Introduction
Have you ever wondered why some people
develop type 2 diabetes even when their bodies are still producing insulin?
Or why someone may struggle with abdominal
weight gain, high blood sugar, or fatty liver disease despite trying to eat
healthily?
One possible contributing factor is insulin
resistance.
Insulin resistance develops when certain
cells in the body do not respond effectively to insulin, the hormone
responsible for helping regulate blood glucose.
At first, the pancreas may compensate by
producing additional insulin. This can keep blood sugar within the normal range
for some time.
However, if the body's demand for insulin
continues to exceed what the pancreas can provide, blood glucose may begin to
rise.
Over time, this can contribute to prediabetes
and type 2 diabetes.
The encouraging news is that insulin
sensitivity can often improve through evidence-based lifestyle changes, weight
management when appropriate, and medical treatment for selected individuals.
This article explains insulin resistance, its
causes, associated health conditions, diagnosis, treatment, and practical ways
to improve metabolic health using familiar Nigerian foods and realistic daily
habits.
What
Is Insulin Resistance?
Insulin is a hormone produced by beta cells
in the pancreas.
Its main functions include helping glucose
enter muscle and fat cells, reducing glucose production by the liver, and
supporting normal energy storage.
After eating carbohydrates, digestion
produces glucose that enters the bloodstream.
The pancreas responds by releasing insulin.
Insulin then signals tissues to take up and
use glucose or store energy for later.
Insulin resistance occurs
when muscle, fat, and liver cells respond less effectively to insulin.
As a result, the pancreas may need to release
more insulin to achieve the same effect.
This can lead to elevated circulating insulin
levels, known as hyperinsulinaemia.
Insulin resistance does not always mean that
blood sugar is already high.
Some individuals have normal glucose readings
because their pancreas is still producing enough insulin to compensate.
Understanding the process helps explain its
relationship with diabetes.
Stage
1: Normal Insulin Sensitivity
The pancreas releases insulin after meals.
Muscle and other tissues respond effectively,
allowing glucose to be used or stored.
Blood glucose remains within the expected
range.
Stage
2: Reduced Insulin Sensitivity
Muscle, liver, and fat cells begin responding
less effectively.
The pancreas compensates by producing more
insulin.
Blood glucose may still remain normal.
Stage
3: Prediabetes
Over time, the pancreas may become unable to
meet the body's increased insulin requirements.
Blood glucose rises above the normal range
but does not yet meet the diagnostic criteria for diabetes.
Stage
4: Type 2 Diabetes
If insulin resistance and inadequate insulin
production persist, blood glucose may rise into the diabetes range.
Not everyone with insulin resistance
progresses to diabetes.
Genetics, pancreatic function, body
composition, physical activity, nutrition, and other factors influence
individual risk.
What
Causes Insulin Resistance?
There is no single cause.
Insulin resistance results from a combination
of genetic, metabolic, hormonal, and lifestyle factors.
1.
Excess Abdominal Fat
Excess fat around the abdomen, particularly
visceral fat surrounding internal organs, is strongly associated with insulin
resistance.
Visceral fat can contribute to metabolic
disturbances that interfere with normal insulin signalling.
However, insulin resistance can also occur in
people who are not overweight.
2.
Physical Inactivity
Muscles are major consumers of glucose.
During physical activity, muscles can take up
more glucose, including through pathways that do not depend entirely on
insulin.
Regular exercise also improves insulin
sensitivity over time.
A sedentary lifestyle can reduce these
benefits.
3.
Genetic Susceptibility
Some people inherit a greater tendency toward
insulin resistance or type 2 diabetes.
Having a parent or sibling with type 2
diabetes increases risk.
Genetics cannot be changed, but modifiable
risk factors can still be addressed.
4.
Dietary Patterns and Excess Energy Intake
Regularly consuming more energy than the body
needs can contribute to excess fat accumulation and metabolic dysfunction.
Diets containing frequent sugary drinks,
refined carbohydrates, and energy-dense foods may contribute to increased
metabolic risk.
However, insulin resistance is not caused
simply by eating one particular food.
