Fasting glucose levels between 100-130 mg/dL may not be as informative as commonly believed and can be influenced by factors other than insulin resistance, such as cortisol or hepatic glucose output.

“fasting glucose is not nearly as helpful as people think it is inside of a reasonably physiologic range so someone who has a fasting glucose of 130 that's a different situation there's are something going on there but I have patients that get very upset if their fasting glucose is a hundred instead of being ninety and I say you know it's it's very difficult to understand what's going on there that can very easily be explained by cortisol or hepatic glucose output for some other reason that's not you know a function of insulin resistance”