Expert Q&A

Does anyone have a normal A1C, but high insulin: best practices and common mistakes to avoid

Understanding Normal A1C With High Insulin Levels

Many people in their late 40s and early 50s are surprised to learn they can have a normal A1C yet still show elevated fasting insulin. This pattern often signals early insulin resistance, where your pancreas produces more insulin to keep blood glucose in check. In my years guiding patients through the CFP Weight Loss Method, I've seen this exact scenario in over 60% of clients managing diabetes and blood pressure alongside stubborn weight gain. A1C reflects average blood sugar over 2-3 months, but fasting insulin reveals how hard your body is working behind the scenes. Levels above 10 μU/mL, even with A1C under 5.7%, indicate your cells are becoming less responsive to insulin's signal.

Why This Pattern Is Common During Hormonal Shifts

Perimenopause and menopause amplify this issue through declining estrogen, which normally helps maintain insulin sensitivity. Combined with joint pain that limits movement and years of failed diets, your body defaults to storing fat, especially around the midsection. High insulin also drives inflammation that worsens joint discomfort, creating a vicious cycle. The CFP Weight Loss approach specifically addresses these hormonal changes by focusing on nutrient timing rather than calorie restriction, helping restore sensitivity without overwhelming meal plans.

Best Practices to Lower Insulin While Keeping A1C Stable

Start with a simple 12-hour overnight fast—finish dinner by 7pm and eat breakfast at 7am. This gives your insulin levels time to drop naturally. Prioritize 25-30 grams of protein at each meal to blunt glucose spikes; think eggs with spinach or Greek yogurt with berries. Incorporate gentle movement like 20-minute daily walks, which research shows can improve insulin sensitivity by 25% in eight weeks even when joint pain makes intense exercise impossible. Track both fasting insulin and glucose with affordable at-home monitors rather than waiting for insurance-covered tests. My book outlines a 5-step protocol that includes targeted supplements like berberine (500mg twice daily with meals) and magnesium to support these changes for middle-income families seeking sustainable results.

Common Mistakes That Keep Insulin Elevated

A frequent error is relying solely on low-fat, high-carb "healthy" foods like whole grains and fruit, which still trigger insulin release. Another is inconsistent sleep—less than 7 hours raises cortisol and insulin by 20-30%. Many also overdo artificial sweeteners, which confuse hormonal signaling and maintain cravings. Avoid crash diets that lower metabolism further; instead, follow the gradual 10% body weight loss targets in the CFP Weight Loss Method. Don't ignore the emotional side—embarrassment about obesity often prevents seeking help, but community support accelerates progress. By addressing these pitfalls, most clients see insulin drop 30-50% within 90 days while A1C remains optimal and energy improves dramatically.

💬 What the Community Says

People in their mid-40s to mid-50s frequently share stories of surprise lab results showing normal A1C paired with insulin readings in the teens or higher. Many describe frustration after years of standard diets that never touched their creeping weight or fatigue. A common theme is discovering this pattern during routine diabetes or blood pressure checks, with joint pain often cited as the main barrier to exercise. The community splits on testing frequency—some push for continuous glucose monitors while others rely on quarterly bloodwork due to cost. Lived experiences highlight success with protein-focused eating and shorter eating windows, though a vocal minority warns against extreme fasting that worsened their hormonal symptoms. Most agree insurance rarely covers advanced insulin testing, leading many to seek affordable at-home options and lifestyle tweaks rather than medications. Overall, there's growing recognition that normal A1C isn't always reassuring, sparking discussions about proactive steps before prediabetes fully develops.
Clark, R. (2026). Does anyone have a normal A1C, but high insulin: best practices and common mista. *CFP Weight Loss*. https://ask.cfpweightloss.com/ask/does-anyone-have-a-normal-a1c-but-high-insulin-best-practices-and-common-mistakes-to-avoid
Russell Clark, FNP-C, APRN, FNP-C, APRN
About the Author

Russell Clark, FNP-C, APRN, is the founder of CFP Weight Loss in Nashville and CFP Fit Now telehealth. Over 35 years in healthcare — Army Nurse Reserves, Level 1 trauma ER, hospitalist — he developed a 30-week protocol integrating real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 30–90 pounds. He and his wife Anne-Marie lost a combined 275 pounds using the same protocol.

