Prediabetes & Insulin Resistance

About This Condition

Prediabetes is diagnosed in approximately 96 million American adults — nearly 38% of the adult population — yet is widely undertreated. Most patients are told to "watch their diet and exercise more" and then monitored annually until they progress to overt diabetes. This is a critical intervention window: insulin resistance is fully reversible in most patients if addressed aggressively before beta-cell exhaustion occurs. The standard HbA1c and fasting glucose criteria miss a significant number of individuals with early insulin resistance — because fasting glucose is often the last marker to rise.

Our Approach

We identify insulin resistance early — often before the HbA1c threshold for prediabetes — by measuring fasting insulin and calculating HOMA-IR. A fasting insulin above 7–10 µIU/mL in the presence of normal fasting glucose indicates insulin resistance that HbA1c will not yet flag. Our intervention is aggressive, structured, and evidence-based: therapeutic carbohydrate reduction, time-restricted eating protocols, resistance training prescriptions (which improve insulin sensitivity independent of weight loss), targeted supplementation (berberine, inositol, magnesium, chromium), and close follow-up. We set quantitative reversal targets — HOMA-IR normalization, fasting insulin normalization — not just "avoid diabetes," and we track progress with quarterly labs and body composition reassessment.