MECHANISM ENGINE
What Is Insulin Resistance?
I got close to this one. Not diagnosed, but close, pre-diabetic range, HbA1c creeping the wrong way year on year, before my GP flagged it properly. Took a proper conversation with him to actually understand what the number meant.
The Bouncer, Working Overtime
Same bouncer from the insulin page, same pub, same queue. Insulin resistance is what happens when the doors stop opening on the first knock. The bouncer has to knock harder, then knock again, then bring in two more bouncers just to get the same queue moving. From the street it still looks fine, the queue’s still clearing, blood sugar’s still roughly normal. Nobody sees the extra staff it’s taking to make that happen. That’s the bit that’s easy to miss, the system isn’t broken yet. It’s working a lot harder than it should have to, and nobody’s checking the staffing levels.
Insulin resistance develops when muscle, fat, and liver cells become less responsive to insulin’s signal, so the pancreas compensates by producing more. For years, this compensation can keep blood glucose looking normal, which is why insulin resistance often goes unnoticed until fasting glucose or HbA1c starts to shift. Drivers include visceral fat, chronic high glucose exposure from a high-UPF diet, poor sleep, and ongoing stress via cortisol.
NHS and Diabetes UK guidance treat insulin resistance as a precursor state rather than a standalone diagnosis, generally picked up through blood tests such as HbA1c and fasting glucose rather than through symptoms, since there usually aren’t any in the early stages.
Articles referencing this concept will populate here automatically as the Library builds.
Related mechanisms
Educational content only, not medical advice. Never stop or change medication without your GP’s supervision. Neil stopped his own medications in February 2024 on his own initiative and told his GP afterwards, with NHS blood tests to show. That is not the approach recommended here. Speak to your GP before changing your fasting pattern, diet, or medication.
What this is based on
NHS and NICE guidance, cross-referenced against Neil’s own NHS blood test record going back to April 2012. See the full timeline and current numbers.