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How To Test For Insulin Resistance
In a normal test for diabetes a doctor will advise a patient to get a HgA1c. In many cases, diabetes may not be detected if it is at or under the normal limit. Insulin resistance is a metabolic condition that requires a higher amount of insulin to push sugar and fat into cells. There is no single test to determine insulin resistance. So, how to test for insulin resistance?
Before we delve into the tests, you may want to check with your insurance to ensure they are covered. Otherwise, no surprises, you need to pay for them and fortunately they are not that expensive. Hence, these tests are necessary to determine insulin resistance and diabetes.
What Tests Do You Need?
Understand the background of the tests will help you provide information to your doctor for the tests you need. As a result, a combination of the tests will help determine insulin resistance.
Fasting Glucose
A sample of blood is taken after a 10 to 12 hour fast and a good marker for detecting diabetes. Reading levels above 95 mg/dL (5.3 mmol/L) indicate insulin resistance. Although fasting glucose may be normal many people can still have significant insulin resistance and pre-diabetes.
Fasting Insulin
Fasting insulin is an inexpensive test but unfortunately, not often ordered by doctors. Anyone with insulin resistance will often have a higher than normal fasting insulin level. Thus, fasting insulin is a good screening test for detecting insulin resistance.
- Normal fasting insulin is between 3 to 8 uIU/mL (18 to 48 pmol/L).
C-Peptide
C-Peptide is a blood test, to determine how much insulin your body is producing. Is a molecule, released in conjunction with insulin and matches it molecule for molecule. Even though it does not influence blood sugar it is useful for determining whether you have type 1 or type 2 diabetes.
C-Peptide is a useful marker of insulin production because it tends to remain in the blood longer than insulin.
- Normal range for is: 0.51 to 2.72 ng/mL (0.17-0.90 nmol/L).
- Low range and high blood glucose levels could be an indicator of type 1 diabetes.
- Low levels of both C-Peptide and blood glucose could indicate liver disease, a severe infection or Addison’s disease.
- High range could indicate insulin resistance, either type 2 diabetes or Cushing’s syndrome.
- High levels of C-Peptide but low blood glucose levels may be a result of insulinoma (cancer of the pancreas) or glucose lowering medication affected the result(1).
Triglycerides TG
Triglycerides are a fat (lipid) found in your blood. During or after eating, your body converts excess calories into triglycerides. The triglycerides are then stored in your fat (adipose) cells.
A cause of high triglycerides is excessive consumption of carbohydrates, specifically refined carbohydrates and sugars. When the liver has sufficient glycogen stored, excess glucose is shunted into the production of fatty acids. Fat cells use these to synthesize triglycerides.
Insulin prevents the breakdown of triglycerides from fat cells, triglycerides will remain high due to insulin resistance.
- Normal — Less than 150 milligrams per deciliter (mg/dL), or less than 1.7 millimoles per liter (mmol/L)
- Borderline high — 150 to 199 mg/dL (1.8 to 2.2 mmol/L)
- High — 200 to 499 mg/dL (2.3 to 5.6 mmol/L)
- Very high — 500 mg/dL or above (5.7 mmol/L or above)(2).
High Density Lipoproteins-Cholesterol HDL-C
HDL cholesterol is an essential fat, the “good cholesterol” and provides stability in every cell of your body. The good cholesterol removes harmful LDL bad cholesterol. HDL-C reduces, reuses, and recycles LDL cholesterol by transporting it to the liver to be reprocessed.
LDL-C receives all of the press and if the readings are normal, no need to worry(3,4). High HDL levels reduce the risk for heart disease — but low levels increase the risk.
Each bit of HDL-C is a microscopic droplet consisting of a bit of lipoprotein around a cholesterol center. The HDL-C particle is dense compared to other types of cholesterol particles, so it’s called high-density.
To travel through the bloodstream, cholesterol has to be transported by helper molecules called lipoproteins. Each lipoprotein has its own preferences for cholesterol, and each acts differently with the cholesterol it carries.
Here are the numbers for the cholesterol test or lipid panel:
- HDL-C greater than 60 mg/dL (1.5 mmol/L) are high. Good.
- HDL-C less than 40 mg/dL (1.0 mmol/L) are low. Not good(5).
HemoglobinA1C HBA1C
This blood test averages blood sugar for the past 2-3 months, providing information on glucose control. It measures the percentage of blood sugar attached to hemoglobin (the protein which carries oxygen in your blood cells). The higher your blood sugar levels, averaged, the more hemoglobin with sugar attached.
