Fasting Insulin

HOMA-IR can identify insulin resistance years before HbA1c or fasting glucose becomes abnormal. Early detection allows a person to address metabolic problems before obvious blood-sugar deterioration appears. The article states that fasting insulin can rise substantially while fasting glucose remains nearly normal. Two people can have the same fasting glucose while having very different insulin physiology. Insulin is described as giving proportional, linear feedback about deterioration while glucose does not. A fasting insulin test is more informative than fasting glucose or HbA1c for detecting early metabolic disease, yet it is rarely ordered. Standard medical practice tests fasting glucose, which stays normal for years while insulin resistance progresses. Routine clinical care often misses insulin resistance because insulin sensitivity or fasting insulin is usually not tested. Fasting insulin is the test that would detect insulin resistance early but is almost never ordered in routine care. Standard metabolic tests—fasting glucose and HbA1c—remain normal until metabolic disease is already well advanced. An insulin-resistant person may need much more insulin to maintain the same f…