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High circulating insulin levels, known as hyperinsulinemia, are a separate but commonly predisposing factor for type 2 diabetes. Insulin resistance is when the cells do not respond appropriately to the " insulin tells the cell to take in glucose" signal.
The most frequent cause of hyperinsulinemia is obesity. Excess fat in the body, especially in the abdominal area, dramatically decreases the sensitivity to insulin. Other causes include hereditary diseases such as insulinoma (a tumor that secretes insulin), congenital hyperinsulinism in babies, and drugs. Hyperinsulinemia is tightly related to glucose intolerance, obesity, hypertension, and dyslipidemia, which are known as metabolic syndrome.

High insulin levels over time are linked to hypertension, weight gain, and a higher risk of cardiovascular disease. Eventually, the pancreas can become overworked and unable to generate enough insulin. This results in high blood sugar and type 2 diabetes.

The mainstay of treatment is lifestyle adjustment, i.e., calorie restriction, weight reduction, and frequent physical exercise to enhance insulin sensitivity. Focusing your diet on whole fresh foods, rich in fiber, low in glycemic index, and minimal in processed carbohydrates helps to lower insulin demand. Weight loss is the cornerstone of therapy; even minor weight loss improves insulin sensitivity. If no improvement occurs in 3 months, the doctor may recommend metformin to increase insulin sensitivity and lower insulin levels.