Medically reviewed by Dr. George Kosco, DO on August 5th, 2023

Video | Definition | Cause | Risk Factors | Skin Signs | What You Can Do | Takeaway

When you have insulin resistance, your cells do not respond to insulin properly. Because insulin is the hormone that moves energy-rich glucose from the foods you eat into your cells, this resistance leaves you feeling low on energy, hungry, and at risk for developing type 2 diabetes. In this post, I’ll share both the subtle and distinct signs of insulin resistance, some of which you can see by looking in the mirror.  

Signs of Insulin Resistance – Do You Have Them? [Video]

In this video, you’ll learn…

• The definition of insulin resistance.
• Risk factors that lead to insulin resistance.
• Things you can do to reverse the condition.

What is Insulin Resistance?

Insulin is a nutrient-storing hormone made by your pancreas. It gets secreted into your bloodstream in response to the presence of glucose. Glucose is an energy source for your cells. Because of this important role, your body has ways of making glucose to ensure that there is always some available.

However, we can also dump glucose into the blood by eating foods that contain carbohydrates. Once inside of you, those carbs break down into single sugar molecules – called glucose – that go to your bloodstream. That rise in blood glucose (sugar) triggers the release of insulin, whose job it is to move the excess glucose into your cells. 

With insulin resistance, your cells do not respond to insulin well. In other words, your cells resist insulin’s attempts to deliver the glucose. Your pancreas can make more insulin to overcome your cells’ resistance for a while, but if your food choices are causing frequent spikes in blood sugar, it can overwhelm the system to a point where your pancreas cannot keep up with the demand.

Without enough insulin to push glucose into the resistant cells, blood glucose levels remain elevated, putting you at risk for developing type 2 diabetes. 

What Causes Insulin Resistance? 

You can see how eating a high-carb diet opens the door to insulin resistance. However, not all carbs are created equal. Some digests slowly, causing a gradual increase in blood sugar levels that, in a healthy person, can be managed by insulin. These slow-digesting carbs come from whole, unprocessed foods like vegetables, high-fiber fruits, nuts, seeds, beans, and unprocessed grains.

Other carbohydrates digest quickly, causing a rapid dumping of sugar into your blood, requiring a large dumping of insulin to bring the level under control. Quick-digesting carbs include sugary drinks like soda or sweetened tea as well as refined carbs like the 3 C’s cookies, cakes, and candies. Because these foods are already in their basic form, your digestive system sends them quickly into your bloodstream with little effort. 

Risk Factors as Signs of Insulin Resistance

You can see that a diet high in refined carbs and sugary drinks is a risk factor for developing insulin resistance. Many risk factors are observable, so we can think of them as potential signs of insulin resistance. These factors include being overweight and having a large waist circumference, which is typically defined as more than 40 inches (102 cm) for men and more than 35 inches (89 cm) for women (1).

Leading a sedentary lifestyle is an additional risk factor. You can also gather clues about your risk by testing your blood sugar to see if it falls in the prediabetes range. Testing your blood sugar level at home is not a definitive test for insulin resistance. However, you can use a home meter to find out your morning fasting blood glucose level. If the level falls in the prediabetes range of 100 to 125 mg/dL (5.6 to 6.9 mmol/L), it is a clue that your blood sugar is not being appropriately regulated (2).

Skin Signs of Insulin Resistance

The risk factors that I mentioned can act as subtle signs of insulin resistance. However, there are more distinct signs that you can notice on your skin. While these skin changes might not be seen on everyone with insulin resistance, dark patches, and skin tags can develop due to the condition.

Dark Patches

The brown to black patches, called acanthosis nigricans, most commonly appear in the armpits or the back and sides of the neck. However, they can also occur in other skin folds, like the elbows, groin, knees, and the area around your belly button (3).

Skin Tags

Skin tags are small, benign skin growths that pop up commonly in the armpits, neck, and groin. But, they can develop on the trunk of your body or your eyelids. Why they develop so often on the skin of those with insulin resistance is debated. However, scientists speculate that because insulin is a growth-promoting hormone, the sustained high insulin levels that result from the condition may be responsible for developing these growths that we call skin tags (3) (4).

