The Short Answer
Insulin resistance often shows up as weight that won’t shift and tiredness, sometimes years before blood sugar itself moves. It has known risk factors and is treated with lifestyle change, medication, or both. The Metabolic Screen gives your doctor what’s needed to plan yours.
Key Takeaways
- Insulin resistance can sit behind tiredness and weight that won’t shift, sometimes years before a standard blood test shows anything.
- It has recognised risk factors: family history of diabetes, more weight carried around the abdomen, low physical activity, PCOS, and an HbA1c that’s sat in the grey zone before.
- The Metabolic Screen looks at how your body handles sugar and insulin together, giving your doctor more to work with when planning treatment, rather than guessing at one.
- Treatment isn’t one thing. It can mean lifestyle changes, medication that improves how the body responds to insulin, weight-management medication, standard diabetes medication, or a combination, decided with a doctor.
- Three tiers, priced flat, each building on the one before it.
Weight is hard to lose but comes back on easily.
You’re tired even after a full night’s sleep.
The sugar cravings feel stronger than they should.
On their own, each is easy to explain away: poor sleep, stress, a slower metabolism. Together, they can point to something specific: an underlying problem with how your body handles sugar.
That problem has a name. It’s called insulin resistance, and it’s more common, and more manageable, than most people realise.
What Insulin Resistance Actually Is
If you’re diabetic, or know someone who is, you’ve probably heard of insulin. But what does it actually do?
Insulin is the hormone produced by the pancreas. It moves sugar out of your blood and into your cells for energy. When your cells stop responding to it as well as they should, your body compensates by making more insulin to get the same job done.
Over time, that response keeps dwindling, and your body keeps compensating by making even more insulin to keep up. Eventually the extra demand on the pancreas catches up, and it’s no longer able to keep pace with the sugar circulating in your blood.
It is an early, usually silent step towards prediabetes and type 2 diabetes, and it can build for years before it shows up on a standard blood test.
Who’s More Likely to Be Affected
A few things raise the likelihood, and none of them mean insulin resistance is definitely present:
- A family history of type 2 diabetes.
- Visceral fat: more weight carried around the abdomen than elsewhere, regardless of overall weight.
- Polycystic ovary syndrome.
- An HbA1c that’s sat in the grey zone before, between 6.1 and 6.9.
Lifestyle Factors
Some of what raises the likelihood comes down to habits, and these are the parts you have the most control over:
- Physical inactivity and a largely sedentary routine.
- Diets high in refined carbohydrates, sugary drinks and processed foods.
- Poor or short sleep.
- Chronic stress: it raises cortisol, the stress hormone, which raises blood sugar.
Having one or more of these is a reason to ask, not a diagnosis to assume. And a healthy routine doesn’t rule it out either, because family history or PCOS can play a part regardless of habits.
How Do You Know You Might Have It?
The most common signs are the ones that are easiest to live with rather than ask about:
- Tiredness that doesn’t lift with sleep.
- Weight that won’t shift despite genuine effort.
- Cravings that feel harder to manage than they should.
Some people also notice patches of darkened, slightly thickened skin, usually at the neck or underarms. None of these prove insulin resistance on their own, and all of them may very well have other explanations too. It’s common to dismiss them and manage around them, until they’re too hard to ignore.
How You Actually Find Out
A symptom or a risk factor is a reason to look further. The Metabolic Screen is how you actually look.
It checks how your body handles sugar and insulin together, in more depth than a single average reading, with exactly how much depending on which tier fits your situation.
That’s the information your doctor needs to work out whether insulin resistance is part of what’s going on, and if it is, to help plan what happens next, whether that’s a change to start with or something more.
What’s in Each Tier
All three tiers need 10 to 12 hours of fasting. They’re the only tests in the range that do.
The Standard tier is a single draw. Advanced and Comprehensive need two: one fasting, one two hours after the glucose drink, so plan a morning around it rather than squeezing it in. Your BMI and waist circumference measurements are taken as part of all three and will be helpful in interpreting the results.
| What’s included | Standalone | With a screening package |
|---|---|---|
| Standard: Fasting glucose, insulin, cortisol | S$248 | S$198 |
| Advanced: Glucose tolerance test, insulin, cortisol | S$298 | S$248 |
| Comprehensive: Glucose tolerance test, insulin, LDH, cortisol | S$348 | S$298 |
Book a Morning Slot
Fasting is easiest overnight and the second draw lands before lunch. Our front desk will sort the exact timing with you when you book.