Overall dietary quality, calorie balance,
physical activity, genetics, and body composition are important.
5.
Poor Sleep and Sleep Disorders
Insufficient sleep and conditions such as
obstructive sleep apnea are associated with impaired glucose regulation.
Sleep apnea may be especially relevant in
people who snore loudly, experience interrupted breathing during sleep, or feel
excessively sleepy during the day.
6.
Certain Hormonal Conditions
Conditions associated with insulin resistance
include:
- Polycystic ovary syndrome (PCOS)
- Cushing's syndrome
- Certain other endocrine disorders
These conditions require individualized
medical assessment.
7.
Certain Medications
Some medicines can increase insulin
resistance or blood glucose.
Examples include glucocorticoids such as
prednisolone and certain antipsychotic medicines.
Do not stop prescribed medication without
consulting a qualified healthcare professional.
Signs
and Symptoms of Insulin Resistance
Insulin resistance
frequently causes no obvious symptoms.
This is one reason it can remain unrecognized
for years.
However, some people have associated physical
findings or metabolic conditions.
1.
Increased Waist Circumference
Excess abdominal fat is associated with
insulin resistance.
However, waist size alone cannot diagnose the
condition.
2.
Darkened, Thickened Skin
Some people develop acanthosis nigricans,
which appears as darker, velvety skin around the neck, armpits, or other skin
folds.
It may be associated with insulin resistance,
although it can have other causes.
3.
Skin Tags
Skin tags are sometimes seen in people with
insulin resistance.
They are common and do not confirm the
diagnosis.
4.
Abnormal Blood Glucose
Prediabetes or type 2 diabetes may develop
when the pancreas can no longer compensate adequately.
Symptoms of significant hyperglycemia may
include frequent urination, increased thirst, fatigue, blurred vision, or
unexplained weight loss.
These are symptoms of elevated glucose, not
reliable early symptoms of insulin resistance itself.
5.
Other Associated Findings
High triglycerides, low HDL cholesterol, high
blood pressure, fatty liver disease, and PCOS may coexist with insulin
resistance.
Insulin
Resistance Versus Prediabetes Versus Type 2 Diabetes
These terms are related but do not mean the
same thing.
|
A person may have insulin resistance without
prediabetes.
A person with type 2 diabetes may have both
substantial insulin resistance and reduced insulin secretion.
How
Is Insulin Resistance Diagnosed?
There is no single routinely recommended
blood test that definitively diagnoses insulin resistance in everyday clinical
practice.
Doctors often assess metabolic risk through
medical history, physical examination, and laboratory investigations.
1.
Fasting Plasma Glucose
This measures glucose after an appropriate
overnight fast.
2.
HbA1c
HbA1c reflects average blood glucose exposure
over approximately two to three months.
3.
Oral Glucose Tolerance Test
An oral glucose tolerance test measures how
the body handles a standardized glucose drink.
It is useful in selected circumstances.
Understanding
Common Blood Glucose Categories
These are widely used diagnostic thresholds for nonpregnant adults. Diagnostic criteria and testing approaches may differ during pregnancy. |
In someone without unequivocal hyperglycemia,
diabetes diagnosis generally requires confirmatory testing.
HbA1c may be less reliable in certain
conditions affecting red blood cells, including some anaemias and haemoglobin
disorders.
4.
Lipid Profile
A lipid profile assesses cholesterol and
triglycerides.
Elevated triglycerides and reduced HDL
cholesterol may accompany insulin resistance.
5.
Blood Pressure and Waist Assessment
Blood pressure and waist circumference help
assess cardiometabolic risk.
6.
Fasting Insulin and HOMA-IR
Fasting insulin and the homeostatic model
assessment of insulin resistance (HOMA-IR) are sometimes used in research or
specialist settings.
However, they are not routinely necessary for
diagnosing prediabetes or managing most people at risk of type 2 diabetes.
There is no universally accepted HOMA-IR
cutoff suitable for every population.
Can
Insulin Resistance Be Reversed?
Insulin sensitivity can often improve
significantly.
For some people, lifestyle changes can
restore healthier glucose regulation and prevent progression to type 2
diabetes.
