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How to Catch Insulin Resistance Early - High-Yield Tests Part 1

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Manage episode 507195674 series 3354367
Content provided by Nick Sterling, MD, PhD, Nick Sterling, and MD. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Nick Sterling, MD, PhD, Nick Sterling, and MD or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
In this episode, we cover the highest-yield lab tests to spot insulin resistance early—often years before routine screening would. I walk through how insulin works, why insulin resistance can be silent for a decade, and which metrics actually move the needle for long-term metabolic health.We dig into fasting glucose and A1C, fasting insulin, and combined indices like HOMA-IR and QUICKI. I also explain when an oral glucose tolerance test or a continuous glucose monitor can add value, the limitations of single time-point labs, and why calibration matters for CGMs. Finally, I preview how lipid test — particularly triglyceride-to-HDL ratio—can flag insulin resistance.Chapter Markers00:00 — Intro00:28 — Insulin resistance as a foundation01:11 — Common causes of mortality in U.S.02:07 — What insulin does (and what goes wrong)02:57 — Glucose tests: fasting glucose & A1C basics04:20 — Early signal: fasting insulin (typical ranges)05:16 — Combined indices: HOMA-IR & QUICKI (cutoffs & caveats)06:18 — OGTT & CGM07:31 — Continuous glucose monitor caveats09:10 — TG/HDL ratio for insulin resistanceHOMA-IR Calculatorhttps://www.mdcalc.com/calc/3120/homa-ir-homeostatic-model-assessment-insulin-resistanceQUICKI Calculatorhttps://www.mdapp.co/insulin-sensitivity-quicki-calculator-324/Quick Referencehttps://nicksterling.com/2025/09/18/quick-reference-guide-tests-for-insulin-resistance-part-1/Spotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9This content is not medical advice, is for general information purposes only,and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.
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19 episodes

Artwork
iconShare
 
Manage episode 507195674 series 3354367
Content provided by Nick Sterling, MD, PhD, Nick Sterling, and MD. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by Nick Sterling, MD, PhD, Nick Sterling, and MD or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://podcastplayer.com/legal.
In this episode, we cover the highest-yield lab tests to spot insulin resistance early—often years before routine screening would. I walk through how insulin works, why insulin resistance can be silent for a decade, and which metrics actually move the needle for long-term metabolic health.We dig into fasting glucose and A1C, fasting insulin, and combined indices like HOMA-IR and QUICKI. I also explain when an oral glucose tolerance test or a continuous glucose monitor can add value, the limitations of single time-point labs, and why calibration matters for CGMs. Finally, I preview how lipid test — particularly triglyceride-to-HDL ratio—can flag insulin resistance.Chapter Markers00:00 — Intro00:28 — Insulin resistance as a foundation01:11 — Common causes of mortality in U.S.02:07 — What insulin does (and what goes wrong)02:57 — Glucose tests: fasting glucose & A1C basics04:20 — Early signal: fasting insulin (typical ranges)05:16 — Combined indices: HOMA-IR & QUICKI (cutoffs & caveats)06:18 — OGTT & CGM07:31 — Continuous glucose monitor caveats09:10 — TG/HDL ratio for insulin resistanceHOMA-IR Calculatorhttps://www.mdcalc.com/calc/3120/homa-ir-homeostatic-model-assessment-insulin-resistanceQUICKI Calculatorhttps://www.mdapp.co/insulin-sensitivity-quicki-calculator-324/Quick Referencehttps://nicksterling.com/2025/09/18/quick-reference-guide-tests-for-insulin-resistance-part-1/Spotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9This content is not medical advice, is for general information purposes only,and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.
  continue reading

19 episodes

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