Disclaimer: Educational only, not medical advice. Always work with your clinician for diagnosis and treatment decisions.

Insulin resistance is one of the most common “missing puzzle pieces” I see in perimenopause and midlife—especially when someone is dealing with belly weight gain, intense cravings, energy crashes, or that frustrating “I’m doing all the right things and nothing is changing” feeling. And here’s the part that surprises many people: insulin resistance can still be present even if you don’t feel like you eat much sugar.

Below is how I think about insulin resistance through an FDN lens, what patterns I look for, and what I typically encourage clients to discuss with their clinician so the full picture can be evaluated.

What insulin resistance actually means (in plain language)

Insulin is a hormone that helps move glucose (blood sugar) from your bloodstream into your cells, where it can be used for energy.

With insulin resistance, your cells become less responsive to insulin. As a result, the body often produces more insulin to keep blood sugar stable—until it can’t compensate as effectively anymore. Over time, this can contribute to metabolic changes, inflammation, and shifts in weight, energy, mood, and sleep.

Where insulin resistance fits in the FDN HIDDEN framework

In the HIDDEN framework, I primarily see insulin resistance as an Energy issue—your cells aren’t efficiently using fuel the way they should. But it rarely stays “just” an energy issue.

It’s also tightly connected to the Nervous system, because stress and sleep dramatically influence glucose regulation dramatically. When cortisol rhythms are dysregulated, sleep is fragmented, or the body is stuck in a chronic “always-on” state, blood sugar tends to become less stable.

Common signs I listen for (especially in perimenopause)

Everyone’s presentation is different, but these are some very common patterns:

• Cravings later in the day (especially sweets or carbs)
• Post-meal fatigue or an afternoon crash
• Stubborn midsection or belly weight gain
• Waking between 2–4am (often wired, anxious, or hungry)
• “Tired but wired” energy
• A lab trend pattern: A1c creeping up, triglycerides increasing, HDL decreasing

These can overlap with thyroid, hormones, gut issues, and chronic stress—so I always look at the broader context.

Labs to discuss with your clinician (and why trends matter)

I’m not a fan of making big conclusions from a single number. I prefer to look at trends, symptoms, and context. With that said, here are common data points to discuss with your clinician:

• A1c
• Fasting glucose
• Triglycerides + HDL (pattern recognition matters here)
• CMP (context-dependent)
• Sometimes fasting insulin (depending on the case)

Your clinician can help interpret results and determine what’s appropriate for your individual situation.

How I support stability using the FDN DRESS framework

In FDN, we focus on foundations that help stabilize physiology—because blood sugar stability often improves when the body feels safe, supported, and resilient.

D — Diet

• Start with a protein-first breakfast (it can make a huge difference for cravings and energy)
• Build balanced meals; think of carbs as a “dose” based on your body’s response
• Increase fiber gradually to support digestion and tolerance

R — Rest

• Aim for a consistent wake time (this supports circadian rhythms)
• Stabilize evening eating to reduce overnight glucose swings

E — Exercise

• Strength train 2–3x/week (progressive, not exhaustive)
• Add post-meal walks (even 10 minutes matters)

S — Stress reduction

• Build a daily downshift practice (your nervous system needs cues of safety)
• Avoid using intense HIIT as “stress relief” if recovery and sleep are already poor

S — Supplements

Some supplements can be supportive, but I prefer targeted choices based on symptoms, tolerance, and clinician guidance—especially in perimenopause and autoimmunity.

The big takeaway

The goal isn’t perfection—it’s stability. When you stabilize blood sugar, you often stabilize energy, cravings, mood, and sleep too. The FDN process helps you stop guessing, identify your dominant driver(s), and build a plan you can sustain.

Ready to dig further and figure out what you can do to feel better? Schedule a call with me today! CLICK HERE