Why Insulin Matters — Long Before Diabetes

What insulin really does, why I pay attention early, and why early changes are often fixable

When we talk about metabolic health, insulin often gets a bad reputation. We hear phrases like “insulin resistance” and assume insulin itself is the problem.

But insulin is not a bad hormone.

Insulin is a hormone of repair, and we actually want insulin to work well. The goal is not to eliminate insulin or suppress it aggressively — the goal is to have just the right amount, at the right time.

Problems arise when insulin is chronically too high or *chronically too low. Both states impair health.

What Insulin Actually Does (When It’s Working Properly)

When insulin is functioning well, it:

• Keeps blood sugar stable

• Helps build and maintain muscle

• Counters cortisol (the stress hormone)

• Supports brain health and memory

• Plays a role in mood and serotonin production

• Supports tissue repair and metabolic balance

  
  

So when insulin stops working efficiently — what we call insulin resistance — the consequences go far beyond blood sugar.

Insulin: The Hormone and the Medication

Insulin is also the injected medication that many people with diabetes eventually need when other medications are no longer effective. In that situation, insulin replaces what the body can no longer produce adequately.

But long before insulin becomes a medication, it is a natural hormone made in the pancreas. It is released every time we eat foods that contain glucose (carbohydrates). Insulin’s job is to move glucose out of the bloodstream and into cells, where it can be used for energy or repair.

When insulin rises too early, too high, or falls too low — especially in the fasting state — it’s often an early sign that the body is struggling to regulate blood sugar properly. This usually happens years before pre-diabetes or diabetes is diagnosed.

At this stage, the problem is often correctable.

Why I Check More Than Just Blood Sugar

Earlier in my career, I didn’t routinely check fasting insulin. Like many physicians, I focused on fasting glucose and HbA1c — the standard tests used to diagnose diabetes.

With additional training in metabolic and hormone health, I realized how much information we were missing.

Fasting insulin is a simple, inexpensive test — often around a $10 blood draw — yet it provides incredibly valuable insight. I now routinely order it as part of my basic lab panel.

Insulin often becomes abnormal long before fasting glucose or HbA1c do.

A Smarter Metabolic Baseline

I use a baseline lab panel that gives us actionable information, not just a pass-or-fail diagnosis.

This typically includes:

• Fasting insulin

• Fasting glucose

• HbA1c

• Additional metabolic and hormone markers when appropriate

  
  

These labs help us understand:

• How efficiently your body is using insulin

• Whether you’re trending toward insulin resistance

• How hormones and metabolism are interacting

• Risk long before diabetes develops

  
  

And yes — we care whether these labs are normal or abnormal.

Trends matter. Early changes matter. Prevention matters.

Understanding HbA1c (and Why I Aim Lower)

HbA1c reflects your average blood sugar over about three months.

Here’s how it’s typically categorized:

• Optimal / ideal: ~5.4

• Prediabetes: 5.7 or higher

• Diabetes: 6.5 or higher

  
  

By the time someone reaches the pre-diabetes range, insulin dysfunction has usually been present for years.

This is why I focus on catching insulin problems earlier — what I often call pre-pre-diabetes — when intervention is most effective.

Why Insulin Resistance Matters (Beyond Blood Sugar)

Insulin resistance is associated with:

• Memory loss and loss of brain tissue

• Weight gain and metabolic slowdown

• Cardiovascular disease and hypertension

• Bone loss

• Increased breast cancer risk (insulin resistance and obesity are very commonly linked)

  
  

This is not just about preventing diabetes. It’s about protecting brain health, heart health, bone health, and long-term vitality, especially for women in midlife.

The Takeaway

Insulin isn’t the villain.

• Too much insulin for too long → problems

• Too little insulin for too long → problems

• Balanced insulin = repair, stability, and protection

  
  

This is why I pay attention to insulin early, long before diabetes develops.

In the next post, I’ll share the practical nutrition, lifestyle, and supplement strategies that can meaningfully improve insulin resistance.