Optimal - The Blog
November 10, 2025
Most people assume that if their blood sugar and A1c are “normal,” their metabolism is healthy. But new research shows that traditional diabetes screening can miss nearly half of the people already on the path toward insulin resistance and metabolic dysfunction.
A New Way to Catch Diabetes Early
A 2014 study led by Dr. Stephen Varvel and colleagues looked at more than 1,600 adults and discovered that almost half of those with “normal” glucose and A1c levels already showed hidden signs of insulin resistance or pancreatic stress, key drivers of type 2 diabetes and heart disease.
By using a comprehensive blood test panel with 19 different biomarkers, researchers were able to identify subtle metabolic changes long before traditional tests could detect them.
Even better, when these participants were rechecked after only a few months, those who received care guided by their biomarker results were three to four times more likely to improve their blood sugar status than to get worse. This finding highlights how early, targeted intervention can dramatically change outcomes.
Why This Matters
Insulin resistance doesn’t happen overnight. It can develop silently for years. During this time, the pancreas works overtime to produce extra insulin to keep blood sugar in check. Eventually, the beta cells tire out, blood sugar begins to rise, and diabetes takes hold.
Identifying this process early gives people a crucial window of opportunity to reverse the trend through improved nutrition, physical activity, stress reduction, and, when appropriate, targeted medical support.
The study by Varvel and colleagues demonstrates that looking beyond glucose alone can uncover the “hidden iceberg” of metabolic risk, offering a clearer picture of true metabolic health.
Common Biomarkers Linked to Insulin Resistance and Metabolic Syndrome
| Biomarker | What It Tells You | Typical Change in Insulin Resistance / Metabolic Syndrome |
|---|---|---|
| Fasting Glucose | Blood sugar at one moment in time | Increases |
| HbA1c | Average blood sugar over 2–3 months | Increases |
| Fructosamine | Shorter-term blood sugar average (2–3 weeks) | Increases |
| α-Hydroxybutyrate (α-HB) | Early signal of insulin resistance | Increases |
| HOMA-IR | Calculated insulin resistance score | Increases |
| Insulin / Proinsulin | Reflects how hard your pancreas is working | Increases |
| C-peptide | Marker of insulin production | Increases early, may fall later |
| Adiponectin | Hormone that improves insulin sensitivity | Decreases |
| Leptin | Hormone from fat cells that regulates appetite | Increases |
| Leptin / BMI ratio | Indicates leptin resistance | Increases |
| Free Fatty Acids | Released from fat tissue during insulin resistance | Increases |
| Ferritin | Reflects iron stores and inflammation | Increases |
| Triglycerides | Reflect altered metabolism of fats and glucose | Increase |
Optimal Takeaways for Better Metabolic Health
- Don’t rely only on glucose or A1c: Many people with “normal” glucose already have early insulin resistance. Comprehensive biomarker testing can catch these shifts before diabetes develops.
- Insulin resistance starts years early: By the time blood sugar rises, the pancreas is already under strain. Early detection allows for timely, reversible change.
- Your fat cells tell a story: High leptin and low adiponectin levels suggest fat tissue dysfunction—an early hallmark of metabolic syndrome.
- Small changes can make a big difference: In the study, many participants improved their blood sugar and metabolic status within just five months through lifestyle and guided care.
- Prevention beats treatment: Knowing your biomarker profile helps you take proactive steps to support your metabolism, improve energy, protect cardiovascular health, and reduce disease risk.
- Comprehensive testing means personalized care: Everyone’s metabolism is unique. Biomarker panels help practitioners tailor prevention and treatment strategies to each individual.
Reference
Varvel, Stephen A et al. “Comprehensive biomarker testing of glycemia, insulin resistance, and beta cell function has greater sensitivity to detect diabetes risk than fasting glucose and HbA1c and is associated with improved glycemic control in clinical practice.” Journal of Cardiovascular Translational Research vol. 7,6 (2014): 597–606. doi:10.1007/s12265-014-9577-1.
This article is distributed under the terms of the Creative Commons Attribution License.
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