Insulin Resistance

Authored by Chris McDermott, APRN, practicing with autonomous authority in Florida | Intercoastal Health, Florida

Introduction

Insulin resistance is a silent but significant disruptor of metabolic health. Often developing insidiously over years, this condition is a precursor to a host of chronic illnesses, including Type 2 Diabetes, cardiovascular disease, and polycystic ovary syndrome (PCOS). At Intercoastal Health, we utilize a functional medicine lens—centered around identifying root causes and addressing system imbalances—to detect, manage, and reverse insulin resistance before it progresses into more serious disease states.

What is Insulin Resistance?

Insulin is a critical hormone produced by the pancreas, responsible for helping cells absorb glucose from the bloodstream to use for energy or storage. In insulin resistance, the cells—particularly in the liver, muscle, and fat—become less responsive to insulin. This dysfunction forces the pancreas to produce more insulin to maintain normal blood glucose levels. Over time, this compensatory mechanism becomes overwhelmed, leading to hyperinsulinemia, impaired glucose regulation, and eventually, Type 2 Diabetes Mellitus.

From a functional medicine standpoint, insulin resistance reflects deeper metabolic imbalances influenced by lifestyle, diet, hormones, inflammation, stress, and environmental exposures.

Clinical Presentation: Signs and Symptoms

Insulin resistance can remain asymptomatic for years. However, early and progressive symptoms may include:

• Fatigue, particularly after eating carbohydrate-rich meals
  
• Increased hunger and persistent carbohydrate cravings
  
• Abdominal weight gain and difficulty losing weight
  
• Skin changes such as acanthosis nigricans or skin tags
  
• Hormonal disruptions, including irregular menstrual cycles and features of PCOS in women
  
• Mental fog or difficulty concentrating
  
• Elevated blood pressure or lipid abnormalities

Diagnostic Evaluation

At Intercoastal Health, we use a comprehensive, biomarker-driven approach to detect dysfunction early—even before conventional labs flag abnormalities.

Key Diagnostic Tools:

• Fasting Insulin and Glucose
  
• C-Peptide
  
• HbA1c
  
• Oral Glucose Insulin Tolerance Test (OGITT)
  
• Lipid Profile
  
• HOMA2-IR (Homeostasis Model Assessment for Insulin Resistance)

Each laboratory value is interpreted through functional medicine standards, evaluating optimal—not just “normal”—ranges.

Functional Medicine Approach to Root Causes

Insulin resistance is multifactorial. Addressing root contributors allows meaningful, long-lasting improvements.

Common Contributing Factors:

• Dietary Imbalances: Refined carbohydrates and processed food intake
  
• Physical Inactivity: Decreased skeletal muscle glucose uptake
  
• Excess Adiposity: Visceral fat drives inflammation
  
• Chronic Stress: Elevated cortisol impairs insulin sensitivity
  
• Poor Sleep: Disrupts circadian regulation of metabolism
  
• Hormonal Dysregulation: Seen in PCOS, thyroid dysfunction, adrenal insufficiency
  
• Environmental Exposures: Heavy metals, endocrine-disrupting chemicals
  
• Genetic Susceptibility: Modifiable with lifestyle optimization

Functional Implications and Disease Risk

Unchecked insulin resistance heightens risk for:

• Type 2 Diabetes
  
• Cardiovascular Disease
  
• Non-Alcoholic Fatty Liver Disease (NAFLD)
  
• Polycystic Ovary Syndrome (PCOS)
  
• Metabolic Syndrome

Early functional intervention can slow or prevent progression.

Clinical Biomarkers and Functional Ranges

Interfering Factors

Factors that can affect lab results:

• Acute illness, infections
  
• Medications (e.g., corticosteroids, beta-blockers)
  
• High-carbohydrate intake prior to fasting labs
  
• Sleep deprivation or acute stress
  
• Hormonal fluctuations (e.g., menstrual phase)

Medications Impacting Insulin Sensitivity

Medications That May Increase Insulin Resistance:

• Corticosteroids
  
• Atypical antipsychotics
  
• Beta-blockers
  
• Some HIV antivirals
  
• Certain oral contraceptives

Medications That May Decrease Insulin Resistance:

• Metformin
  
• Thiazolidinediones
  
• GLP-1 receptor agonists
  
• SGLT-2 inhibitors

Medication management should be coordinated with licensed healthcare providers.

Functional Interventions at Intercoastal Health

1. Therapeutic Nutrition

• Whole-food, anti-inflammatory, low-glycemic diet
  
• Emphasis on fiber, healthy fats, and quality protein
  
• Strategic meal timing (e.g., circadian eating, time-restricted feeding)

2. Targeted Supplementation

• Berberine
  
• Magnesium
  
• Chromium picolinate
  
• Omega-3 fatty acids
  
• Vitamin D

3. Lifestyle Optimization

• Regular aerobic and resistance exercise
  
• Stress reduction strategies (breathwork, meditation)
  
• Sleep hygiene and circadian rhythm support
  
• Detoxification strategies when environmental toxin load is significant

Empowering Patients Through Education

At Intercoastal Health, we help patients understand that insulin resistance is reversible through consistent, root-cause-focused interventions—not just pharmaceutical management.