Lori Esarey MS, APRN-C, ABAAHPGoing Beyond Weight Loss to Achieve Wellness For Life

Unlock Blood Sugar Secrets Beyond A1C, Find Insulin Resistance

5 Oct 2026 · 1 min

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In this segment, the speaker argues that the conventional hemoglobin A1C cutoff for normal glucose control is too high and should be lowered to around 5.4% or below. Because A1C reflects an average of blood glucose over weeks, it can miss post‑meal spikes, especially for people who eat irregularly or skip meals. The speaker recommends pairing A1C with a fasting insulin test, which is easy to obtain and provides a more sensitive indicator of early or “pre‑insulin resistance.” Elevated fasting insulin in the morning—when levels should be low—signals that the body is already compensating for glucose dysregulation, even if A1C appears normal. This combined approach aims to catch subtle metabolic disturbances before they progress to overt diabetes.

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get, you know, that average blood sugar and don't go for the conventional cutoff that really should be less than 5.4 or right at 5.4. Then get that together with the fasting insulin because the hemoglobin A1C, if you're not eating regularly or you're skipping meals, it's gonna average out. But it's a good, it's easy to get. Fasting insulin, also very easy to get. And that really tells us now, it's much more sensitive. It really tells us how much insulin do you have floating in the morning when it should actually be really low because you haven't been eating. So, and that's, you know, sometimes we call it the pre-insulin resistance. That's kind of the most sensitive marker that even everything still might be looking normal, the moment you eat, you actually have quite some blood sugar spikes.