digest
Chapter 1: Start here
If you've been making changes to your nutrition and your exercise and your sleep and you're wondering if any of this is actually helping or is it doing anything? Well, here's some good news. Your body can start showing signs of improvement within just 24 to 48 hours of those changes. That's how fast it can start. The problem is those early signs usually don't show up on a standard lab or a blood test right away. Your A1C takes months to change and your fasting glucose still looks the same. But that doesn't mean nothing is happening. Your body's already been responding to all the work you've been putting in. You just have to know what to look for.
So, in this video, I want to walk you through eight early signs that your insulin resistance is already reversing, starting with the ones that show up first. And there's a very good chance you've already noticed some of these. When I say insulin resistance, I mean that state where your cells are no longer responding well to insulin. So, your body has to keep making more to keep your blood sugar under control. That is one of the most common themes we see in all the conditions that plague us today, such as high blood pressure and heart disease, fatty liver and visceral fat, and pre-diabetes and eventually type 2 diabetes.
If you're new to this channel, I'm Dr. Leonid Kim. I'm a double board certified physician, and on this channel my mission is to give you the science and the practical tools to live longer and feel better. Let's get into it.
Chapter 2: The first sign people notice
Sign number one that your insulin resistance is reversing is decreased bloating and less water retention. This is often one of the very first changes people notice. If you've changed your nutrition or exercise the last few days, you may feel a little lighter and less puffy in the face. You may have a little less swelling in your ankles, and your rings fit a little looser. That's not in your head. There's a real physiological reason for this.
Insulin doesn't just affect blood sugar. It also directly controls how your kidneys handle sodium. When insulin levels are chronically elevated, which is exactly what happens with insulin resistance, your kidneys start holding on to more sodium than they should. When your body holds on to extra sodium, it holds on to extra water right along with it. That's where some of the puffiness comes from. The bloated abdomen, the swollen ankles at the end of the day, or a fuller face, a lot of that is driven by elevated insulin acting on the kidneys.
So when insulin sensitivity starts to improve, one of the first things that happens is insulin levels begin to come down. When that happens, your kidneys start letting go of some of that extra sodium they've been holding on to, and water goes right along with it. So the early drop on the scale in the first few days, or the fact that your face looks a little less round in the morning, is not fat loss just yet. It is one of the earliest signals that what you're doing is actually working.
Chapter 3: The signal your appetite is changing
The second sign surprises a lot of people because of how quickly it can happen. We're talking about reduced hunger and fewer cravings, especially for sugar and processed carbohydrates. This can start happening within the first few days. If you notice you're not reaching for snacks as much, or that typical 3 p.m. sugar craving is just a little quieter, or you can actually make it between meals without feeling shaky, pay attention to that.
When you have insulin resistance, your cells are not absorbing glucose efficiently. Even if there's plenty of glucose floating around in your bloodstream, your cells cannot access it the way they should, and your brain interprets that as a fuel shortage. As a result, it sends out signals that constantly say we need more energy, and it tends to push you toward the fastest energy sources it knows, which are usually sugar and refined carbohydrates, all things that give us rapid blood sugar spikes.
As insulin sensitivity starts to improve, your cells can finally take in glucose more effectively and efficiently. Your brain stops getting that same false alarm, and once that happens, your hunger starts to feel more normal again. That shift has very little to do with willpower. A lot of that excessive hunger and food noise was never a matter of discipline. It was a fuel delivery problem. When the chemistry improves, the cravings often improve right along with it.
Chapter 4: Why energy starts to shift
That brings us to sign number three, which is better energy and less of that heavy, sleepy feeling after meals. You know that feeling after eating, especially after a very carb-heavy meal, where your eyelids get a little heavy and your brain just slows down. A lot of people call that a food coma, and people think that's normal. It is common, but it's definitely not normal.
When you're insulin resistant and you eat a meal high in refined carbohydrates, your blood sugar tends to spike higher and faster. Your pancreas then releases a large amount of insulin trying to bring the glucose down and push it into all the resistant cells. That sharp rise followed by a sharp drop is what often leaves you feeling drained and sleepy.
This is where your mitochondria come in. Mitochondria are tiny structures inside your cells that turn fuel and oxygen into ATP, the usable energy your cells actually run on. Every movement, every muscle contraction, every thought, and every signal your brain sends depends on ATP. When you're insulin resistant, that fuel supply becomes more unstable. Your cells are continuously dealing with spikes and dips instead of a steadier stream of energy, and mitochondria do not work as well under those conditions.
As insulin sensitivity starts to improve, your blood sugar begins to stabilize, those swings flatten out, and your cells can start producing energy more efficiently again. We can actually see this happen pretty quickly. Studies have shown that even just seven days of moderate-intensity cycling can improve mitochondrial function and increase energy production in muscle. So if you've been feeling a little more steady or a little less drained after meals, that's one of the early signs that your metabolism is already moving in the right direction.
Chapter 5: Mental clarity and focus
That leads right into sign number four, which is better mental clarity. If your thinking feels a little sharper lately, if it's easier to focus, or your brain fog is not hitting as hard, that is another early sign that your insulin sensitivity is improving.