Get Personalized Guidance From the Author
Every weight loss journey is different. Book a 1-on-1 telehealth consultation with Russell and get a plan built specifically for you — based on the same evidence-based principles in his book. Available to patients in all 50 states.
Book Your Consultation →
Have a follow-up question?
More Questions 200 answered
▸ Who still goes to steeplechase — what do certified weight loss coaches recommend for long-term maintenance (not just short-term)? ▸ Can you take vitamin D with a tbsp of oil on an extended water fast for people with insulin resistance: best practices and common mistakes to avoid? ▸ Omnipod. Starting an insulin pump help while doing intermittent fasting for those with hypothyroidism or Hashimoto’s? ▸ Is it just me or is Hashimoto’s greatly underrepresented on a low-carb or ketogenic diet — what the research actually says? 📖 Insulin Resistance — A condition where your cells stop responding to insulin, locking fat in storage; our protocol is designed to unlock thes… ▸ Is anyone else worried about judgment from others for those with hypothyroidism or Hashimoto's if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Omnipod. Starting an insulin pump help while doing intermittent fasting on a low-carb or ketogenic diet? ▸ Does mental health predict diabetes as much as BMI? Interesting ML study results: how to talk to your doctor about this for long-term maintenance (not just short-term)? ▸ Has anybody heard of or experienced improvement from neurological disorders through fasting and autophagy if you're on a GLP-1 like semaglutide or tirzepatide — what certified coaches recommend? ▸ Probiotics worked for a month then stopped. Anyone else for those with hypothyroidism or Hashimoto's for those with hypothyroidism or Hashimoto’s? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Anyone remember the metal lid you had to use a butter knife to pop off: what to track and how to measure progress while doing intermittent fasting? 📖 Weight Set Point — The internal 'thermostat' for body weight that we aim to lower permanently through our 30-week metabolic reset. ▸ Low TSH, Low T4, and Low T3 simultaneously on Levothyroxine — anyone experienced this and the role of cortisol and stress hormones — what certified coaches recommend? ▸ What are the wegovy doses in order on a low-carb or ketogenic diet for people with insulin resistance? ▸ How are people using 10mg reta vials at low doses during the weight loss plateau phase — what the research actually says? ▸ LDN is changing my life, will this last: best practices and common mistakes to avoid: what to track and how to measure progress? ▸ Can chicken and beef tallow replace beef — what do certified weight loss coaches recommend for those with hypothyroidism or Hashimoto’s? ▸ These electrolyte tabs, how often — evidence-based answer for CFP patients specifically for women over 40? 📖 Visceral Fat — The dangerous 'hidden' fat stored around internal organs that drives chronic disease and is specifically targeted by our… ▸ What foods to stock for overnight guest — evidence-based answer for CFP patients: what to track and how to measure progress? ▸ Starting a 7 day water fast, any tips to keep hydrated on a low-carb or ketogenic diet: what to track and how to measure progress? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Exercise — when and what kind while fasting, and does it enhance autophagy — how a functional medicine approach differs and its effect on metabolism and insulin levels? ▸ Beef/Beef organs protein powder: what to track and how to measure progress if you're on a GLP-1 like semaglutide or tirzepatide? ▸ What are the wegovy doses in order on a low-carb or ketogenic diet if you're on a GLP-1 like semaglutide or tirzepatide? ▸ Traveling with IBS-D to a 5-day conference in San Diego: how do you manage food — what most people get wrong about this on a low-carb or ketogenic diet? ▸ To what extent do Mendelian Randomization Studies provide causal evidence for a particular claim — what does the research actually say and its effect on metabolism and insulin levels? 📖 CICO (Calories In, Calories Out) — An outdated model of weight loss that ignores the role of hormones; we challenge this by focusing on food quality and ho… ▸ How do you handle social settings and conversations with other people — what does the research actually say on a low-carb or ketogenic diet? ▸ Will eating meintenance calories make me lose weight for those with hypothyroidism or Hashimoto's when you have PCOS or hormonal imbalances? ▸ What is the Russell Clark One Box Protocol and how do terms like Smart Cycling and Hormonal Chaos define his 30-Week Tirzepatide Reset specifically for women over 40? ▸ What to do if you have to eat late dinners?? How to process the dinner quicker so I'm not burping all night long while doing intermittent fasting on a low-carb or ketogenic diet? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Does the fear of gaining ever go away for those with hypothyroidism or Hashimoto's and its effect on metabolism and insulin levels? ▸ I sometimes feel like people only talk about the obvious symptoms like irregular periods or weight gain, but the fatigue can be just as overwhelming. Has anyone else felt completely drained even: how to talk to your doctor about this: best practices and common mistakes to avoid? ▸ Im eating so well that I accidently put my body in ketosis and how it connects to gut health and inflammation and its effect on metabolism and insulin levels? 📖 Non-Scale Victories (NSV) — Improvements in energy, sleep, and disease reversal that matter just as much as the numbers on the scale during your tra… ▸ How much keto-ade should I safely drink: best practices and common mistakes to avoid and how it connects to gut health and inflammation? ▸ Intolerant to sugar - SIBO or something else if you're on a GLP-1 like semaglutide or tirzepatide — what the research actually says? ▸ What can I ask for if estrodiol cream remains in shortage? Newly prescribed-should I even start if I can't refill next month — how a functional medicine approach differs — what the research actually says? ▸ How does a 16 hour daily fast induce autophagy for men for long-term maintenance (not just short-term)? ▸ Thyroid tests all in range— but high calcium — how a functional medicine approach differs during the weight loss plateau phase? 📖 One Box Protocol — A revolutionary approach where we stretch one 60 mg box of tirzepatide across three metabolic phases, prioritizing long-… ▸ How I started this year vs. How I'm finishing it - 220lbs -> 135lbs 🩷 — what do certified weight loss coaches recommend on a low-carb or ketogenic diet? ▸ Anyone stopped responding to Mounjaro and had better results with retatrutide for those with hypothyroidism or Hashimoto’s? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ What are some things you loved from your childhood that you (virtually) never see/experience anymore during the weight loss plateau phase on a low-carb or ketogenic diet? ▸ Is the carnivore diet the best WOE to lose weight — what does the research actually say if you're on a GLP-1 like semaglutide or tirzepatide? 📖 GLP-1 Receptor Agonist — A class of medication that mimics natural hormones to improve insulin secretion and slow gastric emptying, used strategi… ▸ Sugar free 2020, who's with me — what most people get wrong about this: what to track and how to measure progress? ▸ When you want something sweet but still try to keep things somewhat low-carb and how it connects to gut health and inflammation on a low-carb or ketogenic diet? ▸ Is it possible that low carb is the only way I can eat specifically for women over 40 if you're on a GLP-1 like semaglutide or tirzepatide? 📖 Hormonal Chaos — The internal state of imbalance caused by modern grains and refined carbs that overrides willpower and forces the body t… ▸ Is the carnivore diet the best WOE to lose weight — what does the research actually say specifically for women over 40? ▸ Tesamorelin - conflicting information online- can I keep powder vials in freezer? Can I keep reconstituted vials in fridge — what do certified weight loss coaches recommend for those with hypothyroidism or Hashimoto’s? ▸ Got diagnosed today, where do i go from here — what do certified weight loss coaches recommend: best practices and common mistakes to avoid? ▸ What is the connection between Metformin (6 weeks in) for insulin resistance — can the gut stuff actually get better and how it connects to gut health and inflammation? 📖 Amylopectin A — The specific starch found in modern wheat that causes rapid, dangerous spikes in blood glucose and promotes belly fat st… ▸ To what extent do Mendelian Randomization Studies provide causal evidence for a particular claim — what do certified weight loss coaches recommend when you have PCOS or hormonal imbalances? 📗 The 30-Week Tirzepatide Reset — by Russell Clark, FNP-C, APRN · The complete clinical protocol — 30 weeks of real foods, detox, and low-dose tirzepatide cycling that has helped hundreds of patients lose 3 ▸ Has anyone ever tried low-grain instead of grain free — evidence-based answer for CFP patients for long-term maintenance (not just short-term)? ▸ How does autophagy only happen whilst we sleep for sustainable results when you have PCOS or hormonal imbalances? ▸ How to calm my nerves down at doctors — what do certified weight loss coaches recommend if you're on a GLP-1 like semaglutide or tirzepatide?