Who is it evaluated for?
A more detailed metabolic evaluation may be considered in individuals with increased waist circumference, prediabetes, a high triglyceride–low HDL pattern, fatty liver, PCOS, hypertension, or a family history of type 2 diabetes.
How is it planned?
Waist circumference, body composition, glucose-HbA1c, lipids, blood pressure, liver, and personal risks are addressed together. When necessary, fasting insulin and other tests are added; nutrition, physical activity, sleep, weight management, and appropriate medical options are planned individually.
Are insulin resistance and metabolic syndrome the same thing?
No. Although insulin resistance and metabolic syndrome are closely related, they are not synonymous. Metabolic syndrome is a clinical picture in which cardiometabolic risk components such as abdominal adiposity, impaired glucose metabolism, high triglycerides, low HDL, and high blood pressure coexist. Insulin resistance can be an important pathophysiological component of this picture; however, not everyone with insulin resistance meets the criteria for metabolic syndrome, and the evaluation of metabolic syndrome does not rely on insulin levels alone.
In which situations does it come to mind?
- Increase in waist circumference and visceral adiposity
- Prediabetes or borderline high fasting glucose/HbA1c
- High triglycerides and low HDL
- Hypertension
- Polycystic ovary syndrome
- Metabolic dysfunction-associated steatotic liver disease
- Family history of type 2 diabetes
- Physical inactivity and obesity
Which tests can be evaluated?
Fasting glucose and HbA1c are the basic baseline tests for most people. When necessary, an oral glucose tolerance test, fasting insulin, and other tests appropriate for the clinical context may be used. Calculations such as fasting insulin or HOMA-IR can provide complementary information in some cases; however, they should not be treated as a standalone diagnostic “insulin resistance test.”
What does the triglyceride/HDL ratio signify?
The triglyceride/HDL ratio can provide a practical clue about metabolic risk and suggest patterns associated with insulin resistance. Nevertheless, due to age, sex, ethnic characteristics, medications, and laboratory context, it is not a standalone diagnostic criterion. In our clinic, when evaluating the lipid panel, we also interpret this ratio as part of the overall risk picture.
Treatment approach
The strongest foundation consists of sustainable weight management, resistance and aerobic exercise, sleep regulation, a diet containing adequate protein and fiber, cessation of tobacco use, and management of accompanying blood pressure/lipid problems. In individuals who need weight loss, the focus is not only on the number on the scale, but also on waist circumference and the preservation of muscle mass.
In some individuals with prediabetes or a high risk of developing type 2 diabetes, medications such as metformin or pharmacological options used in the treatment of obesity may be appropriate. The choice is made together with BMI, accompanying diseases, pregnancy planning, medications, and individual goals.
Is a CGM necessary?
Continuous glucose monitoring can help some individuals understand the relationship between meals, activity, and glucose responses. However, it is not routinely necessary for everyone without diabetes. When used, the aim should not be to create unnecessary food fear, but to see meaningful patterns.
Our approach at our Bodrum clinic
We do not evaluate insulin resistance merely as “high insulin.” Body composition, waist circumference, blood pressure, glucose/HbA1c, lipid profile, liver health, sleep, and physical capacity are addressed together. For preparation for the initial consultation, address, and appointment information, you can review the Bodrum Clinic page.
Related guides
- Weight Management and Metabolic Health
- Healthy Aging and Longevity
- Obesity and Inability to Lose Weight
- Metabolic Support IV
- IV and Infusion Therapies
Frequently asked questions
Is insulin resistance diabetes?
No. Insulin resistance can be a metabolic background where diabetes risk may increase; however, the diagnosis of diabetes is made using standard glucose and HbA1c criteria.
Can insulin resistance completely resolve?
In many individuals, significant improvement in metabolic indicators can be seen with weight management, physical activity, sleep, and appropriate medical treatment. The response varies from person to person, and long-term sustainability is important.
Can insulin resistance be present even if HbA1c is normal?
Yes, it can. HbA1c reflects average glucose exposure over the past few months; it does not directly measure insulin sensitivity. Even in the presence of a normal HbA1c, waist circumference, lipid pattern, fasting glucose, clinical risks, and additional tests when necessary are evaluated together.
Does HOMA-IR alone diagnose insulin resistance?
No. HOMA-IR is an auxiliary indicator calculated from fasting glucose and insulin. Because threshold values can vary depending on the laboratory method used and the population, it should not be used as a standalone diagnostic tool.
Are prediabetes and insulin resistance the same thing?
No. Prediabetes is a glycemic condition defined by standard glucose or HbA1c criteria. Insulin resistance may contribute to the development of prediabetes, but the two concepts are not synonymous.
References
Written and medically reviewed by: Dr. Kerem Çağlayan
Last medical review: September 10, 2026
