10 August 2026
A Simple Check of Your Metabolic Health
A plain-language guide to the measurements and blood tests that provide a useful picture of your metabolic health.
Dr Sam Rajapaksha · MBBS
Founder & Clinical Lead, wHealthy Labs · 10 August 2026 · 5 min read
Metabolic health describes how well your body manages energy, blood sugar and fats. Problems can develop quietly, often before you feel unwell.
There is no single test that tells you whether your metabolism is healthy. The clearest picture comes from looking at a few simple measurements and blood tests together.
1. Measure your waist
Waist circumference gives an indication of how much fat is stored around your abdomen and internal organs. This can reveal health risks that body weight or body mass index may miss.
To measure your waist:
- Stand relaxed and remove bulky clothing.
- Place a flexible tape around your abdomen, in line with your belly button.
- Keep it snug without pressing into your skin.
- Measure after breathing out normally.
Australian Government guidance describes increased health risk at:
- 94 cm or more for men
- 80 cm or more for women
Risk is considered greatly increased at 102 cm or more for men and 88 cm or more for women. These figures do not apply during pregnancy or to children, and some ethnic groups can develop metabolic risk at lower measurements.
Another simple guide is to keep your waist measurement below half your height. For example, someone who is 170 cm tall would aim for a waist below 85 cm. A waist-to-height ratio of 0.5 or more suggests increased health risk, although it does not diagnose a medical condition.
2. Check your blood pressure
High blood pressure often causes no symptoms. It is linked with heart disease, stroke, kidney disease and problems with blood-sugar control.
One reading is not enough to make a diagnosis. If checking at home, use a validated upper-arm monitor and take readings while seated and relaxed on several different days.
A repeated home average of 135/85 mmHg or higher should be discussed with a health professional. Your ideal blood pressure may be different if you have diabetes, kidney disease or another medical condition.
3. Check your blood-sugar levels
Two common blood tests are useful.
- HbA1c estimates your average blood glucose over the previous two to three months. You do not need to fast.
- Fasting blood glucose measures your glucose after at least eight hours without food.
In Australian guidance, an HbA1c of 6.0% to 6.4% is in the prediabetes range. A result of 6.5% or higher is in the diabetes range.
A fasting glucose result of 6.1 to 6.9 mmol/L is in the prediabetes range. A result of 7.0 mmol/L or higher is in the diabetes range.
A diabetes-range result usually needs to be confirmed with another laboratory test if you do not have symptoms. Your doctor may recommend an oral glucose tolerance test when the initial results are unclear or do not match your risk factors.
4. Check your blood fats
A lipid profile measures cholesterol and triglycerides. Higher triglycerides together with lower HDL, sometimes called “good” cholesterol, commonly occur with insulin resistance.
Results that can be part of a metabolic-risk pattern include:
- Triglycerides of 1.7 mmol/L or higher
- HDL below 1.0 mmol/L in men
- HDL below 1.3 mmol/L in women
These numbers should not be interpreted alone. LDL cholesterol, blood pressure, smoking, kidney health, diabetes and family history also affect your overall risk of heart disease and stroke.
5. Consider liver and kidney health
Your doctor may recommend liver blood tests such as ALT, AST and GGT. Abnormal levels can have many causes, including fatty liver, alcohol, medicines and infections.
Normal liver results do not completely rule out fat or scarring in the liver. Further assessment may be needed when other risk factors are present.
If you have diabetes, high blood pressure or other kidney risk factors, a Kidney Health Check may include:
- A blood test for kidney filtering function
- A urine test for albumin, a type of protein
- A blood pressure check
Do you need a fasting insulin test?
Fasting insulin is often promoted as an early test for insulin resistance. However, it does not provide a clear answer by itself.
Insulin levels can change from day to day, laboratory methods vary, and there is no single cut-off that works for everyone. HOMA-IR, which combines fasting insulin and glucose, has similar limitations.
RACGP guidance does not recommend routine insulin testing to assess insulin resistance in people with prediabetes or type 2 diabetes.
A clinician may occasionally use fasting insulin to answer a specific question. Before having the test, ask: Will this result change my care? In many cases, waist size, blood pressure, glucose and cholesterol already provide enough information to decide on the next steps.
A simple starting checklist
Consider discussing the following with your GP:
- Waist circumference and waist-to-height ratio
- Repeated blood pressure readings
- HbA1c and/or fasting blood glucose
- A lipid profile
- Liver or kidney tests when your history suggests they are needed
You can also complete the Australian Government’s free AUSDRISK questionnaire to estimate your risk of developing type 2 diabetes over the next five years.
The key message
Do not rely on one fashionable test or one “normal” result. A waist measurement, repeated blood pressure, blood-sugar test and lipid profile provide a practical starting picture of metabolic health.
Review the overall pattern with a qualified health professional and focus on meaningful changes over time.
Medical disclaimer
This article provides general information and is not a substitute for individual medical advice. Test selection and interpretation depend on your symptoms, medicines, pregnancy status, medical history and personal risk. Please speak with a qualified health professional about your circumstances. Read our full medical disclaimer.