While psoriasis and insulin resistance (IR) are closely related, the impact of IR on psoriasis treatment remains unclear. For a prospective cohort study in British Journal of Dermatology, Dawei Huang, MD, and colleagues recruited 290 patients with moderate-to-severe plaque psoriasis from the Shanghai Psoriasis Effectiveness Evaluation CoHort. The researchers measured insulin rejection using the triglyceride glucose-body mass index (TyG-BMI) and evaluated psoriasis severity with PASI and the Physician Global Assessment (PGA). They divided patients into high and low IR groups based on median TyG-BMI. The researchers found higher instances of diabetes, BMI, and elevated fasting blood glucose and triglycerides among patients in the high IR group. At 12 weeks, they found the high IR group had lower response rates than the low IR group, with fewer patients in the high IR group achieving PASI 70 and PASI 90. In addition, the odds of achieving a PGA 0/1 response were notably lower in the high IR group. These findings suggest highlight the need for tailored treatment strategies that consider IR levels.