Ulta Lab Tests

Insulin Resistance

Insulin resistance happens when your cells don’t respond well to insulin, so your pancreas makes more to keep blood sugar normal. Over time, this higher insulin demand can raise the risk for prediabetes, type 2 diabetes, fatty liver (NAFLD), and heart disease. A proactive testing plan starts with fasting insulin paired with fasting glucose to estimate HOMA-IR, then adds A1c for long-term glucose trends and a lipid panel for cardiometabolic risk. When results are unclear—or you need a deeper look—tests like a 2-hour oral glucose tolerance test (OGTT) with insulin, C-peptide, and liver enzymes (ALT/AST) can add clarity.

Lab testing can reveal early insulin resistance, set a baseline, and track trends with your clinician. Testing cannotdiagnose or manage by itself, replace a full clinical evaluation, or give treatment advice. Use results with your history, vitals, and (if used) home glucose or CGM data.

Signs, Symptoms & Related Situations

  • Metabolic clues: central weight gain, fatigue after meals, sugar cravings, acanthosis nigricans (dark, velvety neck/skin folds), skin tags.

  • Cardiometabolic risk: high triglycerides, low HDL cholesterol, elevated blood pressure, family history of diabetes or heart disease, sleep apnea.

  • Women’s health: irregular periods or signs of PCOS (polycystic ovary syndrome).

  • When to seek urgent care: severe high-sugar symptoms (vomiting, rapid breathing, confusion, fruity breath) or severe low sugar if on glucose-lowering therapy.
    All symptoms should be evaluated by a qualified clinician.

Why These Tests Matter

What testing can do

  • Detect early insulin excess even when glucose appears “normal.”

  • Stratify cardiometabolic risk with lipids and liver enzymes.

  • Provide objective trends to guide follow-up timing with your clinician.

What testing cannot do

  • Replace clinician judgment, blood pressure/waist checks, or eye/foot exams where indicated.

  • Explain every swing in numbers—hydration, stress, illness, timing, and medicines affect results.

What These Tests Measure (at a glance)

  • Fasting Insulin: baseline insulin output. Best for: estimating resistance with fasting glucose (HOMA-IR). Caveat:must be truly fasting; assays vary.

  • Fasting Glucose: current glucose after an 8–12-hour fast. Best for: baseline status. Caveat: stress/illness can skew results.

  • HOMA-IR (calculated): (fasting insulin × fasting glucose) ÷ constant; higher values suggest resistance. Caveat:method- and unit-dependent; use trends, not single cutoffs.

  • A1c: average glucose over ~2–3 months. Best for: long-term trend. Caveat: can be unreliable with some anemias, kidney disease, pregnancy, or hemoglobin variants.

  • OGTT with Insulin (0/60/120 min): glucose and insulin responses after a glucose drink. Best for: uncovering post-meal spikes and hyperinsulinemia. Caveat: requires strict timing and prep.

  • C-Peptide: your body’s insulin production (endogenous insulin). Best for: separating insulin production vs. action questions. Caveat: interpret with glucose/insulin.

  • Lipid Panel (TG, HDL, LDL): cardiometabolic risk; TG/HDL ratio can hint at insulin resistance. Caveat: keep fasting status consistent.

  • ALT/AST (Liver Panel): screening clues for fatty liver (NAFLD). Caveat: many non-liver and non-metabolic causes exist.

  • hs-CRP (optional): systemic inflammation context. Caveat: nonspecific; interpret with other risk markers.

  • Uric Acid (optional): metabolic risk signal in some individuals. Caveat: affected by diet/medications.

How the Testing Process Works

  1. Choose a starting set: fasting insulin + fasting glucose (to calculate HOMA-IR), A1c, and a lipid panel; consider ALT/AST for NAFLD risk.

  2. Prepare & collect: follow fasting instructions (typically 8–12 hours); standard blood draw.

  3. View results: most labs post within a few days in your secure account.

  4. Follow up: review results with your clinician; if needed, add OGTT with insulin and/or C-peptide for deeper insight.

  5. Monitor trends: repeat selected labs on a schedule to track change over time.

Interpreting Results (General Guidance)

  • High fasting insulin/HOMA-IR with normal glucose suggests early resistance—track trends and risk markers.

  • Normal fasting glucose but high 2-hour OGTT glucose or insulin points to post-meal dysregulation.

  • High TG/low HDL strengthens the case for insulin resistance and higher cardiometabolic risk.

