What Do Elevated Insulin Levels With Normal A1c Level Indicate?
Possible
Detailed Answer:
Elevated insulin levels, despite a normal A1c and fasting/random glucose can still be indicative of Insulin resistance.
There are, however, 2 caveats to this:
A) We lack simple, convenient and accurate tests to diagnose insulin resistance.
Whatever methods we currently have are restricted to research settings such as laboratories and clinical trials.
So the elevated Insulin test result that you have attached, is possibly suggestive of insulin resistance but we cannot conclude so on the basis of this one test alone.
There are indirect ways of estimating this called HOMA-IR, although even this has it's share of shortcomings.
B) A1c and glucose can very well appear normal in the face of an elevated Insulin
This typically occurs early in the progression from normal to pre diabetes. The essential causes of insulin resistance such as overweight/obesity/physical inactivity lead to a gradual rise in blood glucoses. In response to this, the beta cells of the pancreas start producing more insulin to compensate and keep the glucoses (and this is reflected in the A1c too) in the normal range.
The blood insulin levels therefore are high because they are a consequence of the pancreas being overworked to keep glucoses from rising into abnormally high range.
A time comes when the pancreas' insulin producing capacity is overwhelmed and despite it's efforts, blood glucose eventually rises. At this point the person has either diabetes or pre diabetes.
Follow up
Detailed Answer:
There is no published medical literature to the best of my knowledge that has systematically studied this and concluded that chronic stress raises blood insulin levels.
That being said, there is increasing scientific support to the role of stress in causing many chronic conditions in modern life, such as diabetes, blood pressure and weight gain
Second follow up
Detailed Answer:
I believe your comment of skin darkening is in reference to my first reply.
Yes you are correct in that 'acanthosis nigricans' is a clinical finding on examining a person that is typically associated with Insulin resistance.
However it can other in other conditions also such as some medications like niacin and steroids (like prednisone) cause it. It is likely these also induce it through insulin resistance.
There is another skin condition called acrochordans, or simply skin tags. These are also markers of insulin resistance that can be found on clinical examination.
Again, these too can be present even in the absence of insulin resistance. For example, some individuals may constitutionally, genetically or otherwise have a tendency to develop these skin lesions.
Third follow up
Detailed Answer:
There is a medical condition called 'Reactive hypoglycemia' that can occur in pre diabetes or early type 2 diabetes. It is essentially a consequence of insulin resistance.
It can be a tricky entity to deal with because often there is no true hypoglycemia ('low blood glucose') and just some vague symptoms like the kind you are experiencing.
The treatment includes frequent small meals, more fibre, less refined carbohydrates, and in severe cases a medication called acarbose helps
Fourth follow up
Detailed Answer:
Symptoms during and immediately after meals are unlikely due to reactive hypoglycemia.
Glucose levels can well be normal during these episodes, because it is often the speed at which glucoses drop that tends to cause this problem, even if the glucoses remain within the normal range