6 Signs You May Have Insulin Resistance

By Clare Goodwin

Last updated: December 17, 2021

Insulin resistance and PCOS. You may have been diagnosed with the latter, but are not sure whether you also have the former. An insulin resistance test should be one of the first that your doctor does after diagnosing PCOS. Unfortunately, that’s not always the case…

In this article I’ll outline some classic signs and symptoms to help inform you of whether you should be pushing for further testing. Of course, you’re smart women, you know this is not a diagnosis. I’m not a doctor, I’m a degree-qualified nutritionist. Even if I was a doctor, I could not diagnose you via a blog. You need to get a blood test done to know for sure. So, book one as soon as you can.

What is insulin resistance?

Insulin is our storage hormone. When we eat, our body detects a rise in blood sugar (glucose). Our body doesn’t like blood sugar to be high. This is because cells can be damaged if it’s high for prolonged periods of time. These cells include those in the brain, liver, pancreas, heart, and eyes. Therefore, in response to high blood sugar, the body stores excess glucose in muscle and liver cells for later use.

Insulin is the hormone that allows this to happen. It tells the cells to open up and let the glucose in. Insulin is excreted by the pancreas. It binds to a receptor on the cell and tells it to open up. This process is similar to the way a key opens a door. Insulin resistance occurs when insulin no longer works effectively due to chronic low grade inflammation. The key has been used too much, the lock gets worn and the key no longer fits.

As a result, the blood glucose level stays high. The brain believes that more insulin is required. It sends a message to the pancreas to get it to make even more. However, the ‘lock’ is still worn so the extra insulin doesn’t help. If this process continues over a long period of time, the pancreas becomes so fatigued that it’s unable to produce enough insulin. This is called Type 2 diabetes.

How are insulin resistance PCOS connected?

70% of women with PCOS have insulin resistance. Studies have shown that improving insulin resistance can reduce:

Metformin is a drug that you may already know about. It’s often prescribed to help with fertility – you may have even been prescribed it yourself! Metformin is a drug that improves insulin sensitivity. However, it’s not thing that improves insulin sensitivity. In fact, it’s not even effective for many women.

Studies have shown that a very low carbohydrate (ketogenic) diet can be very successful alternative. It can improve insulin resistance, help weight control, and reduce testosterone levels. Reducing testosterone levels is especially important if ovulation is to happen.

How do I know if I have insulin resistance?

The stats say that insulin resistance and PCOS often go hand in hand. A blood test can tell you whether you have insulin resistance. This should measure fasting blood glucose, fasting insulin, and HbA1c (long-term blood glucose performance).

It’s important that you don’t just accept them telling you that your levels are normal. Make sure that you ask for the actual results. The ‘normal’ range for fasting blood glucose is 3.61-5.50 mmol/L. Your level could be deemed ‘normal’ even when it’s 5.49mmol/L. Get the actual figure and then make an informed decision about how normal it actually is.

Here are some more indicators that you should get your levels checked:

1. You have severe hangry attacks

I know you know what I’m talking about! One minute you’re not even hungry, and the next you must eat everything in sight. No food? No problem! The closest boyfriend’s, friend’s, or colleague’s head will suffice. If no food’s available, then you might even start to feel shaky, jittery, and faint. You’re experiencing severe blood sugar crashes. These show that your blood glucose isn’t stable and is not doing what it should be.

2. You store weight around your belly

This is true even if you’re not overweight, or ‘Lean PCOS.’ If you put on weight, where does it go? If the answer is your stomach, then that’s a really good sign that you’ve got some insulin resistance going on. Studies that have looked at both overweight and normal weight women have shown that weight gain around the stomach is a significant sign you have insulin resistance.

3. No matter how many spin classes, miles run and salads you ate, you can’t seem to lose weight

Feel like you’re doing everything ‘right’ and still not losing weight? Insulin resistance might be playing a factor in this.

Studies have shown that insulin resistance impacts the ability to burn fat. In fact, one study showed that the muscles of people with insulin resistance are geared towards fat storage, not fat burning. No wonder it’s hard to lose weight!

4. You’ve developed dark velvety patches in the folds of your skin

These could be under your arms or on the back of your neck. The proper name for them is acanthosis nigricans. It’s caused when insulin-like growth factor (increased by insulin resistance) stimulates the cells in the skin to produce more keratin and dermal fibroblasts.

Studies have shown that insulin resistance is not the only reason that these patches develop. However, they are still a potential indicator of it.

5. You’ve got skin tags

Skin tags are little bits of skin that hang off. I know what you’re thinking, “Oh is that what they’re called?” Yes, I admit, until recently I didn’t know either. Studies have shown that multiple skin tags are a really good indicator of insulin resistance, so if you have them then go and get them checked out.

Summary of Insulin Resistance and PCOS

Insulin resistance and PCOS often go hand in hand.

Insulin resistance causes excess androgens, which causes a lot of the horrible PCOS symptoms.

Longer term, insulin resistance can develop into Type 2 diabetes and put us at risk for all manner of nasty metabolic diseases. But it is reversible, so you need to address it now.

It needs to be diagnosed by blood tests from your doctor, but some signs that you may be insulin resistant include:

  • Blood sugar crashes (aka hangry attacks)
  • Putting on weight around your belly
  • Struggling to lose weight
  • Dark velvety patches on your skin
  • Skin tags