  • A1c vs daily reality: if A1c and home/CGM readings disagree, confirm with fasting/post-meal glucose or OGTT.
    Always interpret results with a qualified healthcare professional.

Choosing Panels vs. Individual Tests

  • Foundational screen: Fasting insulin + fasting glucose (HOMA-IR) + A1c + lipid panel ± ALT/AST.

  • Borderline or mismatched results: add OGTT with insulin to assess post-meal response; consider C-peptide.

  • Ongoing risk tracking: repeat A1c, lipids, and fasting insulin/glucose to watch trends; add ALT/AST if NAFLD risk is present.

  • Special situations (A1c limitations): consider fructosamine or glycated albumin for 2–3-week feedback.

FAQs

Can I have insulin resistance even if my glucose is normal?
Yes. Elevated fasting insulin/HOMA-IR or OGTT insulin can show early resistance before glucose rises.

Is there one best test for insulin resistance?
No single test fits everyone. Many start with fasting insulin + glucose (HOMA-IR) and A1c, then add OGTT with insulin if needed.

Do I need to fast?
Yes for fasting insulin/glucose and usually for lipids. A1c does not require fasting.

What if my A1c seems off?
Confirm with fasting/post-meal glucose, OGTT, or a short-term marker such as fructosamine if appropriate.

Does a high TG/HDL ratio mean insulin resistance?
It’s a risk signal, not a diagnosis. Interpret with glucose/insulin results and other factors.

Can liver tests relate to insulin resistance?
Yes. Elevated ALT may reflect fatty liver, which often travels with insulin resistance—discuss next steps with your clinician.

Internal Links & Cross-References

  • Diabetes Tests Hub

  • Prediabetes & Insulin Resistance

  • Diabetes Screening

  • Blood Sugar Monitoring

  • A1c Testing

  • Lipid Panel & Heart Risk

  • Key Lab Tests: Fasting Insulin • Fasting Plasma Glucose • HOMA-IR (Calculated) • A1c • OGTT with Insulin • C-Peptide • Lipid Panel • ALT/AST • Fructosamine

References

  1. American Diabetes Association. Standards of Care in Diabetes—Prediabetes and Type 2 Diabetes: Screening and Diagnosis.

  2. National Institute of Diabetes and Digestive and Kidney Diseases. Insulin Resistance and Prediabetes.

  3. Endocrine Society. Clinical guidance on insulin resistance and evaluation in adults; PCOS evaluation principles.

  4. American Heart Association/NHLBI. Metabolic Syndrome: Assessment and Cardiometabolic Risk.

  5. American Association for the Study of Liver Diseases. NAFLD Practice Guidance—Metabolic Risk and ALT Elevations.

  6. National Glycohemoglobin Standardization Program. Factors That Interfere With HbA1c Results.

  7. International Federation of Clinical Chemistry. Harmonization considerations for insulin assays and reporting.

Available Tests & Panels

Your insulin resistance test menu is pre-populated in the Ulta Lab Tests system. Start with fasting insulin + fasting glucose (to calculate HOMA-IR) plus A1c and a lipid panel; add ALT/AST for NAFLD risk. If results are unclear or mismatched, consider an OGTT with insulin and C-peptide. Use filters to compare individual markers and bundled panels, and review all results with your clinician.

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The GGT Test measures gamma-glutamyl transferase, an enzyme found in the liver and bile ducts, to evaluate liver health. Elevated GGT may indicate liver disease, bile duct obstruction, alcohol use, or medication side effects. Doctors order this test to investigate symptoms like fatigue, jaundice, dark urine, or abdominal pain and to monitor liver damage. It is often performed with other liver tests to provide a complete picture of liver and bile duct function.

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Also Known As: Gamma Glutamyl Transferase Test, Gamma Glutamyl TransPeptidase Test, GGTP Test, GTP Test
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The Glucagon Test evaluates hormone levels that regulate glucose by stimulating the liver to release stored sugar. Elevated or low glucagon may indicate diabetes, hypoglycemia, metabolic disorders, or pancreatic disease. This test provides insight into endocrine activity, glucose balance, and systemic health conditions related to energy metabolism and hormonal function.

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The Hemoglobin A1c (HbA1c) Test measures average blood glucose over 2–3 months by detecting sugar attached to hemoglobin in red blood cells. It is used to diagnose diabetes, identify prediabetes, and monitor long-term blood sugar control. Doctors rely on the HbA1c test to evaluate treatment effectiveness, guide adjustments, and assess risk for complications, making it essential for diabetes care and metabolic health screening.