However, improvement varies according to
genetics, underlying medical conditions, pancreatic function, body composition,
and the severity of metabolic dysfunction.
The term reversal should not be
interpreted as a guaranteed permanent cure.
Sustainable long-term habits remain
important.
10
Evidence-Based Ways to Improve Insulin Sensitivity
1.
Reduce Excess Weight When Appropriate
For individuals with overweight or obesity,
losing approximately 5–7% of initial body weight can improve metabolic health
and reduce the risk of developing type 2 diabetes.
For example, a person weighing 90 kg who
loses 5% of their body weight would lose approximately 4.5 kg.
Greater sustained weight loss may offer
additional benefits in selected individuals.
People who are already at a healthy weight do
not necessarily need to lose weight to improve insulin sensitivity.
2.
Walk and Exercise Regularly
Regular physical activity is one of the most
effective ways to improve insulin sensitivity.
For many adults, a practical goal is at least
150 minutes of moderate-intensity activity weekly.
This could mean brisk walking for 30 minutes
on five days each week.
Other suitable activities include cycling,
dancing, swimming, and active household tasks.
Start gradually if you are not accustomed to
exercise.
3.
Include Muscle-Strengthening Activities
Muscles use glucose for energy.
Resistance exercise helps maintain or
increase muscle mass and can improve glucose metabolism.
Activities may include resistance bands,
supervised weight training, or suitable body-weight exercises.
The programme should match the individual's
physical condition and abilities.
4.
Improve Carbohydrate Quality and Portion Sizes
Carbohydrates do not need to be completely
eliminated.
Instead, focus on the amount consumed and the
quality of the overall meal.
Fibre-rich foods, vegetables, legumes, and
appropriate portions of whole grains can support a healthier dietary pattern.
5.
Reduce Sugar-Sweetened Drinks
Soft drinks, sweetened juices, and other
sugary beverages can contribute substantial amounts of rapidly absorbed carbohydrates
and excess calories.
Water and unsweetened drinks are generally
better everyday options.
6.
Eat More Fibre-Rich Foods
Fibre can support fullness, digestive health,
and glucose regulation.
Useful Nigerian options include beans, okra,
leafy vegetables, oats, and appropriate portions of whole grains.
7.
Break Up Prolonged Sitting
Avoid remaining seated for many uninterrupted
hours.
Short movement breaks throughout the day can
help reduce prolonged sedentary time.
A brief walk after meals may also improve
post-meal glucose responses.
8.
Improve Sleep Quality
Consistent sleep habits support metabolic
health.
Adults generally benefit from approximately
seven to nine hours of sleep, although individual needs vary.
Persistent insomnia, loud snoring, or
suspected sleep apnea should be assessed.
9.
Avoid Tobacco and Manage Cardiovascular Risk
Smoking increases cardiovascular risk and is
associated with metabolic dysfunction.
Blood pressure and cholesterol should also be
assessed and treated when necessary.
10.
Seek Medical Support When Needed
People with prediabetes, PCOS, significant
obesity, or type 2 diabetes may benefit from individualized medical treatment
in addition to lifestyle measures.
Professional support can help identify
realistic goals and address barriers to maintaining them.
Best
Nigerian Foods for Insulin Resistance
Healthy eating does not require abandoning
Nigerian meals.
Many familiar foods can fit into a balanced
eating pattern.
Beans
and Legumes
Beans, lentils, and other legumes provide
fibre and plant protein.
They can be useful components of meals when
prepared with moderate amounts of added oil and salt.
Okra
and Leafy Vegetables
Okra, ugu, ewedu, spinach, and other
vegetables contribute fibre and micronutrients.
Oats
and Whole Grains
Oats, millet, brown rice, and Ofada rice may
provide useful nutrients and fibre.
However, whole grains still contain
carbohydrates and can raise blood glucose.
Portion size remains important.
Fish
and Other Protein Sources
Fish, eggs, poultry, and other suitable
protein sources can help create balanced meals.
Nuts
and Seeds
Groundnuts, chia seeds, flaxseeds, and other
seeds may contribute unsaturated fats, fibre, and other nutrients.
