According to the Cleveland Clinic, about 1 in 3 U.S. adults is Insulin resistant, but many don’t realize it. Even more are on a path that could lead to insulin resistance in the future. We often assume only people with diabetes need to think about insulin, when in fact it’s something everyone should pay attention to.

What is insulin?

Insulin is a hormone that plays a crucial role in regulating Blood Sugar Levels in the body. It is produced in the pancreas and then released into the bloodstream, allowing cells all throughout the body to take up and utilize glucose as a source of energy.

Glucose is the simplest form of energy the body can use, so when your insulin levels are high, your body will use glucose for energy first. When glucose is not readily available, or when your insulin levels are low (such as during a prolonged fast), the body shifts to using fat as its main energy source.

Our blood sugar levels go up and down throughout the day, and it’s insulin’s job to manage which source—glucose or fat—we tap into for energy.

What causes insulin resistance?

A variety of factors can contribute to the development of insulin resistance, including diet, physical activity, genetic factors, and inflammation.

Insulin resistance happens when our cells stop responding to insulin the way they should. This usually starts to happen after the body’s blood sugar levels have been elevated over a long period of time. When your blood sugar is high, your insulin levels will be higher too as the insulin works to store all the excess glucose.

If blood sugar and insulin are both elevated too often, cells start to become resistant to the effects of insulin. When insulin doesn’t work as well, more sugar stays in the blood, which means our blood sugar levels get even higher, causing the body to try to produce even more insulin.

Eventually, the pancreas becomes overworked and isn’t able to work as well. If you’ve ever been burned out from work or other responsibilities, you’ve likely experienced something similar. If you work too hard for too long, the quality of your work starts to suffer and you aren’t able to do as much. The same thing happens to the pancreas when it hits its own version of burnout: it won’t be able to produce as much insulin, something we need to maintain normal, healthy blood glucose levels.

With insulin resistance being the driving force behind many of today’s leading health conditions, including type 2 diabetes and obesity, this is a big deal. Insulin resistance affects not just our health, but how we live our lives.

Who can become insulin resistant?

Anyone can become insulin resistant, but any of the following factors can put you at higher risk:

• Being over age 45
• First-degree relative with diabetes
• Family history of gestational diabetes, stroke, or heart disease
• African, Latino, or Native American ancestry
• Being overweight or obese
• High blood pressure
• Having a sedentary lifestyle
• Smoking
• Certain medical conditions like PCOS, Cushing’s syndrome, sleep apnea, and fatty liver disease

What are the symptoms of insulin resistance?

Not everyone who is insulin resistant will have noticeable symptoms. Usually a blood test and doctor’s visit are required to determine if you’re insulin resistant.

However, there are some symptoms associated with insulin resistance, especially as it worsens. These include:

• High blood pressure
• High triglycerides
• Low HDL cholesterol (aka, the good cholesterol)
• Elevated blood sugar
• Increased thirst
• Increased urination
• Increased hunger
• Skin infections or wounds that take a long time to heal

The best way to keep insulin levels in check is to stay informed about your health and live a healthy lifestyle.

How to find out if you’re insulin resistant

Insulin resistance is tricky to spot because, as mentioned, there are often no symptoms, and it takes some detective work to find out what’s happening inside the body. A simple self-assessment (like this one) can help you get an idea of where you might fall on the insulin resistance scale. A self-assessment is also a good place to help you figure out what questions to ask your doctor at your next appointment.

That being said, it is important to see your doctor regularly to know where you’re truly at with your health. They will review your medical and family history, go over any symptoms you may be having, and can order blood tests to check your glucose, cholesterol, and triglyceride levels.

A holistic view of your health is the best way to determine where you’re at regarding insulin resistance, which you can do with the help of your doctor.

How to reverse insulin resistance

If untreated, insulin resistance can become chronic. But for many people, insulin resistance can be reversed or greatly improved with a combination of lifestyle changes.

Maintain a healthy weight. Excess body weight, particularly around the abdomen, is one of the biggest risk factors for insulin resistance. As such, maintaining a healthy weight should be top of mind for anyone wanting to avoid or reverse insulin resistance.

Stay physically active. Regular exercise helps the body soak up excess blood sugar for energy, and can increase the sensitivity of insulin receptors (not to mention it can help you maintain a healthy weight). Both aerobic exercise and strength training can be beneficial, so you have plenty of options on the type of exercise you pursue. Strive for at least 150 minutes of moderate physical activity each week.

Eat more fiber. Controlling carbohydrates is important to keeping overall glucose levels low, which helps keep insulin levels in check. The simplest way to do this is by eating plenty of fiber: whole grains, vegetables, and legumes in particular. Here’s a useful tip to remember: starting off your meal with a fiber-rich food can help mitigate some of the effects carbs have on our body, so be sure to eat your greens first!

Try intermittent fasting. Going prolonged periods of time without eating—12 to 16 hours—gives your body a break from fluctuating blood sugar levels that occur when we eat. Fasting allows the body to use up the sugar in our bloodstream and switch over to fat for energy.

Stress less, sleep more. We all know that chronic stress or inadequate sleep can affect our health, so it shouldn’t surprise you that it can contribute to insulin resistance too. Make sure you’re taking time to relax each day, and follow that up with 7–9 hours of sleep each night.

Avoid alcohol and smoking. Alcohol can disrupt the normal balance of glucose and insulin in the body, and smoking can disrupt glucose metabolism. Limiting both as much as you can can make a difference in reversing insulin resistance.

Insulin resistance can lead to a variety of health conditions, but the good news is that we can do a lot to avoid and even reverse it—and it’s well worth the trouble.