Hair Loss

In addition to dark patches and skin tags, a person with insulin resistance may notice progressive diffuse thinning of the hair that leads to bald patches. There are many reasons for hair loss, so its connection to insulin resistance is still being debated. However, if you have been noticing hair loss and have other skin manifestations or risk factors, it is another clue that you may have insulin resistance (3). 

What Can You Do about Insulin Resistance? 

Testing (HOMA-IR)

If you have signs of insulin resistance, there are tests that can diagnose the condition. The gold standard for insulin resistance diagnosis is something called the euglycemic insulin clamp. Unfortunately, this test is invasive and expensive, so it is used in research studies and not something you can ask your family doctor to perform. 

However, you can ask your doctor for a couple of blood tests that can get you closer to a diagnosis. There is an index referred to as the homeostasis model assessment of insulin resistance (HOMA-IR). You can calculate your HOMA-IR score by plugging the results of two blood tests into a formula. The two blood tests that your doctor can order are your fasting glucose level and your fasting insulin level. The website, The Blood Code, has an online calculator that will do the math for you and provides the ranges from normal to significant insulin resistance. 

Diet and Lifestyle Changes to Reverse Insulin Resistance

You can make diet and lifestyle changes that reverse insulin resistance. Carbohydrates are the type of food that cause the highest rise in blood sugar and insulin levels. By following a low carb diet, you lessen insulin’s workload, making insulin resistance less of an issue (5).

If you are just getting started with a low-carb diet, take the first step by counting how many grams of carbohydrates you are taking in, aiming for no more than 125 grams per day. Most animal-based foods are naturally low in carbs. When choosing plant-based foods, pick the ones that still look like the plant they came from and avoid the packaged foods that have been manufactured to look healthy. For instance, eat the green vegetables from the produce area, not the green veggie sticks from the chip aisle.

Exercise

Getting regular exercise makes it easier for your cells to take in glucose, essentially reversing the resistance they once had. The nice thing is that all forms of exercise have been shown to help, so whether you enjoy aerobic-style exercises like walking or riding a bike or prefer lifting weights at the gym, you will benefit (6) (7).

Takeaway

Insulin resistance is a common condition that is strongly influenced by your food choices and activity level. A complete diagnosis requires blood work, but there are signs that point to the presence of the condition. Some of these signs are seen on the skin. Dark patches and skin tags that develop on your neck, under your arms, or around other skin folds are often associated with insulin resistance.

There are also observable risk factors that, if present, may indicate insulin resistance. These risk factors include being overweight with a large waist measurement and leading a sedentary lifestyle. The good news is that you can take steps to improve the insulin sensitivity of your cells and halt the progression of this condition.

The best place to start is with your diet. By lowering your overall carb intake and focusing on whole, unprocessed foods, you maintain stable blood sugar and insulin levels that keep your body healthy. You can download my list of 100 low carb foods! Thanks for reading and have a great rest of your day!

References

(1) Hardy, Olga T., Michael P. Czech, and Silvia Corvera. “What causes the insulin resistance underlying obesity?.” Current opinion in endocrinology, diabetes, and obesity 19.2 (2012): 81.

(2) “Diabetes.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 30 Oct. 2020, www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451.

(3) González-Saldivar, Gloria, et al. “Skin manifestations of insulin resistance: from a biochemical stance to a clinical diagnosis and management.” Dermatology and therapy 7.1 (2017): 37-51.

(4) Tamega, Andreia de Almeida, et al. “Association between skin tags and insulin resistance.” Anais brasileiros de dermatologia 85.1 (2010): 25-31.

(5) Feinman, Richard D., et al. “Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base.” Nutrition 31.1 (2015): 1-13.

(6) Koopman, René, et al. “A single session of resistance exercise enhances insulin sensitivity for at least 24 h in healthy men.” European journal of applied physiology 94.1 (2005): 180-187.

(7) Borghouts, L. B., and H. A. Keizer. “Exercise and insulin sensitivity: a review.” International journal of sports medicine 21.01 (2000): 1-12.

About the Author

Becky Gillaspy, DC graduated Summa Cum Laude with research honors from Palmer College of Chiropractic in 1991.