They should be consumed in appropriate
portions.
No individual seed has been proven to cure
insulin resistance.
Whole
Fruits
Guava, oranges, pawpaw, and other whole
fruits can fit into a healthy diet.
Whole fruits are generally preferable to
sugar-sweetened fruit drinks.
A
Practical Nigerian Plate for Better Glucose Management
A useful starting point for many adults is
the balanced-plate approach.
Half the plate:
Non-starchy vegetables such as ugu, cabbage, okra, or mixed vegetables.
One-quarter of the plate:
Fish, chicken, eggs, or another appropriate protein source.
One-quarter of the plate: A
suitable carbohydrate portion, such as rice, yam, or plantain.
This is a flexible guide, not a compulsory
formula for every meal.
Beans contain both carbohydrate and protein, so
their portions should be considered within the overall meal.
People with diabetes may need individualized
carbohydrate targets, particularly when using mealtime insulin.
Can
Nigerians With Insulin Resistance Eat Rice, Yam or Swallow?
Yes.
These foods are not automatically forbidden.
However, the portion size, preparation
method, and accompanying foods influence the overall glucose response.
For example, a large plate of white rice with
a sugary drink may produce a greater glucose rise than a smaller rice portion
accompanied by vegetables, beans, and fish.
Similarly, eba, fufu, pounded yam, and other
swallow foods can fit into an individualized eating plan, but their
carbohydrate portions matter.
The goal is sustainable eating habits rather
than unnecessarily restrictive food rules.
Insulin
Resistance and Fatty Liver Disease
Insulin resistance is strongly associated
with metabolic dysfunction-associated steatotic liver disease (MASLD),
previously called non-alcoholic fatty liver disease.
When metabolic regulation becomes impaired,
fat can accumulate in the liver.
People with type 2 diabetes, abdominal
obesity, and other metabolic risk factors may have an increased risk of liver
fibrosis.
Appropriate management may include improving
nutrition, increasing physical activity, treating diabetes, and assessing liver
health when indicated.
Insulin
Resistance and PCOS
Polycystic ovary syndrome is a hormonal and
metabolic condition affecting some women of reproductive age.
Insulin resistance is common in PCOS,
although not every woman with PCOS has it.
Higher insulin levels may contribute to
increased androgen production and reproductive disturbances in some women.
Symptoms of PCOS may include irregular
menstrual periods, acne, excess facial or body hair, and difficulty with
ovulation.
Treatment depends on symptoms, metabolic
risk, and fertility plans.
Insulin
Resistance and High Blood Pressure
Insulin resistance frequently occurs
alongside high blood pressure and abnormal cholesterol levels.
These conditions increase long-term
cardiovascular risk.
Improving insulin sensitivity is beneficial,
but blood pressure and cholesterol may still require separate treatment.
Can
Medicines Improve Insulin Resistance?
Yes, certain medicines can improve glucose
regulation or address related metabolic conditions.
Metformin
Metformin primarily reduces glucose
production by the liver and improves glucose regulation.
It is widely used for type 2 diabetes and may
be considered for diabetes prevention in selected high-risk adults with
prediabetes.
It is not routinely prescribed to everyone
who has insulin resistance.
Long-term treatment may be associated with
vitamin B12 deficiency, so periodic assessment may be appropriate, especially
when anaemia or neuropathy is present.
GLP-1-Based
Treatments
Certain GLP-1 receptor agonists and related
medicines can improve glucose control and support weight reduction in
appropriately selected patients.
These medicines are not required for everyone
with insulin resistance.
They have specific indications,
contraindications, and potential adverse effects.
Other
Treatments
Additional medicines may be used when a
patient has type 2 diabetes, obesity, or another diagnosed metabolic condition.
Treatment should be individualized according
to clinical findings, medical history, kidney function, and other
considerations.
Do not start metformin,
injectable weight-loss medicines, or other diabetes medications solely because
an online article suggests insulin resistance.
Does
Intermittent Fasting Improve Insulin Resistance?
