Insulin resistance vs pre-diabetes – What’s the difference?

In this article, we explore insulin resistance and pre‑diabetes. While some people use these terms interchangeably, they aren’t quite the same. We’re here to set the record straight and answer key questions about both, read on to learn more.

Does “insulin resistance” mean the same thing as “pre-diabetes”?

No, these terms are not the same, although they are closely related. Both conditions have problems either using or making insulin in the body. Insulin is the hormone secreted by the pancreas, regulating the glucose that enters the blood stream as food is broken down after eating. After a meal, insulin levels rise to make sure that the right amount of glucose enters the cells in the body.¹

The differences between the two conditions

Insulin resistance:
This is the underlying condition where the cells of the muscles, fatty tissue and liver stop responding as well to insulin. These cells can’t take up as much glucose from the blood. Initially the body tries to compensate for insulin resistance by making more insulin to maintain normal blood glucose levels. Over time the pancreas can’t produce enough insulin to overcome insulin resistance. This leads to high blood glucose and the development of pre-diabetes.

Pre-diabetes:
This is defined as the diagnosable state of elevated blood sugar that arises from having insulin resistance. With pre-diabetes you will have higher-than-normal blood glucose but it is not high enough yet to be classified as Type 2 diabetes.

How would you know if you are insulin resistant?

There is no single test to determine if you are insulin resistant and many people have no symptoms. Doctors look at a combination of blood glucose levels, cholesterol levels and physical examination results. Test results may show elevated blood pressure, having a combination of high triglycerides and low HDL cholesterol (this is the good cholesterol), high insulin levels on fasting or after a glucose load and an elevated fasting blood glucose.

A physical sign associated with insulin resistance is the appearance of dark, velvety patches of skin under the armpits, the side and back of the neck and in the groin area. Other signs can be skintags around the neck and in the armpits, acne and oily skin, excess hair growth on the face or the body in females and central obesity (an increased waist circumference or abdominal fat).

How would you know if you have pre-diabetes?

Pre-diabetes doesn’t have any symptoms and only shows up with health screening such as a fasting blood glucose test or a HbAC1 test. A HbAC1 test measures the average blood glucose levels over the past two to three months. Higher levels indicate poor, long-term blood glucose control and can indicate whether someone has normal, pre-diabetic or diabetic blood glucose levels.

How do you become insulin resistant?

There are a number of factors that can influence whether or not you develop insulin resistance including a lack of physical activity, eating a diet that is high in processed foods, refined carbohydrates and sugary drinks and having excess weight around the tummy. Genetics plays a part, including having a family history of insulin resistance. Certain ethnicities such as Pacific Island or Maori heritage can increase your risk. Poor sleep or a chronic lack of sleep, smoking, some medications and hormone changes such as pregnancy, PCOS and menopause can all increase the risk of developing insulin resistance.²

Can either of these conditions be reversed?

The good news is that both of these conditions can be reversed and having either of these conditions does not mean that you will definitely go on to develop Type 2 diabetes. The lifestyle changes listed as follows can make a dramatic difference to halt or reverse these conditions:³

• Weight management – A weight loss of 5 to 10% of body weight can significantly improve insulin sensitivity.
• Movement – Regular physical activity helps muscles use glucose more effectively.
• Diet – eating a diet rich in whole foods, while decreasing your intake of processed foods, refined carbohydrates and sugary drinks will improve insulin resistance.
• Manage stress – high levels of stress hormones like cortisol can negatively affect insulin sensitivity.
• Quit smoking – smoking worsens insulin sensitivity and overall metabolic health.
• Treat any sleep disorders – poor sleep affects the hormones that regulate blood sugar and appetite.
• Manage related conditions like high blood pressure and high cholesterol.

Lifestyle changes, regular exercise and healthy eating can help return blood sugar levels to normal and treat or reverse pre-diabetes.