Your doctor is likely checking your blood sugar and missing the number that moves years earlier. Ask for a fasting insulin test at your next bloodwork.
Insulin resistance builds quietly. Long before fasting glucose rises, the pancreas compensates by releasing more insulin to push glucose into cells, so your glucose can read normal while insulin climbs behind it.
Surgery Won’t Fix Your Leaky Bladder (But This 7-Second Ritual Will)
My name is Dr. Sarah Pachtman Shetty and I want you to know that you’ve been lied to when it comes to pee leaks.
Let’s bust some myths:
❌ “It's normal after kids/getting older.”
It's COMMON, not normal. And common means it can be fixed.
❌ “You need surgery to fix it.”
Surgery is expensive, scary, and doesn’t really fix the root cause.
❌ “You just have a small bladder, it must run in the family.”
No it doesn’t. That’s just an excuse doctors make up to avoid treating you.
Your bladder CAN be reset in just 7 seconds a day. You don’t need invasive surgery, annoying kegels or toxic pills.
I made a free video showing you exactly how:
That is why a normal fasting glucose or A1c can be falsely reassuring. Those tests catch the stage where the compensation is already failing, not the earlier window where you have far more room to act.
Fasting insulin, often paired with glucose to calculate a value called HOMA-IR, is a well-established research marker of insulin resistance. It is not a formal screening guideline like A1c, and assays and cutoffs are not standardized, so treat it as an early signal rather than a settled diagnosis.
Here the distinction matters. Standard lab reference ranges run wide, often up to the mid-twenties in microunits per milliliter, but that range reflects the general population rather than a metabolic target, and clinicians focused on prevention generally read a lower fasting insulin within the normal range as more reassuring.
This is pointed at you. Insulin sensitivity tends to fall through the menopausal transition as visceral fat rises, and fasting insulin can flag that shift while your standard labs still look clean.
The ask is specific. Say you want a fasting insulin level drawn alongside your fasting glucose, ask your clinician to calculate HOMA-IR, and do it after a true overnight fast of eight to twelve hours.
If it comes back elevated, you already have the levers, the post-meal walk, resistance training, protein at each meal, and steady sleep, all of which improve insulin sensitivity.
Fasting glucose tells you where you are, and fasting insulin tells you where you are heading. Ask for both, and get the early number while it is still early enough to change.