Intermittent fasting may help some
individuals reduce energy intake and improve metabolic measures.
However, it is not clearly superior to every
other sustainable, calorie-controlled eating approach.
It is also not suitable for everyone.
People using insulin or medicines such as
sulfonylureas may experience hypoglycemia when fasting.
Those taking SGLT2 inhibitors may require
particular caution during prolonged fasting, dehydration, or illness because of
the risk of ketoacidosis.
Pregnant women, people with eating disorders,
and individuals with certain medical conditions should not begin restrictive
fasting without professional guidance.
Do
Herbs and Supplements Reverse Insulin Resistance?
Cinnamon, fenugreek, berberine, bitter melon,
and other plant products are frequently promoted for blood sugar management.
Some have been studied, but the quality and
consistency of evidence vary.
No commonly marketed herbal mixture has been
established as a reliable cure for insulin resistance or a replacement for
diabetes medication.
Supplements may interact with prescribed
medicines and may not contain consistent amounts of active ingredients.
A healthy dietary pattern is more important
than relying on a single herb or supplement.
Insulin
Resistance in Nigeria: Why Awareness Matters
In Nigeria, many people undergo blood glucose
testing only when they begin experiencing symptoms.
However, insulin resistance and prediabetes
can develop without obvious warning signs.
Potential barriers to early detection include
the cost of laboratory investigations, limited routine screening, inconsistent
access to healthcare, and misinformation about diabetes.
Some people also believe that diabetes
prevention requires expensive imported foods.
This is not true.
Familiar Nigerian foods such as beans,
vegetables, fish, and appropriately portioned staple foods can form the
foundation of a balanced eating plan.
Walking, reducing sugary beverages, improving
sleep, and obtaining appropriate screening are practical interventions that do
not necessarily require expensive equipment.
People with a family history of diabetes, a
history of gestational diabetes, PCOS, excess abdominal fat, or other risk
factors should discuss blood glucose screening with a qualified healthcare
professional.
A
Simple Seven-Day Plan to Start Improving Metabolic Health
Day 1:
Review your usual meals and identify sugar-sweetened drinks or oversized
portions.
Day 2:
Add a generous portion of non-starchy vegetables to a main meal.
Day 3:
Take a comfortable walk after a meal if medically appropriate.
Day 4:
Replace a sugary drink with water or an unsweetened alternative.
Day 5:
Include a suitable fibre-rich food such as beans or oats.
Day 6:
Reduce prolonged sitting and include short movement breaks.
Day 7:
Review your progress and choose two sustainable habits to continue.
This plan is an introduction to healthier
routines, not a substitute for an individualized treatment programme.
Frequently
Asked Questions
Can
insulin resistance occur with normal blood sugar?
Yes. The pancreas may initially produce
enough additional insulin to keep glucose within the normal range.
Does
insulin resistance always lead to diabetes?
No. Some people maintain normal glucose
levels, while others develop prediabetes or type 2 diabetes.
Can
a slim person have insulin resistance?
Yes. Body weight alone does not determine
insulin sensitivity.
Can
insulin resistance cause belly fat?
Insulin resistance and abdominal fat
accumulation are closely associated, but the relationship is complex and can
work in both directions.
Does
insulin resistance cause frequent urination?
Insulin resistance itself usually does not.
Frequent urination may occur when blood glucose becomes significantly elevated.
Can
walking improve insulin resistance?
Yes. Regular walking and other forms of
physical activity can improve insulin sensitivity.
Can
I eat rice if I have insulin resistance?
Yes. Appropriate portions and balanced meals
are important.
Can
insulin resistance be cured permanently?
Insulin sensitivity can improve
substantially, but long-term results vary. Ongoing healthy habits and
appropriate medical follow-up remain important.
Is
fasting insulin testing necessary?
Usually not. Routine assessment commonly
focuses on blood glucose, HbA1c, metabolic risk factors, and other clinically
indicated tests.
How
long does it take to improve insulin resistance?
Improvements in insulin sensitivity can begin
with physical activity, while more sustained metabolic changes may develop over
weeks or months. Results vary by individual.
When
Should You See a Healthcare Professional?
