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Presumably, the prevalence of insulin resistance alone (without the full-blown syndrome) is much higher. How can I tell if I am insulin resistant? If you are overweight, you are more likely to be insulin resistant, especially if you are carrying extra weight in your belly. If you have any of the symptoms of metabolic syndrome listed above, you are more likely to be insulin resistant. Additionally, people who respond well to reduced carbohydrate diets may be more likely to be insulin resistant. (See Different Diets for Different Bodies). I have based this article, "Is Low Carb For You?", partly on the premise that insulin resistant people are likely to benefit most from reducing carbohydrates in their diets. Some experts use a fasting insulin test to help determine hyperinsulinemia and insulin resistance. If insulin resistance is the first step, what comes next? If the pancreas keeps having to put out high levels of insulin, eventually it can't keep doing it. The common explanation is that the beta-cells in the pancreas become "exhausted," but it actually may be that the high insulin and/or even slightly higher blood glucose starts to do damage to the beta cells. In any case, at that point, blood glucose starts to rise even more, and the path towards Type 2 diabetes is truly begun. When fasting blood glucose reaches 100 mg/dl, it is called "prediabetes," and when it reaches 126, it is called "diabetes." You can see that these are invisible lines along a path of increasing inability for the body to deal with sugar: First, insulin is less effective, and then not enough insulin is available to do the job. 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