Hyperinsulinemia: An Overview Of High Insulin Levels

We don’t talk about hyperinsulinemia enough.

Hyperglycemia? Sure, all the time!

But why should high blood sugar get all the attention?

After all, hyperinsulinemia is ultimately the connection between hyperglycemia and insulin resistance.

If we can prevent hyperinsulinemia, then we can do ourselves well by preventing insulin resistance and type 2 diabetes.

So let’s talk about how we can do that.

What is hyperinsulinemia?

Hyperinsulinemia is relatively easy to understand once you break this term up into its root parts.

“Hyper” means high, and “-emia” means blood. So, simply put, hyperinsulinemia is high levels of serum insulin.

Insulin is a hormone that the pancreas makes. Insulin tells the cells in your adipose tissue (also known as fat cells), liver, and muscle to take up glucose so that your body can use it for energy.

We get glucose from the food we eat. The liver can also make glucose when necessary, like when we are fasting.

After you eat, blood glucose levels rise. Plasma insulin then increases to lower blood glucose and attempt to keep it in the normal range.

Insulin resistance syndrome happens when the cells in your muscles, fat, and liver do not respond effectively to fed or fasting insulin. As a result, cells won’t take up glucose from your blood as efficiently. To make up for this, your pancreas will make even more excess insulin in an attempt to get more glucose into your cells.

Unfortunately, this can also lead to what we call glucose intolerance or impaired glucose tolerance.

This means that your cells have a weaker response to insulin and sign an underlying problem.

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Is it a form of diabetes?

To put it bluntly, no. Hyperinsulinemia is not diabetes mellitus. Especially if hyperinsulinemia is the only symptom present. However, both diabetes and hyperinsulinemia can be caused by insulin resistance.

Hyperinsulinemia is often associated with type 2 diabetes, even though it is not technically a form of diabetes.

Chronic hyperinsulinemia results from any number of metabolic disorders and conditions. It can also happen due to a poor diet.

Although hyperinsulinemia is often present in patients with early type 2 diabetes, it is not the cause. It is only one symptom of diabetes.


Hyperinsulinemia doesn’t usually cause any signs or symptoms. The exception is in people with insulinomas.

In these patients, hyperinsulinemia can lead to low blood sugar. When it becomes severe hypoglycemia, this is what we call persistent hyperinsulinemic hypoglycemia.

Since hyperinsulinemia doesn’t cause noticeable symptoms, it’s essential to have your doctor check your plasma glucose levels regularly.

If your hyperinsulinemia progresses, it could eventually turn into type 2 diabetes.

Here are symptoms of type 2 diabetes to look out for:

  • Extreme thirst
  • Extreme hunger
  • Feeling hungry even after eating a meal
  • Increased urination
  • More frequent urination
  • Tingling sensations in the hands
  • Tingling sensations in the feet
  • Feeling more tired than usual
  • Frequent infections

For most people, blood glucose levels need to be relatively high in order to cause symptoms.

However, some research studies show that people with prediabetes can get early changes in their eyes.

These changes can eventually lead to retinopathy. Retinopathy is more common in people with diabetes.

Getting tested for hyperinsulinemia

If you don’t have any symptoms, your doctor can confirm whether hyperinsulinemia is present or not by doing blood work.

Your doctor can also test for insulin sensitivity. The gold standard for this is called the hyperinsulinemia euglycemic clamp. Although this test is accurate, it is also complicated. This is why it is used mainly for research purposes.

Doctors more often look at fasting plasma glucose or hemoglobin A1c to diagnose prediabetes.

In addition, they will sometimes perform an oral glucose tolerance test (called the OGTT for short), but this is more expensive and not user-friendly.

Hemoglobin A1c gives a picture of your blood glucose levels over the past three months.

On the other hand, the fasting plasma glucose and oral glucose tolerance test show a snapshot of your blood glucose levels when they took the test.

Although hemoglobin A1c can give you a good idea of your long-term glucose levels, it is not as sensitive as the other tests.

This means that the hemoglobin A1c test might miss prediabetes that the oral glucose tolerance test would catch.


Researchers don’t fully understand the cause of insulin resistance and prediabetes. However, they do know that being overweight and sedentary are significant factors.

Hyperinsulinemia is most often caused by insulin resistance. This is a condition where your body does not respond well to insulin’s effects in the body. Your pancreas then tries to compensate by making even more insulin.

Insulin resistance can eventually lead to the development of type 2 diabetes. Finally, this happens if your pancreas can’t keep up with the body’s insulin requirements to maintain and control blood sugar levels.

In rare cases, hyperinsulinemia can be caused by insulinoma. This is a rare tumor on the pancreatic beta cells that produce insulin.

