A letter before we begin

I'm so glad you're here.

Too many people are told to change their habits, but no one ever shows them how.

"Eat healthier" is not a plan. Advice without the how, and without follow-through, means very little.

That's why I made this course. Over the next three modules, you'll learn what insulin resistance and prediabetes really are, how to read what your labs are telling you, and the first simple steps that make a real difference.

One thing I want you to know from the start: insulin resistance is not a character flaw. It isn't proof that you did something wrong. It's your body asking for help, and you're listening.

I work alongside your medical team, never in place of it. Keep your doctor in the loop, keep taking any medicine you've been prescribed, and bring what you learn here to your next appointment.

Let's get started.

Dr. LaVera

Meet Mrs. D.

Mrs. D. was healthy by every standard test. Her BMI was 22. Her glucose was normal. Her HbA1c was normal. No one looked further. But her body was already struggling, and nobody thought to check. By the time the problem was found, it had progressed. She was told to change her lifestyle. No plan. No guidance. No useful follow-up.

Keep her in mind. You'll learn who she really was in Module 3.

Insulin is the key to the door

After you eat, sugar (glucose) from your food moves into your blood. Your pancreas sends out insulin, which works like a key. It unlocks the doors to your muscle, liver, and fat cells so sugar can get inside and become energy.

Insulin resistance: the locks get sticky

With insulin resistance, the locks get sticky. Your cells stop answering the door. Your pancreas does what any loyal worker would: it makes more and more insulin to push the sugar through.

For years, that extra effort keeps your blood sugar looking normal on a lab report. That's why insulin resistance can hide. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH), puts it plainly: people with insulin resistance and prediabetes usually have no symptoms. NIDDK also notes that doctors may not test for insulin resistance at all, because the formal test is mostly used in research. A large British study (Whitehall II) that followed 6,538 adults found that insulin sensitivity was falling steeply for about 5 years before a type 2 diabetes diagnosis, while blood sugar barely moved until the last 3 years. (Tabák et al., 2009) (In Module 2, I'll show you simple ways to estimate it from ordinary blood tests.)

Prediabetes: the pancreas starts to tire

Over time, the pancreas can't keep up. Blood sugar starts to creep up. When it's higher than normal but not high enough to be called type 2 diabetes, that's prediabetes. NIDDK defines it with these blood tests:

One path, different stages

Think of insulin resistance and prediabetes as stops on the same road. They are not two separate problems.

You can have insulin resistance for years with "normal" labs. And not everyone with prediabetes goes on to type 2 diabetes. What you do now matters.

How many people have it and don't know

You are far from alone.

• 97.6 million adults in the United States had prediabetes in 2021. That's more than 1 in 3 adults. (NIDDK)
• 27.2 million of them were 65 or older, and another 37.5 million were 45 to 64. (NIDDK)
• Most people with prediabetes don't know they have it. In national survey data from 2011 to 2020, 84% of adults with prediabetes were unaware of it. (Wang et al., 2025, an analysis of the NIH-indexed National Health and Nutrition Examination Survey)
• Even full type 2 diabetes often goes unnoticed. About 8.7 million US adults had diabetes but hadn't been diagnosed. That's nearly 1 in 4 adults with diabetes. (NIDDK)

There are no official counts for insulin resistance alone, because it's rarely tested. Since it comes before prediabetes, the true number is likely even higher.

Why years, or decades, of "waiting and watching" is risky

Many people are told to "keep an eye on it" and come back in six months. Meanwhile, the quiet strain can go on for years. Here's what research shows can happen when insulin resistance and prediabetes are left alone:

• Type 2 diabetes. NIDDK reports that people with prediabetes have a high chance of developing type 2 diabetes within 5 to 10 years. In the Diabetes Prevention Program, about 11% a year of people in the placebo group developed diabetes.
• Heart and blood vessels. NIDDK notes that some people with prediabetes already have changes in their blood vessels, which can lead to some of the same problems type 2 diabetes causes. Insulin resistance and prediabetes are also linked to high blood pressure, unhealthy cholesterol and triglycerides, and metabolic syndrome, a cluster that raises the risk of heart disease and stroke.
• Liver. Fatty liver disease (NAFLD, now also called MASLD).
• Kidneys, nerves, and eyes. Once type 2 diabetes develops, high blood sugar can damage the kidneys, the nerves (especially in the feet), and the eyes, which can lead to low vision and blindness. NIDDK says type 2 diabetes can affect almost every part of the body.
• Brain. NIDDK notes that high blood glucose raises the chance of developing dementia. Research reviews also link insulin resistance to memory loss and Alzheimer's disease. Those links don't prove that fixing insulin resistance prevents dementia, but they're a powerful reason to act now.

Research links insulin resistance to a higher risk of heart disease.

Looking for root causes

Conventional care often waits for a number to cross a line, then treats the number. A functional, whole-person approach asks a different question: why is this happening in your body, in your life, right now?

Insulin resistance usually has more than one driver:

• Muscle loss, which happens naturally as we age. Muscle is where most of the sugar from a meal goes.
• What and how we eat: ultra-processed food, sugary drinks, and meals built around refined starch.
• Poor sleep and chronic stress.
• Hormone shifts, such as menopause and changing testosterone levels.
• Inflammation and gut health.
• Toxic load: tobacco, alcohol, and some everyday chemicals.
• Not moving enough, and doing it all alone.

Notice what's not on that list: willpower, laziness, or being a bad person. Symptoms are clues, not character.

The good news

Your body responds to change, often faster than people expect. NIDDK states that healthy living may help prevent or reverse insulin resistance and prediabetes.

In the NIH-funded Diabetes Prevention Program, everyday lifestyle changes cut the chance of developing type 2 diabetes by 58%. For people 60 and older, it was 71%. Lifestyle change worked better than the diabetes medicine in the same study.