The American Diabetes Association recommends 2 checks per year minimum and 7.0% (53 mmol/mol) but work with your doctor. To point out, that at 5.6% you will probably be insulin resistant. The numbers may seem low, but the ADA keeps changing the numbers and you could be insulin resistant for years.
- Lower is better, an HBA1C between 5.6% and 6.4% (38 and 46 mmol/mol) indicates pre-diabetes.
- Greater than 6.4% (>46 mmol/mol) is diabetes.
Homeostatic Model Assessment- Insulin Resistance HOMA-IR
HOMA was developed in 1985 by Matthews et al. It is a technique to measure insulin resistance and beta-cell function from basal (fasting) glucose and basal insulin. HOMA uses the glucose and insulin variability relationship to predict fasting steady state glucose and insulin concentrations.
HOMA is a model of the relationship of glucose and insulin dynamics that predicts fasting steady-state glucose and insulin concentrations to determine insulin resistance and B-cell function. Insulin is secreted from the pancreatic β-cell in response to glucose levels, while, being regulated by insulin-mediated glucose output from the liver. Therefore, a defective B-cell function will not respond properly to glucose stimulated insulin secretion.
Correspondingly, insulin resistance affects insulin’s lack of glucose uptake. The HOMA uses a set of simple, mathematical equations to describe glucose-insulin relationship. A disadvantage of the HOMA as with all mathematical models, are the limitations and cannot provide a “full” metabolic description.
The model only uses basal values, otherwise it will not yield any usable estimates of function. HOMA is still a homeostatic model, which means it calculates a steady-state solution. The HOMA model is a robust, simple, clinical tool to determine insulin resistance and the latest version is HOMA2.
The HOMA2, free for personal use downloadable calculator
How to Calculate HOMA-IR:
Insulin uIU/mL (mU/L) (multiplied by) X Glucose (mg/dL) (equals) = HOMA-IR
The HOMA-IR calculation requires U.S. standard units.
International S.I. units:
Insulin: pmol/L to uIU/mL, divide by (÷) 6
Glucose: mmol/L to mg/dL, multiply by (x) 18
Healthy Range: 1.0 (0.5–1.4)
Less than 1.0 means you are insulin-sensitive which is optimal.
Above 1.9 indicates early insulin resistance.
Above 2.9 indicates significant insulin resistance(6). Additionally, Dr. Richard Mauer gives a great description of the meaning of HOMA.
TG:HDL-C Ratio
The TG:HDL-C is an excellent, low cost, precision, and easy test to determine insulin resistance. Comparatively, to an insulin test, it is very low cost. People with insulin resistance, TG levels increased while HDL-C levels decreased.
TG:HDL-C ratio is an alternative tool for gauging insulin resistance. The higher the ratio the poorer health status due to a large amount of circulating fats in the blood stream and/or a low amount of healthy cholesterol. A TG:HDL-C ratio of ≥3 indicates significant insulin resistance.
How to Calculate TG:HDL-C:
TG (mg/dL) (divided by) / HDL-C (mg/dL) (equals) = TG:HDL-C
The TG:HDL calculation requires U.S. standard units.
International S.I. units:
HDL: mmol/L to mg/dL: multiply by (x) 39
TG: mmol/L to mg/dL: multiply by (x) 89
Healthy: 1.0
Optimal range: 0.5–1.9
Some insulin resistance: 2.0–3.0
Significant insulin resistance and heart disease risk is found at ratios >3.0(7). See Dr. Richard Mauer’s site.
The Importance Of Insulin Resistance Tests
“Should you be tested, absolutely not, only if you care” – Dr Joseph Kraft(8). Furthermore, for those of you that do care, these tests will save your life. Consequently, hyperinsulinemia left unchecked and progressing on for years is a pathology of the arterial wall.
The wall is an insulin sensitive tissue, chronic exposure to high levels of insulin results in formation of lipid filled lesions similar to early atherosclerosis(9). In addition, long term insulin resistance results in Atherosclerosis found in the vast majority of diabetic cases. Insulin can stimulate the arterial muscle cell proliferation and lipid synthesis in the arterial wall, the phenomena is called endothelial dysfunction.(10).
Surprisingly, many people die from heart attack and stroke and not know they are diabetic. Furthermore, is it any wonder that 80% of type two diabetics suffer and die from cardiovascular issues (11).
