You can't see plaque building in your arteries or blood pressure climbing, but skin changes are visible. Insulin resistance, a common precursor to prediabetes and diabetes, shows up on the skin more often than people realize. Ben Bikman, a metabolic scientist and Levels advisor, explains in his book Why We Get Sick how too much circulating insulin doesn't just affect internal organs. It can also show up as visible changes to your body's largest organ. From dark patches of skin to unexplained bumps, these are worth understanding, since they can be some of the earliest visible clues that something metabolic is off.