and lack of physical activity, and is known as a change that underlies prediabetes and metabolic syndrome. Losing 5–10% of your body weight and exercising regularly are the basics of management.

Insulin is a hormone released from the pancreas that moves glucose from the blood into cells. When insulin resistance develops, the same amount of insulin no longer lowers blood glucose enough, so the pancreas makes more insulin. If this goes on for a long time, blood glucose gradually starts to rise.

For this reason, insulin resistance is described as a change that underlies prediabetes, such as impaired fasting glucose and impaired glucose tolerance, and metabolic syndrome. The more visceral fat you have, the higher your insulin resistance tends to be, so waist circumference is an indirect indicator of insulin resistance.

Signs that may suggest insulin resistance

Abdominal obesity

Waist circumference of 90 cm or more for men, 85 cm or more for women (Korean criteria)

Fasting blood glucose of 5.6 mmol/L or higher

Or HbA1c of 5.7% or higher (prediabetes)

Triglycerides ↑ · HDL ↓

Triglycerides of 1.7 mmol/L or higher; HDL below 1.0 for men, below 1.3 for women

* These signs overlap with the diagnostic criteria for metabolic syndrome. Insulin resistance itself is evaluated with blood tests (such as fasting insulin), and your health care provider makes the judgement.

Management basics

Lose 5–10% of body weight

Korea's KDCA recommends losing 5–10% of body weight and keeping it off if you have prediabetes and a BMI of 23 or higher.

Use your muscles

Muscle is the tissue that uses the most glucose. Combine 150 minutes of aerobic exercise a week with strength training 2–3 times a week.

Cut back on refined carbohydrates and sweet drinks

Reduce foods that raise blood glucose sharply, and eat regular meals.

Frequently asked questions

Is insulin resistance diabetes?

No. Insulin resistance is a metabolic change that appears before diabetes develops, and it underlies prediabetes and metabolic syndrome. Diabetes diagnostic criteria are met at a fasting blood glucose of 7.0 mmol/L or higher or an HbA1c of 6.5% or higher.

How is insulin resistance checked?

It is evaluated with indices that use fasting blood glucose and fasting insulin levels (such as HOMA-IR). Testing and interpretation are done at a medical facility. Metabolic syndrome items such as waist circumference, fasting blood glucose, triglycerides, and HDL are indirect signs.

Can insulin resistance be reversed?

Weight loss and regular physical activity are known to improve insulin sensitivity. For prediabetes, the KDCA recommends losing 5–10% of body weight, at least 150 minutes a week of aerobic exercise, and strength training 2–3 times a week.

KDCA National Health Information Portal, “Diabetes”
KDCA National Health Information Portal, “Metabolic Syndrome”
KDCA National Health Information Portal, “Obesity”