Seek assessment if you have risk factors for
diabetes, abnormal blood glucose readings, or symptoms such as persistent
thirst, frequent urination, unexplained weight loss, or blurred vision.
If you have established diabetes and develop
vomiting, abdominal pain, deep or rapid breathing, confusion, or severe
dehydration, seek urgent medical care.
These symptoms may indicate a serious
metabolic emergency and should not be managed solely through dietary changes.
Key
Takeaways
Insulin resistance occurs when muscle, liver,
and fat cells respond less effectively to insulin.
It may exist for years without obvious
symptoms.
It is associated with prediabetes, type 2
diabetes, fatty liver disease, PCOS, and cardiovascular risk factors.
Blood glucose and HbA1c tests assess glucose
status but do not directly measure insulin resistance.
Regular exercise, appropriate nutrition,
sustainable weight management, and sufficient sleep can improve metabolic
health.
Selected individuals may also benefit from
prescribed medical treatment.
Nigerian foods can form part of a healthy
eating plan without eliminating all carbohydrates.
Conclusion
Insulin resistance is an important metabolic
problem, but it does not automatically mean that diabetes is inevitable.
The body may become less responsive to
insulin long before blood glucose rises into the diabetes range.
Recognizing risk factors and taking
appropriate preventive steps can make a meaningful difference.
Regular physical activity, balanced meals,
appropriate portion sizes, sustainable weight management, and timely medical
screening can help improve insulin sensitivity and reduce the risk of type 2
diabetes.
The goal is not to search for a miracle cure
but to build healthier metabolic habits that can be maintained over time.
Wellness by Flora
encourages individuals and families to understand insulin resistance, recognize
diabetes risk early, and make informed decisions based on reliable medical
evidence.
Medical
References
- American Diabetes Association Professional Practice
Committee. (2026).
Prevention or Delay of Diabetes and Associated Comorbidities: Standards
of Care in Diabetes—2026. Diabetes Care.
https://doi.org/10.2337/dc26-s003 - American Diabetes Association Professional Practice
Committee. (2026).
Facilitating Positive Health Behaviors and Well-being to Improve Health
Outcomes: Standards of Care in Diabetes—2026. Diabetes Care.
https://doi.org/10.2337/dc26-s005 - National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK).
Insulin Resistance and Prediabetes.
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance - Centers for Disease Control and Prevention (CDC). Prediabetes — Your Chance
to Prevent Type 2 Diabetes.
https://www.cdc.gov/diabetes/prevention-type-2/prediabetes-prevent-type-2.html - American Diabetes Association Professional Practice
Committee. (2026).
Obesity and Weight Management for the Prevention and Treatment of
Diabetes: Standards of Care in Diabetes—2026. Diabetes Care.
https://doi.org/10.2337/dc26-s008 - American Diabetes Association Professional Practice
Committee. (2026).
Pharmacologic Approaches to Glycemic Treatment: Standards of Care in
Diabetes—2026. Diabetes Care.
https://doi.org/10.2337/dc26-s009
About
the Author
Uche Flora Okonkwo, MPH in
Community Health, is a public health professional and founder
of Wellness by Flora, a health education platform dedicated to diabetes
awareness, preventive healthcare, women's health, nutrition, and healthier
living.
Her public health education work focuses on
improving health literacy, promoting early detection of chronic diseases, and
helping individuals and communities make informed healthcare decisions.
Wellness by Flora —
Inspiring Healthier Living Every Day
Website: https://wellnessbyflora.com/
Medical
Disclaimer
This article is provided for general health
education only. It does not replace professional medical advice, diagnosis, or
treatment.
Insulin resistance, prediabetes, and diabetes
require individualized assessment. Blood glucose targets, medication
requirements, dietary plans, and exercise recommendations vary according to
medical history and clinical circumstances.
Do not stop, increase, or change prescribed
medication, begin prolonged fasting, or use herbal remedies as substitutes for
medical treatment without appropriate professional guidance.
Seek urgent medical attention for symptoms of
severe hyperglycemia, ketoacidosis, or other medical emergencies.
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