The Simple Habits That Reversed My Pre-Diabetes

Welcome to the Commune Podcast. My name is Jeff Krasnow. So five years ago, I was suffering from many of the most anodyne symptoms of modern life. Brain fog, chronic fatigue, insomnia, excess fat around the middle. Maybe you can relate. These symptoms are so common that we've normalized them. But it wasn't until I slapped a continuous glucose monitor on my triceps that I got a rude awakening. I was teetering on the edge of diabetes.

with pre-diabetic fasting blood glucose levels of 125 milligrams per deciliter. So in today's episode, I'm diving deep into pre-diabetes and early metabolic dysfunction, what the latest research says. how common it really is, and spoiler alert, more common than you think, and most importantly, the practical protocols I use and still use to reclaim control of my blood sugar. We'll talk about food movement, testing, and even some supplemental ideas that might help.

All of that wrapped in the real experience of someone who has walked this path. So if you've ever wondered whether your blood sugar is quietly creeping upward, even if you feel fine, well, this episode is for you. By the way, if you want more of my musings, like this very episode started out as a trickle of ideas that I had while I was walking down the West Side Highway in New York City. I do a lot of this over on my Substack. So you can find me at jeffkrasnow.substack.com.

I'm also doing a lot more on YouTube these days, including releasing all of my interviews I've done on the show as video episodes. And you can watch those over on my YouTube channel at Jeff Krasnow. Okay, so... The statistics are just staggering. Approximately 38 million Americans have diabetes and nearly 98 million adults have prediabetes. That means more than one in three American adults are living.

with prediabetes. And what is even more concerning is that over 80% of the people with prediabetes don't even know they have it. I was one of them. Before we dive in, let me clarify something really important. When I talk about diabetes in this episode, I'm specifically referring to type 2 diabetes. Type 1 diabetes is fundamentally different. It's an autoimmune condition.

often appearing in childhood or adolescence in which the immune system attacks and destroys the pancreas' insulin-producing beta cells, leading to insulin deficiency and the need for lifelong insulin. Now while both conditions involve elevated blood glucose levels, their relationship with insulin is totally different.

In type 1 diabetes, the body can't produce insulin at all, or enough of it. And in type 2 diabetes, the body still produces insulin, often too much of it at first, but the cells become resistant to its effects. This insulin resistance prevents glucose from efficiently leaving the bloodstream and entering the cells where it's needed for energy. But here's the good news, and I know this from personal experience, prediabetes is both preventable...

and in many cases, reversible. So today, I'm going to share with you the protocols that work for me. Now, why does this matter so much? Because diabetes is no joke. It's associated with a cascade.

of serious downstream conditions neuropathy or nerve damage retinopathy vision problems kidney disease cardiovascular disease and alzheimer's dementia In fact, Alzheimer's is sometimes referred to as type 3 diabetes because it's so often characterized by insulin resistance in the brain, essentially the brain's inability to make energy effectively.

I had a fascinating conversation with Dr. Ben Bickman about this in a previous episode where he discussed his research on hippocampal tissue from people who died with Alzheimer's. And what he found was clear evidence of insulin resistance. in the brain now here's where our modern medical system often fails us now we typically don't diagnose pre-diabetes until it's almost too late you go to your primary care physician you get a blood panel and the main marker hemoglobin a1c

gets checked. If you're below the diabetes threshold, you just generally don't get a call. You can be trudging through life, thinking everything is fine. But diabetes exists on a spectrum. You could be careening toward diabetes, teetering at the highest end of prediabetes without even knowing it. That was me. This is exactly why catching it early is so critical.

It's much easier to reverse prediabetes with lifestyle changes than to manage full-blown diabetes. Now, let's talk about what these numbers actually mean because understanding them is your first line of defense. Pre-diabetes is characterized by fasting blood sugar levels between 100 and 125 milligrams per deciliter. Personally, I was at the very highest edge of that range.

when I discovered it by wearing a continuous glucose monitor. Once you're over 125 milligrams per deciliter fasting, you've crossed into diabetes territory. I'll talk more about continuous glucose monitors or CGMs later in the episode. The hemoglobin A1c test measures your average blood sugar over approximately three months. And here are the ranges. Below 5.7% is normal.

5.7 to 6.4% is prediabetes and 6.5% or higher is diabetes. Unlike a finger prick test or continuous glucose monitor that measures your blood glucose. moment to moment, in a snapshot, A1C gives you a three-month average. Now, continuous glucose monitors are a pretty good proxy for metabolic health, but they're not perfect. They measure blood glucose, which is actually downstream from insulin.

So think about it. Your pancreas could be working overtime, producing tons of insulin to clear glucose from your bloodstream. That's what it does. And that might keep blood glucose levels okay in the short term, but eventually you'll build up insulin resistance and you'll... lose the ability to clear glucose effectively. So when glucose stays in your bloodstream and isn't used for energy by your cells, it has several fates. Some of it can be stored as glycogen for a rainy day. That's okay.