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Also Known As: A1c Test, HbA1c Test, Glycated Hemoglobin Test
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The Islet Cell Antibody Screen with Reflex to Titer detects autoantibodies directed against pancreatic islet cells, which play a key role in insulin production. The presence of islet cell antibodies suggests autoimmune destruction of beta cells, often associated with type 1 diabetes or latent autoimmune diabetes in adults (LADA). Reflex testing to titer quantifies antibody concentration for diagnostic confirmation.

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The Testosterone Free and Total Test measures total testosterone and free, bioavailable testosterone in blood for both men and women. It helps diagnose hormone imbalance, infertility, low libido, erectile dysfunction in men, irregular periods, or PCOS in women. Doctors also order it to assess fatigue, mood changes, or muscle weakness and to monitor hormone therapy. This test provides key insight into reproductive, endocrine, and overall metabolic health.

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Also Known As: Bound and Unbound Testosterone, Uncapped Testosterone Test
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The Testosterone Total Male Test measures testosterone levels in men to assess reproductive, sexual, and hormonal health. It helps diagnose low testosterone (hypogonadism), infertility, and erectile dysfunction. Doctors use it to evaluate fatigue, muscle loss, or low libido and to monitor testosterone therapy, hormonal balance, bone health, and overall metabolism.

Patient must be male and 18 years of age or older.
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The Testosterone Total Test measures total testosterone levels in blood to evaluate reproductive, sexual, and endocrine health. In men, it helps diagnose hypogonadism, infertility, erectile dysfunction, or low libido. In women, abnormal levels may indicate PCOS or hormonal imbalance. Doctors use this test to investigate fatigue, muscle weakness, or mood changes and to monitor testosterone therapy. It provides key insight into hormone balance and metabolic health.

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Also Known As: Total Testostone LCMS Test, Uncapped Testosterone Test
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The Triglycerides Test measures triglyceride levels in blood to evaluate heart health and metabolic function. High levels may increase risk for cardiovascular disease, atherosclerosis, or pancreatitis, while low levels may reflect nutritional issues. Doctors use this test as part of lipid screening to assess patients with obesity, diabetes, or high cholesterol. Results provide vital insight into fat metabolism, cardiovascular risk, and overall wellness management.

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The Uric Acid Test measures uric acid levels in blood to assess kidney function and detect gout, a form of arthritis caused by uric acid buildup. High levels may also signal kidney disease, kidney stones, or metabolic disorders, while low levels can occur with liver disease. Doctors use this test to investigate joint pain, swelling, or frequent urination, and to monitor treatment for gout, kidney stones, or chemotherapy-related complications.

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The Zinc Transporter 8 Antibody Test detects autoantibodies targeting the ZnT8 protein, a marker associated with autoimmune diabetes, including type 1 diabetes and latent autoimmune diabetes in adults (LADA). These antibodies appear early in disease development and can help distinguish autoimmune diabetes from type 2 diabetes. This test provides insight into pancreatic autoimmunity, beta cell damage, and progression of autoimmune disorders.

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Also Known As: ZnT8 Antibody Test
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The GLP-1 Basic Blood Test Panel provides a comprehensive baseline for metabolic health by evaluating glucose control, insulin levels, lipids, thyroid function, organ health, and blood cell markers. Designed to support GLP-1–related monitoring and preventive care, this panel delivers clinically relevant insights that help patients and healthcare providers understand metabolic trends, assess risk, and track changes over time.

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Insulin Resistance And Common Testing Procedures

Insulin resistance affects over one-third of American adults. Many of those adults will go on to develop diabetes and a host of related conditions, including metabolic syndrome, which can lead to strokes, heart attacks, and other serious conditions. 

Many people believe they will be able to tell when their blood sugar levels change, and they begin to develop insulin resistance. Unfortunately, most people don't develop any symptoms until insulin resistance has progressed to much more serious conditions. That's where insulin resistance tests come in. 

This is because not only is insulin resistance manageable, but it can also be reversible. The key to reversing insulin resistance is catching it early. If you're able to do so before it becomes prediabetes or even Type 2 diabetes, you can take charge of your health and make informed decisions.

Read on to learn about insulin resistance, when most people begin to develop symptoms, and how you can get safe, secure, and reliable insulin resistance tests, even without health insurance.

What Is Insulin Resistance?