Finally, diabetic retinopathy, neuropathy, nephropathy and cardiovascular issues are chronic conditions that damage the body. In fact, the process for each of these chronic conditions takes years even decades to develop. Thus, insulin resistance and high blood sugar will keep on doing damage(12).
So, I hope you understand how to test for insulin resistance. Besides, you will never know until you get the proper and timely tests. Regardless, let me know what you think in the comments.
Thanks for dropping by and reading.
For further reading on diabetes and general health go to my Recommended Books To Read page.
References
1. C-Peptide Test – https://www.diabetes.co.uk/c-peptide-test.html
2. Triglycerides –https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186
5. HDL Cholesterol – https://www.webmd.com/cholesterol-management/guide/hdl-cholesterol-the-good-cholesterol#1
6. the Bloodcode.com HOMA calculator https://www.thebloodcode.com/homa-ir-calculator/
7. the Bloodcode.com Calculator https://www.thebloodcode.com/calculators/
8. Diabetes Epidemic and You, Dr. Joseph R. Kraft, Trafford Publishing, 2008.
9. Stout, 1979 – https://link.springer.com/content/pdf/10.1007%2FBF01219790.pdf
10. Role of Insulin Resistance in Endothelial Dysfunction – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594115/
11. Reasner, 2008 – https://www.ncbi.nlm.nih.gov/pubmed/18670366
12. Insulin Resistance: A Clinical Handbook, Andrew Krentz, Wiley-Blackwell, June 9, 2008.
Thank you so much for such an informative post on Insulin Resistance tests. My aunt is a type 2 diabetic and she needs to inject Insulin now which is unfortunate. I will certainly share this post with my aunt which will be helpful to her. I will certainly get all the test necessary for her as well, so that she can test for insulin resistance. Thanks for providing the links 🙂
Cheers!
Hello Nuttanee,
I am glad that you appreciate the information. Sorry to hear about your aunt. There is always hope for your aunt by changing her lifestyle and working with her doctor and nutritionist that can get the blood sugar and insulin levels down to reverse and put type 2 diabetes into remission.
I recommend you read my post Lose Weight Keep it Off, and What does Insulin Resistance Mean.
Thanks for reading and your comments.
Jimmy.
Thank you for this information, my father suffers from diabetes. His case became very serious and now we only manage it because of his refusal to go through routine medical checks.
Thank you for highlighting the various type of tests, I do carry out insulin resistance test by using the fasting glucose and fasting insulin and measuring using the HOMA calculator. My calculation is almost at 1.0 which is very good.
Hello Parameter,
I am sorry to hear about your father, try to limit his sugar and processed food intake. The problem is he does not want help from the medical system and he is slowly poisoning himself. High blood sugar is toxic. Unfortunately you cannot help people if they don’t want to be helped.
Take care of your self so you can take care of him. You seem to be healthy so keep doing what you are doing.
Thanks for reading and your comments.
Jimmy.
Thank you for a very informative post. Based on a number of blood tests, I have been told that I am pre-diabetic and it is becoming more of a concern as I get older. I am more interested in exactly what that means and how I can address the potential health issue. Are there certain tests I should ask my doctor about and be concerned with?
Hello Lee,
All of the tests that I mentioned in this post to measure insulin resistance are the minimum tests you should be asking your doctor for. Along with a test to check your liver (ALT, and AST) and kidneys (Albumin/Creatinine ratio – urine) . You should also have a complete physical and get your eyes tested. Recommended by the American Diabetes Association.
Now that you have been diagnosed as being diabetic you will need to adjust your lifestyle and lower your blood sugar to normal levels and get your insulin resistance down.
Thanks for reading and your comments.
Jimmy.
First of all, thank you for the hard work you put in to bring this website together. I found this a very useful article here so i do appreciate it. I spent much time reading this article because it’s value to me and my family. I have bookmarked this post as a reference and for further reading. Insulin is vital for bodies specifically in balancing blood sugar.
Thanks you for this great insight.
Hello Mugalu,
I am glad this article is useful to you and your family, please do come back and read my other posts too. I have a huge list of Recommended Books To Read page for some excellent reading, please check that out too.
Thanks for dropping by and your comments.
Jimmy.
Hi,
Let me get it straight. A person can experience insuline resistance but not necessarily be diabetic? What I understood is that it can eventually turn into diabetes. That’s why pre-diabetes needs to be taken care of.
Thank you for making us aware of the importance of getting tested. It’s better to prevent.
