Insulin resistance clinic in Seoul, led by an internist

What an insulin resistance clinic in Seoul looks for

Insulin is the hormone that moves glucose from the blood into muscle, liver and fat cells. In insulin resistance, these cells respond less well, so the pancreas makes more insulin to keep blood sugar normal. For years, glucose readings can look fine while insulin levels quietly rise. Over time, the pancreas may struggle to keep up, leading to prediabetes and type 2 diabetes.

At our insulin resistance clinic in Seoul, Dr. HyunSung Park, a board-certified internal medicine specialist, looks at the full metabolic picture: weight and waist size, blood pressure, cholesterol, liver health and family history. Insulin resistance is closely linked with abdominal fat, fatty liver, polycystic ovary syndrome (PCOS), high triglycerides and low HDL cholesterol.

Because insulin resistance sits at the crossroads of so many conditions, it makes sense to have it assessed by a doctor who manages metabolic health every day. Dr. Park, also a gastroenterology subspecialist, pays particular attention to the liver, which plays a central role in how the body handles glucose and fat.

Signs that may suggest insulin resistance

Many people have no symptoms. These features raise suspicion and are good reasons to be tested.

• Increasing waist size or weight gain concentrated around the abdomen
• Darker, velvety skin patches on the neck or armpits (acanthosis nigricans) or many skin tags
• Fatty liver found on ultrasound or raised liver enzymes
• High triglycerides, low HDL cholesterol or high blood pressure
• PCOS, irregular periods or a history of gestational diabetes
• A parent or sibling with type 2 diabetes
• Energy dips or strong cravings after carbohydrate-heavy meals

The tests we use

There is no single perfect test for insulin resistance, so we combine measures and interpret them together.

• Fasting glucose and fasting insulin: taken after an 8–10 hour fast; a high insulin level with normal glucose can be an early sign
• HOMA-IR: a calculation using fasting glucose and insulin to estimate insulin resistance; useful for tracking, though cut-offs vary by population and lab
• HbA1c: reflects average blood sugar over about three months; 5.7–6.4% suggests prediabetes and 6.5% or higher, if confirmed, indicates diabetes
• Oral glucose tolerance test (OGTT): glucose is measured before and two hours after a sugary drink, and can find problems that fasting tests miss
• Supporting tests such as lipids, liver function, kidney function, thyroid function and body composition

Treatment: lifestyle first, medicine where appropriate

Lifestyle change is the foundation and can substantially improve insulin sensitivity. Losing even a modest share of body weight, reducing refined carbohydrates and sugary drinks, eating more fiber and protein, being active most days and adding resistance training to build muscle all help. Improving sleep and reducing alcohol matter too.

Medicines may be considered when lifestyle alone is not enough or risk is high. Metformin improves how the liver handles glucose and is widely used in prediabetes and type 2 diabetes; side effects include stomach upset and, with long-term use, lower vitamin B12. GLP-1 medicines such as semaglutide or tirzepatide may be appropriate for people who also meet weight-management or diabetes criteria. Dr. Park reviews benefits, risks and costs with you before any prescription.

Follow-up is part of treatment. We usually repeat key tests after a few months to see whether insulin, HbA1c, lipids and liver enzymes are moving in the right direction, and adjust the plan if they are not. If you already have type 2 diabetes, we can also manage it as part of ongoing care.

Who should be assessed, and red flags

Testing is worthwhile for adults with excess weight or abdominal fat, a family history of diabetes, PCOS, fatty liver, high blood pressure or abnormal cholesterol, and for anyone with a history of gestational diabetes. Results are interpreted together; one borderline number does not mean you have a disease.

Some symptoms suggest high blood sugar that needs prompt care: extreme thirst, frequent urination, unexplained weight loss and blurred vision. Call 119 or go to an emergency room if these come with vomiting, abdominal pain, deep rapid breathing, confusion or drowsiness, which can signal a diabetic emergency.