Insulin resistance is an extremely common condition. It occurs when your body's cells don't respond as well to the hormone and therefore don't use the glucose (sugar) from your blood as effectively. Your pancreas responds to the higher levels of glucose in your blood by producing more insulin. 

About Insulin Resistance

While your body may be able to adjust for a while, insulin resistance can worsen over time. As more glucose builds up in your blood and your body produces even more insulin, your cells can become resistant to it. As insulin resistance progresses, it can lead to diabetes, hypoglycemia, and hyperglycemia.

Insulin resistance syndrome can also include a host of related conditions. In addition to diabetes, these include high cholesterol, high blood pressure, and obesity. 

Insulin resistance is extremely common, and it frequently progresses to diabetes. The CDC estimates that over 1 in 3 adults in the United States are prediabetic, and over 10% of the adult population has diabetes.

Risk Factors for Insulin Resistance

Since insulin resistance is so common, most adults are at risk for developing it, especially as they age. Your doctor will likely recommend that you get tested for insulin resistance and diabetes at age 40, along with tests for other markers of health, even if you are not experiencing symptoms and have no other risk factors.

For younger adults, testing is advisable if you have any of these risk factors:

  • Obesity, especially with a high percentage of belly fat
  • Family history of diabetes
  • Previous diagnosis of gestational diabetes
  • Have other health conditions, such as sleep apnea, polycystic ovary syndrome (PCOS), or nonalcoholic fatty liver disease
  • Sedentary lifestyle
  • High blood pressure
  • Smoking
  • Diet high in carbohydrates
  • Are African-American, Latino, or Native American

Causes of Insulin Resistance

Researchers aren't entirely sure what causes insulin resistance. They believe that the link between weight gain, especially belly fat, and insulin resistance may result from chronic inflammation caused by hormones produced by belly fat.

Lack of physical activity can also be a cause of insulin resistance. Regular physical activity helps your body regulate your blood glucose levels.

While there is still a lot of research to be done, this information is enough to help you take charge of your health. If you know you have insulin resistance, you can make changes that may help you avoid progressing to prediabetes or diabetes. 

Signs and Symptoms of Insulin Resistance

Since your body is working so hard to make up for insulin resistance, many people have few symptoms, especially at first. Even once symptoms begin to appear, it's impossible to tell if you have insulin resistance syndrome just based on how you feel.

There are, however, some signs and symptoms to watch out for:

  • darkened skin, especially on the armpits, neck, and groin
  • skin tags
  • fatigue
  • increased hunger or thirst
  • cravings for sweet or salty foods
  • frequent urination
  • tingling in hands or feet

Many people, however, will not experience these symptoms until their insulin resistance has progressed to prediabetes or even diabetes. It would be best if you also kept a close eye on other signs that indicate a higher risk for insulin resistance syndrome, such as:

  • a waistline over 40 inches in men and 35 inches in women
  • high blood pressure
  • high fasting glucose levels
  • high triglyceride levels

The good news is that you can reverse insulin resistance with physical activity and weight loss, adjustments in diet, and other lifestyle changes. Testing for insulin resistance with Ulta Lab Tests can help you take control of your health and take preventative measures before insulin resistance progresses to more serious conditions.

Lab Tests for Insulin Resistance

No single test can determine whether you have developed insulin resistance with 100% accuracy. However, a few standard, non-invasive blood tests taken together can provide results on insulin resistance as well as other indicators of type 2 diabetes and related conditions. If you have many symptoms and/or risk factors for diabetes, your doctor may recommend more comprehensive blood panels or additional tests.

Two standard tests, insulin and glucose tests are frequently used to evaluate insulin resistance. There are also hemoglobin tests that show your average blood sugar levels over the last 2-3 months and help diagnose diabetes. Lipid panels and others can also provide more information about your overall health and possible insulin resistance or prediabetes.

Glucose Tests

There are three common types of glucose tests:

  • Fasting glucose test - After fasting for at least 8 hours, this test measures your blood sugar.
  • Oral glucose tolerance test - Just as with the fasting plasma glucose test, you'll fast for at least 8 hours and then take the test. You'll then drink a sugary solution. After another 2 hours, you'll retake the test to compare differences in blood sugar levels.
  • Insulin response to glucose test - The insulin response to glucose infusion is helpful in evaluating patients with hypoglycemia and suspected insulin resistance.

These tests are very similar. Either can help you evaluate whether you have insulin resistance or other related blood sugar problems.

