During menopause, how can insulin resistance be assessed in practice?
During menopause, insulin resistance isn’t usually diagnosed from symptoms alone. In practice, it’s assessed with a few common lab tests your clinician can order.
How insulin resistance is assessed
Most often, your doctor will start with a fasting blood glucose and a hemoglobin A1c. A1c reflects your average blood sugar over the past three months, so it gives a broader view than a single glucose reading.
Another helpful option is a glucose tolerance test, where you drink a measured sugar solution and your blood sugar is checked afterward, usually at the two hour mark. This shows how well your body handles a glucose load and whether your blood sugar comes back down appropriately.
Some clinicians will also check a fasting insulin level along with glucose. From those two numbers, a calculation called HOMA IR, short for homeostatic model assessment of insulin resistance, can be done. There’s debate about how useful this is in routine practice, but it’s commonly used in research and sometimes in clinical care.
If you have a history of gestational diabetes, PCOS, a strong family history of diabetes, increasing waist circumference, or come from an ethnic background with higher diabetes risk, your clinician may be more proactive about screening.
If you’d like to hear a menopause specialist walk through these tests, Dr. Richa Mittal covers this clearly in our webinar chapter on testing for insulin resistance here: Spooked by Menopausal Weight Gain? | Dr. Richa Mittal - Testing for Insulin Resistance
At Alloy, when we work with women in midlife who are struggling with weight changes or belly fat, we look at the full metabolic picture, not just the scale. If weight and insulin resistance are concerns, our Weight Care program offers physician guided evaluation and, when appropriate, treatments like GLP 1 medications as part of a broader plan. You can learn more here: Weight Care Program Weight Care Program
If you’re noticing new midsection weight gain during menopause, it’s reasonable to ask your clinician about these labs. They’re simple, accessible tests that can give you a lot of clarity about what’s going on metabolically.
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