Hello Enrique,
I agree that you have to be aware and prevent if you can. Being diagnosed with insulin resistance means that you will have to make an adjustment to your lifestyle. Insulin resistance means you are prediabetic, which means you are diabetic.
As I stated before your blood sugar can be normal or above normal for years or even decades, but your insulin will slowly be creeping up above normal levels to the point that you become insulin resistant.
Thanks for dropping by and your comments.
Jimmy.
I do believe it is very important to test for insulin resistance since the consequences of leaving hyperinsulinemia unchecked and progressing can be fatal. To be honest though, I used to think that the test for insulin was strictly for those already diagnosed with diabetes. Now I guess I’d have to schedule a meeting with my doctor.
Thanks for sharing Jimmy, this has been really informative.
Hello Rhain,
The test for insulin resistance is important for everyone because there are so many undiagnosed cases of both diabetes and insulin resistance. The sooner you get tested the sooner you will know.
Thanks for dropping by and your comments.
Jimmy.
Many thanks for writing such a beautiful article. This article is very useful to me because my father has diabetes and he has to take insulin. My father is a type 2 diabetic and have been dealing with this problem for a long time. My father has a doctor and will show this article to him as it is very helpful This article explains how to test for insulin resistance and now I understand. You certainly deserve the praise for such a beautiful study. I will follow the tests to understand insulin resistance in your article to keep my father aware. Diabetes as I understand is in control and we need to make him better. There are a few books mentioned in the article, I will definitely be reading them, and I will bookmark for future reading. Most people, like me have benefited greatly from reading your article.
Thanks for the informative article.
Hello Shanta,
Please ensure that when your father gets the tests for insulin resistance you get tested too. These tests are for everyone diabetic or not. Note, insulin resistance can go on for years before you are diagnosed with diabetes.
I also have a Recommended Books to Read page that I will list on the post.
Thanks for dropping by and your comments.
Hello, I enjoyed your article and find it is very helpful. I’m also a diabetic, which means I should get tested to see how insulin resistant I am. On my next test I will try and get all of the tests that you recommend. I have a question though, Do you think I need to get the C-Peptide test?
Thanks for sharing this post.
Hello Sabrina,
I am glad that the information is helpful and hope you do get yourself tested to see how insulin resistant you are. Go to your doctor and get your regular tests plus the ones I recommend. Once you have all of your numbers from your blood panel you can plug them into the calculators. A C-Peptide test is used for checking for type 1 and type 2 diabetes and is also a great marker for inflammation.
Thanks for dropping by and your comments.
Jimmy.
I have been dealing with my diabetes since I was six years old and honestly I have only heard about the importance of the A1c in your body. Of course, my endocrinologist always sends me to do all the lipid panels tests every 3 months, but she has never actually explained to me what each test was about. I’ve recently just started using an insulin pump and I had to take a test (I’m not sure if it was the C-Peptide, but it was expensive. Luckily, my insurance covered it). Growing up my diabetes was never taken care of and I remember when I was about 17 going to an endocrinologist and him telling me that my A1c was over 13%. I didn’t understand it until I got in my 20s. Now, in my latest A1c test my blood sugar had an average of 6.45%. Sadly, due to my diabetes not being treated while growing up, I’m now seeing the negative results, such as CKD and retinopathy.
Hello Stephanie,
Are you a T1 or T2? Nowadays 3 year old’s have been diagnosed with T2 diabetes. A1c is an important marker for determining diabetes but the other tests such as fasting insulin, fasting glucose, triglycerides, HDL-C and c-Peptide are helpful for determining insulin resistance.
T1’s can be insulin resistant too, high blood sugar is toxic and not managed well can lead to all sorts of metabolic issues. Good thing for having insurance, one thing I did not mention is there are a number of websites that offer low priced blood panels. C-Peptide is released when insulin is released and is a good marker for problems.
Be careful with high blood sugar as there have been cases where Diabetic Ketoacidosis has been detected in much lower A1c’s and 200 mg/dl of fasting glucose. Also I have 2 very good friends, one is a long time kidney transplant patient and now on dialysis, long-term affects of T2. The other person has retinopathy and has a cataract in his eye and gets a needle every 2 weeks in the eye, and will soon need surgery to save the eye. He too suffered and still suffers from long term T2 diabetes.
I am not going to preach to anyone, but you need to start by changing your lifestyle. Diet, exercise, stress management, sleep are factors that contribute to diabetes.
Thanks for dropping by and your comments.