Hemoglobin A1C Tests

This test evaluates your average blood sugar levels over 2 to 3 months. This is especially useful if you show symptoms of prediabetes or diabetes and are often part of a full panel of tests to determine whether you have diabetes or are at risk of contracting diabetes soon.

Additional tests can be ordered to determine levels of insulin resistance and gather essential information could include:

Insulin testing: While results from a fasting test can vary, it's typical for people with severe insulin resistance to show elevated levels

hs-CRP testing: This can evaluate cardiac risk by looking at low levels of inflammation in the body. Insulin resistance can cause an increase in inflammation.

LDL-P testing: This measures the number of low-density lipoprotein particles in the body via lipoprotein sub-fractions testing. It's believed that certain types of LDL particles, such as small and dense particles, are linked to an increased risk for cardiovascular disease.

Insulin tolerance testing: Although this type of testing isn't common, it's one way to determine how sensitive to insulin a person is. The test is beneficial for people that are obese or suffering from PCOS. During the test, a person will receive an insulin infusion via an IV. From there, levels of insulin and glucose will be measured.

FAQ About Insulin Resistance and Insulin Resistance Tests

It can be overwhelming to realize that you may have insulin resistance and related conditions. And with so many tests available, it can be challenging to make sense of your options. Read on for helpful answers to frequently asked questions about insulin resistance and insulin resistance tests. 

Won't I Start Feeling Bad if I Am Developing Insulin Resistance?

Not necessarily. While some people will begin to experience the symptoms listed above before their insulin resistance syndrome progresses, other people won't feel any different until they are prediabetic or even have full diabetes. 

Your body is adept at compensating for insulin resistance, and your pancreas is working hard to make up for it. That's part of why you won't necessarily feel bad until you've progressed beyond insulin resistance.

If I Develop Insulin Resistance, Will I Definitely Get Diabetes?

No, the good news is that insulin resistance can be slowed, stopped, and even reversed. You might not even need medication. Many people can adjust their blood sugar levels and reverse insulin resistance with diet and lifestyle changes.

Some of the most important lifestyle changes that you can make now are quitting smoking, moderating your consumption of alcohol, exercising, and eating a balanced, healthy diet.

Just 30 minutes a day of moderate physical activity 5 days a week can make a huge difference. You don't have to run a marathon--even brisk walking can transform your body and help reverse insulin resistance.

A balanced diet, including lots of fruits and veggies, whole grains, lean meat, and other sources of protein, can also help. Studies have shown that losing just 5 to 7 percent of your body weight can help reduce your risk of getting diabetes.

Depending on the severity of your insulin resistance and other symptoms and risk factors, your doctor may prescribe a medication called metformin. This helps control your blood sugar.

Can't I Just Change My Lifestyle Without Getting Tested?

It certainly helps to make lifestyle improvements no matter what. However, while very common and potentially reversible, insulin resistance is also very dangerous. In addition to leading to type 2 diabetes, it and other related conditions can lead to severe complications if left untreated. These include stroke, heart attack, kidney disease, eye problems, Alzheimer's disease, and others.

The best thing you can do for your health is arm yourself with information, then consult with your doctor about your test results. The more you know about your condition, the better you can manage and even reverse your insulin resistance while also monitoring any possible complications.

What Is the Best Test for Me?

It depends on your concerns, symptoms, and the risk factors outlined above. Suppose you are in good health and don't have any risk factors for insulin resistance or diabetes but want to make sure that you aren't beginning to develop insulin resistance without being aware of it. In that case, a simple insulin resistance panel might be best.

This panel requires overnight fasting. It then uses a combination of markers to evaluate the insulin levels in your blood.

On the other hand, if you are experiencing worrisome symptoms, have a family history of diabetes, or are otherwise high-risk, you may be better served by a full Diabetes & Insulin Resistance panel. These panels include all of the tests mentioned above, as well as a few others, and also require fasting overnight.

Is My Information Safe?

Absolutely. Your results will be available in your secure web portal. No one else will have access to your information unless the release of test results is ordered by law.

Do I Need Health Insurance or a Physician Referral?

We don't require a referral from a doctor, and we offer the same low prices to everyone, with or without health insurance.

What You Can Do Next

Insulin resistance, while very common, is a potentially harmful condition that can progress to prediabetes and type 2 diabetes. It can even lead to dangerous or fatal events, like a heart attack or stroke.

However, the good news is that you can take your health into your own hands. Book simple, secure insulin resistance tests today, and get the information you need to make decisions about your health and lifestyle.