What are possible reasons for elevated insulin in my teen year old daughter from fasting blood work?

Hyperinsulinemia: Is most commonly seen in children & teens with obesity, a bmi of > 95th %ile. It can be a precursor to diabetes mellitus type ii, especially with a family history of dm ii, & part of metabolic syndrome, with high cholesterol/ triglycerides & high blood pressure. It usually means that Insulin resistance is developing, causing the pancreas to produce more insulin. Follow-up & diet change are needed.

Insulin resistance: Her cells may not be allowing the glucose in her blood stream to enter, forcing her pancreas to release more Insulin to help.