Why Metabolic Health Is Upstream
Fix this and you downstream-protect everything
Metabolic dysfunction isn't one more condition on the list — it's the root cause of the majority of non-smoking-related aging disease. Cardiovascular, dementia, cancer, fatty liver, sarcopenia, erectile dysfunction, polycystic ovary syndrome, NAFLD → addressing insulin resistance hits all of them at once.
Alzheimer's as 'Type 3 Diabetes'
Researchers increasingly refer to Alzheimer's as 'Type 3 Diabetes' because brain insulin resistance appears to precede and drive much of the pathology. Diabetics have ~60% higher Alzheimer's risk. Insulin signalling in the brain is required for memory consolidation.
Cardiovascular disease — insulin is causal
Insulin resistance drives atherogenesis through multiple parallel paths: raises ApoB-carrying particle count, promotes endothelial dysfunction, increases inflammation, worsens lipid particle size. Post-insulin-resistance interventions (metformin, GLP-1s) reduce cardiovascular events. The causal chain is now well-established.
Select every condition with insulin resistance as upstream driver:
Select every condition where insulin resistance is a meaningful upstream driver.
Insulin resistance precedes glucose elevation by 10–15 years
Fasting glucose stays normal until late-stage insulin resistance because the pancreas compensates by pumping out more insulin. By the time fasting glucose creeps above 100 mg/dL, the underlying machinery has been failing for a decade. That's why fasting INSULIN (not glucose) is the early-warning marker — and why HbA1c alone misses early metabolic dysfunction. Target fasting insulin: <7 µIU/mL (most labs flag only at >25); target HOMA-IR: <1.5.
Key Takeaway
If you can do ONE thing for your long-term health, fix your metabolic health. Get fasting insulin + HOMA-IR tested (not just glucose / HbA1c — those lag by a decade). If elevated, prioritise it above lipid optimisation, blood pressure, and most supplement stacks. The downstream protective effect is enormous.