Over 115 million American adults have prediabetes, and roughly 8 in 10 of them don’t know it. That makes it closer to the norm than the exception, and it’s quietly the physiological engine behind a lot of what this site already talks about, cravings, energy crashes, and stubborn weight gain. The encouraging part, backed by solid research: this is one of the most reversible health conditions there is.
What prediabetes and insulin resistance are
Insulin resistance means your cells have started ignoring insulin’s signal to let sugar in, so your body produces more and more insulin to get the same job done. Prediabetes is the stage where blood sugar has started rising as a result, but hasn’t crossed into diabetes territory yet. A fasting glucose under 100 mg/dL is considered normal, 100 to 125 is prediabetes, and 126 or above is diabetes. An A1C, which reflects your average blood sugar over the past two to three months, follows a similar pattern: under 5.7 percent is normal, 5.7 to 6.4 percent is prediabetes, and 6.5 percent or higher is diabetes.
One part a lot of people don’t know: you can have real insulin resistance with A1C and fasting glucose numbers that still look normal. Elevated insulin is one of the earliest detectable signs of this whole process, and it can show up years before glucose numbers move enough to get flagged on a standard test.
The signs most people miss
Because standard bloodwork can look fine for a while, a lot of people live with insulin resistance without a diagnosis, going only on how they feel. Some of the more common signs: fatigue that doesn’t add up even with decent sleep, weight that creeps up despite eating carefully, an afternoon energy crash that shows up like clockwork, brain fog, and intense cravings for carbs and sugar specifically. That last one connects directly to the sugar-craving cycle, the same insulin dynamics driving that cycle are often the earliest visible sign that something bigger is going on. A less commonly known sign is a darkened, velvety patch of skin at the back of the neck, in the armpits, or in skin folds, called acanthosis nigricans.
None of this replaces real bloodwork. If several of these sound familiar, it’s worth asking your doctor for a fasting insulin and glucose panel, rather than guessing from symptoms alone.
Bloodwork aside, the craving side of this is something you can read on yourself today. The free quiz takes about two minutes.
This one is genuinely reversible
This is where the research stands out. The landmark Diabetes Prevention Program found that losing just 5 to 7 percent of body weight, combined with about 150 minutes of activity a week, cut the risk of progressing to type 2 diabetes by 58 percent, and by 71 percent in adults over 60. More recent research looking specifically at prediabetes remission found that weight loss of more than 5 percent put prediabetes into remission in about 73 percent of people studied. That’s not a rare, lucky outcome. It’s the expected result of a fairly modest, sustainable change.
The studies landed on the same plate
That’s not a coincidence. Building meals around protein and fat, adding a vegetable, weaning sugar down instead of cutting it overnight: that’s the territory these studies are working in. Protein and fiber both improve insulin sensitivity directly, by slowing digestion and softening the spike, which is this same mechanism described one level up.
I have some personal history here worth naming. I lost close to 100 pounds and reversed my own prediabetes once, using almost exactly this approach, and I’ve also lived the other side of it, watching some of that progress slip when life got stressful. You can read more of that on the about page. I don’t say that to suggest it’s simple or that it stays fixed forever without attention, I say it because the research backing this up isn’t abstract to me.
If you’re in perimenopause or menopause, this is worth double attention, since insulin sensitivity naturally declines during that transition on top of everything else already happening hormonally.
Get the bloodwork, then build the plate
If several of the signs above sound familiar, start with a fasting insulin and glucose panel. That’s a conversation with your doctor, not something to diagnose yourself from a list on a website. Alongside it, the approach is the one this whole site runs on: protein and fat leading the plate, a vegetable with it, sugar weaned down rather than cut off overnight. The protein and macro calculator gives you your own numbers, and the Plate Builder handles tonight.
The activity half of that study deserves naming rather than skipping, since it was half the protocol. It was about 150 minutes a week, which works out at roughly twenty minutes a day of walking. If that sounds like a lot to start, what a walk after a meal does to your blood sugar covers why ten minutes after dinner does more than the same ten minutes at any other hour.
Seventy-three percent is the number I’d hold onto from all of this. That’s how many people in the remission research put their prediabetes behind them by losing a bit over 5 percent of their body weight. Not all of it. About five percent.