What insulin resistance is
Insulin helps muscle, fat and liver cells use glucose. When they respond less to it, the pancreas can produce more insulin (compensatory hyperinsulinemia) to keep glycemia normal. If this compensation is not enough, glycemia rises. Insulin resistance and prediabetes are not synonyms: resistance can exist with normal glycemia. When the pancreatic beta cells can no longer compensate, type 2 diabetes develops.
Who is at higher risk
Risk is linked to overweight, especially abdominal fat (overweight and obesity), low physical activity and a family history of diabetes. Previous gestational diabetes, polycystic ovary syndrome, fatty liver, dyslipidemia, hypertension and some metabolic disorders also matter. There are often no symptoms. Dark, thick patches on the neck or armpits (acanthosis nigricans) may accompany insulin resistance, but do not establish the diagnosis.
How prediabetes is diagnosed
Fasting glycemia, HbA1c or the glucose tolerance test (glycemia 2 hours after 75 g of glucose) is used, as appropriate. The relevant values are: fasting glycemia 100–125 mg/dl (5.6–6.9 mmol/L), HbA1c 5.7–6.4%, 2-hour glycemia after the load 140–199 mg/dl. Results are interpreted taking into account conditions that can affect the test, such as anemia or recent illness. Measuring insulin and indices such as HOMA-IR do not replace the glycemic criteria and are not automatically needed in every patient. A single result should not be interpreted without context.
What you can do
A plan with suitable nutrition, physical activity and weight control can lower the risk of type 2 diabetes; even a moderate weight loss, around 5–7% of body weight, and physical activity of at least about 150 minutes a week reduce the risk considerably. Goals should be achievable and fit the state of health. In selected patients, medicines may also be needed. They are not prescribed just because an insulin test is raised. For nutrition see nutrition and home care.
How often checks are needed
The doctor sets the follow-up interval; for prediabetes glycemia is checked at least yearly, while visits take place every 6 months to a year, or sooner when the doctor considers it reasonable. Blood pressure (target below 130/80 mmHg, blood pressure 13 over 8), the lipid profile and weight are also assessed. An improved test does not remove the need for follow-up.
Care at Tirana Polyclinic: we offer endocrinology consultation, interpretation of tests and an individualized plan for controlling metabolic risk.
Key sources
This information is educational and does not replace a visit to the doctor. Do not change your treatment without consulting your doctor. Updated: October 2026.