From the Guidelines
A serum insulin level of 36 μIU/mL indicates insulin resistance, suggesting the need for lifestyle modifications and further evaluation to prevent the development of type 2 diabetes and its associated morbidity and mortality. Based on the evidence from the American Diabetes Association's Standards of Medical Care in Diabetes-2021 1, insulin resistance is a key factor in the development of type 2 diabetes, and elevated insulin levels can be an indicator of this condition. The normal fasting insulin range is typically between 3-25 μIU/mL, and a level of 36 μIU/mL is considered elevated, suggesting that the body's cells are not responding properly to insulin. Some key points to consider include:
- Insulin resistance can lead to pancreatic exhaustion and type 2 diabetes if not addressed 1
- Lifestyle modifications such as weight loss, increased physical activity, and dietary changes can help improve insulin sensitivity 1
- Further testing, including glucose tolerance tests, HbA1c, or HOMA-IR, may be necessary to assess metabolic health 1
- Regular monitoring of insulin and glucose levels is crucial to track changes in metabolic status and prevent the development of type 2 diabetes and its associated complications 1.
From the Research
Serum Insulin Levels
- A serum insulin level of 36 can be considered high, as seen in patients with type 2 diabetes mellitus 2
- High fasting serum insulin levels are often associated with hypertension and poor glycemic control 2
- Patients with high fasting serum insulin levels may benefit from treatment with biguanides, such as metformin, rather than sulphonylureas 2
Insulin Resistance
- Serum insulin levels are poor measures of insulin resistance, and measuring insulin resistance in clinical practice has no clinical benefit 3
- Instead, clinicians should focus on identifying risk factors for diabetes and cardiovascular disease, such as fasting glucose and lipid levels, hypertension, and central obesity 3
Treatment Options
- Pioglitazone, a thiazolidinedione, has been shown to improve glycemic control, reduce vascular risk, and increase insulin sensitivity in patients with type 2 diabetes mellitus 4, 5, 6
- Pioglitazone may be a useful treatment option for patients with high serum insulin levels and insulin resistance, particularly when used in combination with other oral antihyperglycaemic agents 5, 6