What to do if insulin is high and no diabetes

by Sushmita
(Kolkata)






Question


Sir , I'm 30 yr and my weight is 150 kg. I have done all my tests, which results everything normal but my insulin is high.


My doctor prescribed medicine is GLYCIPHAGE SR AND FOLVITE. I started my workout in gym recently, so what are the precautions I should take. I wish you will reply me.


—Sushmita, Kolkata





Quick Answer


High insulin with normal glucose can occur when the pancreas is producing extra insulin to overcome insulin resistance. However, one insulin result does not diagnose insulin resistance. Insulin tests are not well standardized, and the result must be interpreted with fasting status, glucose, HbA1c, laboratory range, medicines, and symptoms.


Glyciphage SR is generally a brand of extended-release metformin, but confirm the package and dose. Folvite contains folic acid; its reason cannot be determined from the information given. Start gym exercise gradually, use joint-friendly activities, and obtain medical review before vigorous training if you have chest discomfort, unusual breathlessness, dizziness, palpitations, fainting, uncontrolled blood pressure, or known heart, kidney, or eye disease.




Answer by Dr. Albana Greca, MD, MMedSc



Hello Sushmita,


Normal glucose is reassuring, but early insulin resistance can make the pancreas release extra insulin while glucose remains normal. Progression to prediabetes is possible but not inevitable.



Does High Insulin Confirm Insulin Resistance?


No. Interpret insulin with the exact value, units, laboratory range, fasting duration, and simultaneous glucose. Assays differ between laboratories, and routine insulin testing is not the main way to diagnose diabetes risk.


Prediabetes and diabetes are diagnosed with laboratory glucose-based tests:



  • HbA1c: prediabetes 5.7–6.4%; diabetes at least 6.5% when confirmed

  • Fasting plasma glucose: prediabetes 100–125 mg/dL; diabetes at least 126 mg/dL when confirmed

  • Two-hour 75-gram OGTT: prediabetes 140–199 mg/dL; diabetes at least 200 mg/dL


Ask for copies of all results. See our blood-test guide.



What Should Be Reviewed?



  • Height, BMI, waist, and blood pressure

  • Fasting glucose, HbA1c, and possibly an OGTT

  • Lipids, kidney, and liver tests

  • Medicines affecting weight or glucose

  • Sleep-apnea symptoms, acanthosis nigricans, or PCOS features when applicable


Height is needed to calculate BMI, but 150 kg warrants comprehensive weight-management assessment.



Why Might Metformin Have Been Prescribed?


Glyciphage SR is commonly extended-release metformin. It reduces liver glucose output and improves insulin sensitivity. It may be considered for high-risk prediabetes, especially in younger adults with BMI at least 35 kg/m², higher fasting glucose or HbA1c, or prior gestational diabetes.


High insulin alone does not prove metformin is necessary. Ask what diagnosis the prescription is treating, and do not change the dose yourself.



Metformin Safety Points



  • Take it as prescribed, usually with food.

  • Nausea, diarrhea, gas, and abdominal discomfort can occur.

  • Kidney function must be checked.

  • Long-term use may lower vitamin B12.

  • Metformin alone has a low hypoglycemia risk.


Report persistent vomiting, diarrhea, dehydration, unusual weakness, or rapid breathing. See our treatment guide.



Why Was Folvite Prescribed?


Folvite is folic acid. It may be prescribed for deficiency, pregnancy planning, anemia, elevated homocysteine, or another reason. Indian ancestry alone does not explain the prescription.


Folic acid lowers homocysteine but does not routinely prevent major cardiovascular events. Ask why it was prescribed and for how long.



Gym Precautions at a Weight of 150 kg


Progress gradually to reduce joint injury. Begin with low-impact aerobic activity and supervised resistance training when available.



  • Start with 10–15 minutes and increase gradually.

  • Use cycling, pool exercise, elliptical, seated cardio, or comfortable walking.

  • Do resistance exercise 2–3 times weekly on nonconsecutive days.

  • Warm up, cool down, use supportive shoes, and inspect the feet.

  • Hydrate, avoid exercise during acute illness, and do not hold your breath while lifting.

  • Interrupt sitting at least every 30 minutes.


Build toward 150 minutes of moderate activity weekly. A trainer may guide exercise but should not alter medicines or prescribe extreme diets.




Stop Exercise and Seek Medical Advice For



  • Chest pain or pressure

  • Severe or unusual breathlessness

  • Dizziness, fainting, or persistent palpitations

  • Sudden weakness or visual change

  • Joint pain affecting walking

  • Calf swelling or sudden breathlessness




Do You Need to Check Glucose During Exercise?


With normal glucose and metformin alone, routine gym testing may not be needed. Check glucose during shaking, sweating, dizziness, weakness, or confusion.


Avoid prolonged fasting and severe calorie restriction. Use a balanced eating plan with adequate protein. See our meal-planning guide.



What Weight Goal Is Reasonable?


A first goal of losing 5–7% of starting weight may improve metabolic risk. At 150 kg, that is about 7.5–10.5 kg.


Discuss structured nutrition, behavioral support, weight-management medicine, and metabolic surgery assessment when appropriate. Exercise helps even before major weight loss.




Recommended Follow-Up



  1. Obtain the exact insulin, glucose, HbA1c, lipid, kidney, and liver results.

  2. Ask why metformin and folic acid were prescribed.

  3. Have blood pressure and cardiovascular symptoms reviewed before vigorous exercise.

  4. Follow a gradual, joint-friendly gym program.

  5. Repeat diabetes screening at the interval recommended by the clinician.




Remember: high insulin with normal glucose may suggest insulin resistance, but insulin alone is not diagnostic. Confirm glucose-based risk, clarify each medicine, and increase exercise gradually with attention to joints, breathing, hydration, and sustainable weight loss.




Written by: Dr. Albana Greca, MD, MMedSc, Family Physician

Medically reviewed by: Dr. Ruden Cakoni, MD, Endocrinologist

Last medically reviewed: August 5, 2026


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Safety note: High insulin and a body weight of 150 kg require individualized medical and weight-management assessment; do not change prescribed medicine from an online answer.



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