What Each Test Is Actually Looking For
Glucose / Glucose Tolerance Test
Your fasting glucose levels show the amount of sugar circulating in your bloodstream at the time of draw. It’s good as a snapshot for a baseline reading.
The glucose tolerance test shows your doctor how your body handles sugar in real time, not just where it landed in the morning or on average.
Insulin
A fasting insulin measurement is similar to fasting glucose: a snapshot of your baseline. But it isn’t a test that stands alone.
Cortisol
Cortisol is known as the stress hormone. When you’re under stress (or perceived stress), cortisol signals the liver to release stored sugar for quick energy, which is useful in short bursts for fight-or-flight situations.
If it stays high for long stretches, it can increase the sugar circulating in your bloodstream, make your cells respond less well to insulin and encourage fat to be stored around the abdomen.
Lactate Dehydrogenase (LDH)
LDH is an enzyme involved in how your cells turn glucose into energy, and it’s found in most tissues. It rises when cells turn over or are under strain, which happens normally as well as abnormally.
Put together, these are the components your doctor uses to work out whether what you’re feeling, the tiredness, the weight that isn’t moving, has a metabolic explanation worth acting on, or whether it doesn’t.
What Can Be Done About It
Treatment isn’t just about medication, and what suits one person may not suit another.
Depending on your results, that may include changes to diet and activity, medication that improves how the body responds to insulin, medication used for weight management, or standard diabetes medication if things have progressed that far.
Often it’s a combination, adjusted over time rather than a fixed plan from day one. Managing it is a two-way effort: your doctor guides the plan, and you carry it through day to day.
What’s right for you depends on your history and your day-to-day life, which is exactly what a conversation with a doctor is for.
Conclusion
Tiredness that doesn’t lift and weight that won’t shift are common, and they’re not something to just live with.
Insulin resistance is one possible reason, it has real risk factors, and it’s manageable once you know what you’re dealing with.
The Metabolic Screen is how you find out, and a conversation with our doctor is how you turn that into a plan.
Frequently Asked Questions
What does it cost?
Standard is $248, Advanced is $298 and Comprehensive is $348. Booked alongside a screening package, they’re $198, $248 and $298. All figures include GST.
Do I really need to fast?
Yes, 10 to 12 hours, and it’s the one part that isn’t negotiable. Advanced and Comprehensive measure what happens when sugar is introduced, and that only works from a known starting point.
How long will I be at the clinic?
For Standard, as long as a normal blood draw. For Advanced and Comprehensive, at least two hours, because of the second draw.
Is insulin resistance the same as diabetes?
No. It’s often what’s happening before diabetes develops, and recognising it earlier means more options for managing it, not fewer.
Can insulin resistance be reversed?
It can often be improved with the right changes, though how much and how quickly varies from person to person. It’s not something we can promise in general. That’s part of what the conversation with your doctor, after your results, is for.
Is this a test for stress, because of the cortisol?
No. It’s read as context, not as a measure of stress or tiredness.
Recognise some of this in yourself?
That’s worth a conversation, not a guess. Book an appointment and we’ll work out what’s actually going on, and what, if anything, to do about it.
Sources
- American Diabetes Association Professional Practice Committee. Standards of Care in Diabetes, Section 2, Diagnosis and Classification of Diabetes.
- Freeman AM, Acevedo LA, Pennings N. Insulin Resistance. StatPearls, 2023.
- Healthier SG chronic care protocol, Screening for Diabetes Mellitus.
- Association for Diagnostics and Laboratory Medicine. Optimal Testing: Guide to Lab Test Utilization, Insulin, 2024.
- Farhana A, Lappin SL. Biochemistry, Lactate Dehydrogenase. StatPearls, 2023.
- Pasieka AM, Rafacho A. Impact of Glucocorticoid Excess on Glucose Tolerance: Clinical and Preclinical Evidence. Metabolites, 2016;6(3):24.