Your brain makes up only about 2% of your body's weight, but it uses about 20% of your body's total energy. When energy delivery is off, your brain feels it almost immediately. Your brain cells have their own insulin receptors, so when insulin signaling is not working well, glucose delivery to the brain becomes less efficient. But there is more to the story than just your brain running low on fuel. Insulin resistance is also linked to chronic low-grade inflammation, which translates to less blood reaching your brain tissue. This is why it's so important to reverse insulin resistance. It gives you a triple whammy of low fuel, poor circulation, and increased inflammation.
As insulin sensitivity improves, so does your brain's ability to take in glucose efficiently and run on a steady supply of energy. Over time, that translates into clearer thinking, better focus, and less brain fog. Research shows this can appear within days to a couple of weeks of lifestyle changes.
Chapter 6: The sleep connection
Sign number five is really interesting because this relationship goes both ways. As insulin sensitivity improves, sleep often improves too. But poor sleep can also worsen insulin resistance, so these two problems can feed off each other. The research on this is pretty eye-opening. A study published in the Journal of Clinical Endocrinology and Metabolism took healthy participants through two different conditions. In one phase they got 8 hours in bed, and in the other phase their sleep was restricted. Nothing else changed: same diet, same activity. The only difference was less sleep.
After just five nights of this, researchers measured insulin sensitivity using a hyperinsulinemic euglycemic clamp, the gold standard test for how well the body responds to insulin. When they restricted sleep, insulin sensitivity dropped by about 25%, and peripheral insulin sensitivity, which is how well your muscles and tissues take in glucose, dropped by 29%. This was a small study with only 14 participants, but multiple meta-analyses since then have confirmed the same pattern: poor sleep pushes insulin resistance in the wrong direction.
So what happens when you start reversing insulin resistance? The negative loop begins to break. As inflammation comes down and blood sugar becomes more stable, sleep quality starts to improve. You may spend more time in deeper, more restorative sleep, wake up less during the night, and feel more rested in the morning. Because your blood sugar is more stable, you're also not getting the middle-of-the-night cortisol spikes that wake you up. The amazing part is that better sleep further improves insulin sensitivity. The same loop that was working against you now works in your favor.
Chapter 7: This matters more than the scale
Sign number six is that your waist circumference may start to go down, sometimes even before you see changes on the scale. This is one of the most encouraging changes because it reminds us that the scale is not the only thing that matters. In the early phases, how your clothes fit tells you much more about your progress than your body weight.
There is a very strong link between insulin resistance and visceral fat, the fat stored around your internal organs, especially in your liver, intestines, and pancreas. Insulin is one of the main hormonal signals that influences where your body stores fat. When insulin stays chronically elevated, the body is pushed toward storing more fat centrally around the abdomen and organs. As insulin levels come down, visceral fat begins to change as well. Multiple studies have shown that even a modest 5% loss in total body weight can lead to a 15 to 25% reduction in visceral fat. You don't need dramatic total weight loss to start making meaningful progress where it matters most.
Exercise can supercharge this progress. In these meta-analyses, 5% weight loss with exercise led to a 21% reduction in visceral fat, compared with only 13% with diet alone. Diet can absolutely get you there and is the foundation of everything we do, but adding exercise nearly doubles the visceral fat loss. If you're already cleaning up nutrition and wondering whether the exercise piece is worth your time, this is one of the many places where it really pays off.
Chapter 8: Blood pressure and blood vessels
Blood pressure is another area where people can see changes relatively quickly. As insulin sensitivity improves, blood pressure often starts to come down too, because insulin resistance directly affects blood vessels. Inside your arteries is a thin inner lining called the endothelium. When that lining is healthy, it keeps blood vessels flexible so they can relax and widen when needed. Insulin resistance causes chronic low-grade inflammation and oxidative stress, which damages this endothelial layer. Blood vessels become stiffer and don't relax as well, and this is one of the things that raises blood pressure.
This connection goes far beyond salt or body weight. It is also about what is happening at the level of the vessel wall. As insulin sensitivity improves, the endothelial lining starts to recover and blood vessels regain some of their flexibility. Studies show these changes can appear within days to weeks. If you're checking your blood pressure at home and noticing it trending down, even by a few points, that is a real sign your blood pressure is already responding.
Chapter 9: Skin changes
Let's talk about your skin. This one usually takes longer than the others, anywhere from a few weeks to several months, but it is one of the more visible signs. Insulin resistance drives many skin changes, and one of the best known is acanthosis nigricans, the darker, velvety patches that often show up on the neck, under the arms, or in skin folds. Insulin resistance can also contribute to acne through increased androgen activity. Androgens are a group of hormones that include testosterone. When insulin stays chronically elevated, androgen levels can rise, leading to more oil production and more breakouts. Insulin resistance can also lead to skin tags, the small soft growths that usually appear on the neck, underarms, or back.
As insulin levels come down and sensitivity improves, the main driver behind these skin changes weakens. Acne starts clearing as androgen levels normalize. Acanthosis nigricans can gradually lighten. Existing skin tags won't go away on their own, but you may stop getting new ones. Early on in the journey to get healthier, I encourage all of my patients to focus on these early signs and milestones, because they show up much sooner than changes in blood work. Hope this is helpful. Stay healthy, and I'll see you in the next one.