Another rare cause of hyperinsulinemia is nesidioblastosis. This is a congenital hyperinsulinism condition where there is an excessive amount of cells or increased growth of insulin producing cells in the pancreas.

Scientists state that obesity and visceral adiposity (fat around the organs) are the leading causes of insulin resistance.

Men with a waist measurement over 40 inches and women with a waist measurement over 35 inches link with insulin resistance.

This is still true if your body mass index falls within the healthy normal range!

Researchers used to believe that fat tissue was for energy storage. However, we now know that belly fat makes hormones and other substances that can lead to inflammation.

Inflammation likely plays a role in insulin sensitivity, type 2 diabetes, and cardiovascular disease.

Risk Factors

The following factors can also increase your risk of developing hyperinsulinemia:

  • Obesity
  • Age 45 or older
  • Having a parent or sibling with diabetes
  • Physical inactivity. This is because regular physical activity causes body changes that make it easier to keep your blood glucose tolerance levels in check.
  • Health conditions like hypertension (high blood pressure) or high plasma triglycerides
  • A history of gestational diabetes
  • A history of heart disease or stroke
  • Polycystic ovary syndrome (called PCOS for short)
  • Metabolic syndrome (this is a combination of high blood pressure, high cholesterol, and large waist circumference)
  • Taking certain medications such as glucocorticoids, antipsychotics, and HIV medications
  • Hormonal disorders like acromegaly and Cushing’s syndrome
  • Sleep problems such as sleep apnea

Or being of one of the following ethnicities:

  • African American
  • Alaska Native
  • Native American
  • Asian American
  • Hispanic
  • Native Hawaiian
  • Pacific Islander American

As you can see, there are both genetic as well as lifestyle factors that can increase your risk of developing hyperinsulinemia.

Some of these are controllable, such as the lifestyle factors of diet, physical activity, and weight. Others are not within our realm of control, such as family history, age, or ethnicity.


Insulin resistance and high insulin concentrations in the blood increase your risk of progressing to type 2 diabetes mellitus.

The American Diabetes Association says that up to 50 percent of people with insulin resistance and prediabetes will develop type 2 diabetes if they don’t make any lifestyle changes.

Hyperinsulinemia and insulin resistance also increases the risk of the following:

  • Being overweight
  • Having high cholesterol
  • Having elevated blood pressure

Sometimes, people with elevated insulin and insulin resistance can develop acanthosis nigricans. These are dark velvety patches often on the back of the neck, near the groin, and in the armpits.

Experts have theorized that it is a buildup of insulin inside of skin cells that causes acanthosis nigricans. Therefore, since there’s a link between insulin resistance and skin tags, a person who’s insulin-resistant may also get skin tags in these same areas.


It is vital to treat hyperinsulinemia by targeting the underlying problem. If you have prediabetes, you can help to prevent progression to diabetes by exercising 30 minutes per day five days of the week and eating a healthy diet.

Did you know that losing just seven percent of your body weight can decrease your risk of developing diabetes?

Making healthy lifestyle choices is the most effective way to get your blood glucose levels into the healthy range and stay there.


Hyperinsulinemia can be a bit of an enigma. This is because of its lack of outright symptoms but high-risk outcomes if left untreated.

And although hyperinsulinemia is not in and of itself diabetes, it can increase risk of developing diabetes.

Although researchers are not fully aware of all causes, there are some lifestyle factors and genetic factors related to hyperinsulinemia.

Focus on the lifestyle factors since these are the ones you can control.

And it’s crucial that you do so. This is because hyperinsulinemia can progress to diabetes, overweight, high cholesterol, and high blood pressure.

When it comes to treating hyperinsulinemia, always focus on the root cause. Treat your hyperinsulinemia through exercise, eating a healthy diet, and losing some weight.

As always, you must speak to your doctor if you suspect you may have hyperinsulinemia.

They will be able to run tests to determine whether that is true or not.

Your health care provider can then guide you through a treatment plan to get your insulin action back on track.

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  1. American Diabetes Association. (2016). Classification and diagnosis of diabetes. Diabetes Care. 39 (Suppl. 1), S13-22.
  2. American Diabetes Association. (2017). Standards of medical care in diabetes. Diabetes Care. 40 (1), Suppl 1.
  3. Diabetes Prevention Program Research Group. (2015). Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study. The Lancet: Diabetes & Endocrinology. 3 (11), 866-75.
  4. Tabak, AG; Herder, C; Rathmann, W; Brunner, EJ & Kivimaki, M. (2012). Prediabetes: A high-risk state for developing diabetes. Lancet. 379 (9833), 2279-90. 

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