Part 2 of the Thrive Beyond 50 Diabetes Series
In the first article of this series, we discussed prediabetes and why it often develops silently over many years before most people realize anything is wrong. The encouraging news was that prediabetes is often reversible through healthy lifestyle changes. But that raises an important question: What actually causes prediabetes in the first place?
The answer is something called insulin resistance. If prediabetes is the warning light on your dashboard, insulin resistance is the engine problem that turned the light on. In fact, insulin resistance often begins years, and sometimes decades, before blood sugar ever rises enough to earn the diagnosis of prediabetes or Type 2 diabetes. Understanding this process is one of the most important steps toward protecting your long-term health.
To understand insulin resistance, we first need to understand insulin itself. Insulin is a hormone produced by specialized beta cells in the pancreas. Every time you eat carbohydrates, and to a lesser extent protein, your digestive system breaks those foods down into nutrients that enter your bloodstream. One of those nutrients is glucose, the body’s primary source of energy. As blood glucose begins to rise after a meal, the pancreas releases insulin.
Think of insulin as the body’s traffic director. Its job is to move glucose out of the bloodstream and into the cells where it can be used for energy or stored for later use. Muscle cells, liver cells, and fat cells all respond to insulin’s signal. When everything is working properly, blood sugar rises after a meal, insulin is released, glucose enters the cells, and blood sugar gradually returns to normal. It’s an elegant system that works remarkably well…until it doesn’t.
Imagine trying to have a conversation in a crowded restaurant. At first, everyone hears one another without difficulty. As more people enter the room, the noise level increases. Soon everyone begins speaking a little louder just to be heard. Eventually, people are practically shouting across the table. The message hasn’t changed…the environment has.
A similar process occurs with insulin resistance. Over time, our cells become less responsive to insulin’s message. Scientists are still uncovering every reason why this happens, but excess body fat, particularly around the abdomen, chronic overeating, physical inactivity, poor sleep, chronic stress, genetics, aging, and diets rich in highly processed foods all contribute. The insulin “message” is still being sent, but the cells don’t respond as effectively.
The pancreas responds by doing exactly what you would expect – it simply produces more insulin. This is an incredibly important point that many people never hear. During the early stages of insulin resistance, blood sugar may still appear perfectly normal because the pancreas is working overtime to keep it there. The problem isn’t necessarily high glucose…not yet, at least. The problem is that insulin levels are becoming chronically elevated in an attempt to compensate.
For years, even decades, the pancreas may successfully keep blood sugar within the normal range by producing larger and larger amounts of insulin. On routine laboratory testing, everything may appear fine. Meanwhile, beneath the surface, the body is becoming increasingly resistant to insulin’s effects. Eventually, however, the pancreas can no longer keep up with the increasing demand.
As insulin-producing cells begin to struggle, blood sugar slowly rises. This is often the point where someone is told they have prediabetes. If the underlying insulin resistance continues unchecked, blood sugar climbs further, eventually leading to a diagnosis of Type 2 diabetes. This gradual progression explains why diabetes doesn’t develop overnight. It is usually the final chapter of a story that began years earlier.
Insulin resistance affects far more than blood sugar. Elevated insulin levels influence nearly every organ system in the body. It encourages the storage of excess calories as body fat, particularly around the waistline. It makes weight loss more difficult for many people. It contributes to abnormal cholesterol patterns, elevated triglycerides, high blood pressure, fatty liver disease, chronic inflammation, and an increased risk of cardiovascular disease. In many ways, insulin resistance sits at the center of what healthcare providers refer to as metabolic syndrome.
One of the reasons I emphasize resistance training so often is because muscle is one of the body’s greatest allies in fighting insulin resistance. Healthy muscle acts like a giant sponge for glucose. When you exercise, especially during resistance training, your muscles pull glucose from the bloodstream to use as fuel. Even more impressive, contracting muscles can absorb glucose with less dependence on insulin, helping lower blood sugar naturally. Building and maintaining muscle therefore improves the body’s ability to manage glucose while simultaneously increasing metabolic health.
Beginning around the age of 30, adults gradually lose muscle mass unless they actively work to preserve it. By the time many people reach their sixties or seventies, years of muscle loss combined with decreased physical activity can significantly reduce the body’s ability to regulate glucose efficiently. It’s yet another reminder that strength training isn’t just about looking better; it’s about improving how your body functions every single day.
The good news is that insulin resistance is not an irreversible condition.
-Weight loss, when appropriate, often improves insulin sensitivity.
-Regular physical activity helps muscles respond better to insulin.
-Resistance training builds new muscle tissue that can absorb more glucose.
-Walking after meals helps lower blood sugar.
-Eating adequate protein supports muscle maintenance, while increasing fiber and reducing ultra-processed foods improves overall metabolic health.
-Quality sleep and effective stress management also play surprisingly important roles.
These aren’t isolated recommendations; they work together.
Each healthy choice nudges your metabolism back toward balance. One workout won’t reverse years of insulin resistance, just as one unhealthy meal doesn’t cause diabetes. But hundreds of healthy decisions accumulated over months and years can profoundly improve how your body responds to insulin.
Dr. Edwards’ Take
One of the biggest shifts I hope people make is changing the way they think about diabetes. Too often, we focus entirely on blood sugar while overlooking the years of insulin resistance that came before it. If we wait until glucose becomes elevated before making changes, we’ve missed a tremendous opportunity.
This is one reason I appreciate functional medicine. Rather than asking, “What disease does this person have?” we also ask, “What process is driving the disease?” Insulin resistance is one of those underlying processes. The earlier we recognize it, the more opportunity we have to change its course.
In the next installment of this series, we’ll take a closer look at Type 2 diabetes itself. We’ll explore exactly what happens inside the body as insulin resistance progresses, why blood sugar eventually rises, and why understanding the disease process is the first step toward taking control of your health.
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