Jimmy
Hello there. Thank you for sharing this information on how to test for insulin resistance. This is very helpful and educating too and would be of great help to many out there just as it has helped me in a way. I have been wondering how type 1 diabetes and type 2 diabetes are tested for. Now I know it’s C-Peptide.
The benefits of these tests are awesome and life saving.
Regards!
Hello Mr. Bizzy,
I am glad that you found this post helpful and educating. C-Peptide is good for detecting type 1 diabetes among other things and can detect other inflammation markers such as insulin resistance.
I agree that having all of these tests available are helpful in detecting insulin resistance.
Thanks for reading and commenting.
Jimmy.
Wow! Thank you for this very useful article. I feel more aware of the level of glucose in the blood. So far, all I know in insulin resistance test is only based on fasting blood sugar, post coenam blood sugar and HBA1C. However, because of your article I know more like C-Peptide and HOMA-IR.
In my opinion, an insulin resistance test to measure diabetes is a must-do every year. Because, we never know how our body’s metabolism changes. I remember 3 years ago, when I did a medical check-up, it was found that I had a safe glucose level. However, a year after during my medical check-up, I discovered that my glucose level was at pre-diabetes level. So, insulin resistance tests really need to be done and we must be aware of it.
However, what I’m still confused about , is whether TG: HDL-C ratio , C-Peptide and HOMA-IR needs to be done to ensure that someone has diabetes or not (since it is not cheap, I think)? Is it not enough with HBA1c and glucose levels in the blood data?
Thanks
Hello Kylie,
Your diagnosis for prediabetes means you are insulin resistant, you might want to look at your lifestyle and make necessary changes. You should talk to your doctor and nutritionist about diet then other changes you need to make to get back to normal levels.
To clear up your confusion, even though you have your HBA1c and fasting glucose level these may indicate normal. This is why you need to do the lipids panel, as triglycerides go up HDL-C will go down and you can calculate insulin resistance. Same with the HOMA calculator now you have an actual fasting insulin reading and usually if insulin is high you can almost bet that you have insulin resistance.
Thanks for dropping by and your comments.
Jimmy.
Diabetes, I think is something one must be really weary of and I must just say that those who have it never wanted to.
But a lot of people out of sheer ignorance have it.
I must really commend you for this in depth analysis on how to test for insulin resistance, even in its early days because once it gets deep into the body it might be too late.
Thumbs up on providing the information.
Hello Carol,
Yes insulin resistance and diabetes are 2 things to be weary of, you may have it and not know it and have metabolic issues that will affect your livelihood. Make sure you get tested for insulin resistance because anyone could have it.
Thanks for reading and your comments.
Jimmy.
Hey, Your guide is very useful for every one to Test For Insulin Resistance. In many cases, diabetes may not be detected if it is at or under the normal limit. Insulin resistance is a metabolic condition that requires a higher amount of insulin to push sugar and fat into cells.
My Grand father has been diabetic for 20 years now. Recently, the doctor started Insulin just before his bedtime. Now I have a little more knowledge about it via your post.
Hello Parveen,
I am glad you found my post useful. There are many cases where people have been detected with insulin resistance and do not know it. Yes it could be an on going thing.
Sorry to hear about your grandfather and his diabetes.
Thanks for dropping by and your comment.
Diabetes I think is something one has to be really weary of and most people do not want it. A lot of people out of sheer ignorance get diabetes and that is too bad.
I must really commend you for this in depth analysis on how to control diabetes even in its early days because once someone gets insulin resistance it might be too late for the person.
Thumbs up on this.
Hello Carol,
Diabetes is a silent crippler and yes you must change your lifestyle in order to manage diabetes correctly. Even though your A1c is normal you should be careful to also manage insulin resistance. There are tests you can take and measure insulin resistance. Read the post How To Test For Insulin Resistance.
Thanks for dropping by and reading.
Jimmy.
Hello there,
Thanks for this awesome article, it has been of help to me and I am sure it will be of great help to the public. I must say that your have done a great job explaining the tests to determine insulin resistance as a graduate student of chemistry. I would say that these options you have given are the best ways to test for insulin resistance and I am going to go to my doctor and get tested for insulin resistance and diabetes.
Keep up the good work.
Hello my friend,
Insulin resistance is in fact prediabetes and if you understand hyperinsulinemia they all mean the same thing. So if you are hyperinsulinemic, you are insulin resistant and diabetic.
Although your blood sugar is normal or close to normal, insulin resistance is very sneaky and will do deadly damage to your body in the long term.
Thanks for dropping by and your comment.