INSULIN RESISTANCE — THE SILENT PROGRESSION
HOW FASTING GLUCOSE STAYS 'NORMAL' WHILE INSULIN RESISTANCE BUILDS FOR A DECADE
1
OPTIMAL
2
EARLY IR
3
ESTABLISHED IR
4
PRE-DIABETES
5
TYPE 2 DIABETES
HIGH
MID
LOW
LEVEL
Year 0
Year 3–5
Year 6–8
Year 9–12
Year 12+
INSULIN ↑↑ (fasting)
Rising for years before glucose moves
GLUCOSE ↑ (late stage)
"Normal" for years 0–9
Fasting Insulin (optimal: <6 μIU/mL)
Fasting Glucose (normal range: <5.5 mmol/L)
STANDARD GP TESTING SHOWS "NORMAL" ACROSS THIS ENTIRE WINDOW
OPTIMAL
ALL MARKERS GOOD
Glucose: 3.9–5.0
Insulin: 2–6 μIU/mL
HOMA-IR: <1.0
HbA1c: 4.8–5.2%
✓ Good energy
✓ Weight stable
✓ No cravings
Intervention: maintain
lifestyle foundations
GP: no concern ✓
TDG: confirms ✓
EARLY IR
INSULIN RISING
Glucose: 4.8–5.3
Insulin: 8–12 μIU/mL ↑
HOMA-IR: 1.5–2.5 ↑
HbA1c: 5.2–5.5%
⚠ Afternoon crash
⚠ Sugar cravings
⚠ Belly fat building
Intervention: protein
first · move after meals
GP: no concern ✗
TDG: catches this ✓
ESTABLISHED IR
CELLS IGNORING INSULIN
Glucose: 5.0–5.5
Insulin: 14–20 μIU/mL ↑↑
HOMA-IR: 3–5 ↑↑
HbA1c: 5.4–5.6%
✗ Weight loss resistant
✗ Fatigue · brain fog
✗ Raised inflammation
Intervention: strength
training · carb timing
GP: no concern ✗
TDG: HOMA-IR flags ✓
PRE-DIABETES
GLUCOSE FINALLY RISING
Glucose: 5.6–6.9 ↑
Insulin: varies ↑↑
HOMA-IR: >5
HbA1c: 5.7–6.4% ↑
✗ GP now concerned
✗ 5–10 yrs damage done
✗ Cardiovascular risk
Intervention: urgent —
metformin often offered
GP: flagged (late) ✓
TDG: caught years ago
TYPE 2 DIABETES
BETA CELL EXHAUSTION
Glucose: >7.0 ↑↑
Insulin: may drop
HOMA-IR: elevated
HbA1c: >6.5% ↑↑
✗ Medication required
✗ Organ risk begins
✗ Reversal harder
This is why we test
fasting insulin. Now.
GP: treating disease
TDG: preventable
DETECTIVE HEALTH · STEPHEN DUNCAN MSC FDN-P · BLOOD CHEMISTRY TESTING · DETECTIVE-HEALTH.COM