What is Insulin Resistance and Do You Have It
Insulin resistance is the condition in which the body's cells stop responding normally to insulin, requiring the pancreas to produce increasingly large amounts of the hormone to manage blood sugar. It is the primary driver of Type 2 diabetes and is present for years, sometimes decades, before diabetes is diagnosed. In India, it is one of the most prevalent and least recognised metabolic conditions.
How insulin resistance develops
When you eat carbohydrates, blood glucose rises. The pancreas releases insulin to signal cells to absorb that glucose for energy. In a healthy metabolic state, this process is efficient and blood sugar returns to baseline quickly.
When cells are repeatedly exposed to high insulin levels from a consistently high-carbohydrate, high-sugar diet, they gradually become less sensitive to insulin's signal. The pancreas compensates by producing more insulin. Over time, even large amounts of insulin cannot adequately manage blood sugar, and glucose remains elevated. This is insulin resistance.
Why Indians are disproportionately affected
Indians develop insulin resistance at lower body weights than Western populations due to a genetic tendency toward higher visceral fat at equivalent BMI levels. The standard Indian diet, with its heavy reliance on refined carbohydrates, further elevates risk. Studies have found that Indians develop Type 2 diabetes on average ten years earlier than Europeans and at significantly lower body weights.
Signs that may indicate insulin resistance
Insulin resistance has few obvious symptoms in its early stages, which is why it goes undetected for so long. Signs worth noting include persistent fatigue after meals, difficulty losing weight despite dietary effort, strong carbohydrate cravings, brain fog after eating, darkened skin patches at the neck or armpits (acanthosis nigricans), and frequent hunger shortly after eating.
The most reliable detection method is a fasting insulin test alongside a fasting glucose test. The ratio of the two, called HOMA-IR, is a sensitive marker of insulin resistance that appears years before HbA1c or fasting glucose become abnormal.
What dietary changes help most
Reduce refined carbohydrates and replace with whole grains, millets, and legumes that release glucose slowly. Increase dietary fibre, which slows glucose absorption at every meal. Add protein to every meal, which reduces the insulin response required. Reduce added sugar in all forms. These changes, applied consistently, can meaningfully improve insulin sensitivity within eight to twelve weeks.