But excess glucose can also get stored as fat, specifically triglycerides that are stored in adipose tissue, which begins a vicious cycle because more adipose tissue, particularly visceral fat, becomes inflammatory and leads to a greater prevalence.

of diabetes. Another is glycation, which is when glucose binds to proteins, creating what are known as advanced glycation end products or ages. And these are inflammatory molecules strongly associated with heart disease. This is one of the key links between high blood glucose diabetes and cardiovascular disease okay we'll be right back after this brief ad break with the protocols that you can use to manage blood sugar

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Okay, let's get back to the good stuff, the actionable protocols that you can implement today. And just a quick disclaimer, I'm not a medical doctor. I'm simply sharing what's worked for me in managing my blood sugar and overall metabolic health. So let's start with diet. Firstly, cut down on refined carbohydrates. Now, this might seem obvious, but it bears repeating. Glucose is a molecule that comes from carbohydrates that you eat.

Your body metabolizes these foods in your small intestine, and they're absorbed into your bloodstream, and this drives up glucose levels. If you're concerned about prediabetes, I'd recommend reducing your intake of things like refined grains, refined sugar, ultra-processed foods, and high-starch foods. I used to call the carb-heavy diet carbicide.

But you shouldn't really totally eliminate carbs. Your body does need glucose to make energy. Instead, consider changing the ratio of your macronutrients. Consider getting... 20-25% of your overall calories from carbohydrates and the balance from proteins and fats. The second dietary protocol focuses on the power of fiber, especially in the morning.

Now, this is huge, and it flies directly in the face of what we typically do and eat in our culture. We eat bagels and cereal and muffins first thing in the morning. These are foods loaded with carbohydrates that spike blood glucose. But... If you eat fiber first,

Nuts, leafy greens, avocados, legumes. Then something remarkable happens. Soluble fiber creates a gel-like lattice on the inside of your small intestine. Now, we don't actually digest fiber ourselves. We outsource that to our gut bacteria. What fiber does is slow down the absorption of all macronutrients into the bloodstream. This is why fiber is so important, particularly eating it first. That gel-like barrier blunts blood glucose spikes instead of your blood sugar looking like the Alps.

or the andes It looks like the rolling hills of Georgia. Okay, my third dietary protocol is prioritizing protein in the morning. This is incredibly important because your body's more primed to metabolize protein early in the day. If you can get 30 to 40 grams of protein in the morning... you'll experience several benefits, such as greater satiety. Protein keeps you feeling full, unlike carbohydrates, which...

can cause a spike in energy followed by a crash and renewed hunger. And protein has a thermic effect. So while protein has four calories per gram, it actually takes significant energy for your body to break it down and digest it. So the net effect is... closer to three calories per gram, where carbs contain four calories per gram, fat contains nine, and alcohol, somewhat wistfully, seven. You can easily combine protein and fiber in the morning with something like nuts and yogurt.

That's a great one. So the fourth dietary protocol is time-restricted eating, also known as intermittent fasting. Now, I've found that adopting a fasting routine can be incredibly helpful for controlling blood sugar. Now, there are a few different ways to approach it. But I generally follow the 16-8 method, which means I consolidate all my food consumption in an eight-hour window, usually more or less between 11 and 7.

Now, importantly, I try to finish my last meal about three hours before bed, and that gives my body time to digest and allows insulin levels to drop. before sleep, so the body can focus on repair and restoration instead of growth. Now, ideally, that eating window would start earlier in the day. Our metabolism tends to be more active in the morning, but...

Life happens. So you have to balance health with your social life and try not to get too rigid or obsessive about it. Arthorexia or the fixation on perfect eating can create its own set of problems. There are several science-backed benefits to fasting. Number one, pancreatic rest. Even consolidating your eating into a 10 or 12-hour window gives your pancreas a much-needed break from constant insulin production.

And when you reduce that demand, your insulin sensitivity improves. Your body becomes better at responding to insulin when you need it. Okay, number two, metabolic flexibility. Fasting helps your body become more efficient at switching between burning glucose and fat for energy rather than relying solely on carbohydrates. You become more of a Prius.

Number three, mitochondrial biogenesis. Some research suggests that fasting can stimulate the creation of new mitochondria, the power plants inside your cells that produce energy. And number four, autophagy. When your body senses a nutrient deficient state, pathways like AMPK trigger autophagy, a cleanup process where old

damaged proteins are broken down and recycled into new ones. It's one of the body's most remarkable repair mechanisms. Autophagy generally requires longer fasting periods, though, so we'll save that for another episode. Beyond diet, movement. is absolutely critical for managing blood glucose. The easiest and most effective protocol everyone should implement is postprandial movement or simply moving after every meal. Walk, do some push-ups or pull-ups, air squats, or even have an animated...

dishwashing session, anything counts. Right after you eat, you naturally get a glucose spike. Now, if you engage in some physical activity, your muscles become hungry for glucose and will readily take it up from your bloodstream. And by moving after meals, you actively control blood glucose in the most natural way.

possible. Resistance training is also huge for blood glucose management. By resistance training, I mean getting in the gym and lifting heavy weights, doing bodyweight exercises, or using resistance bands. Anything that overloads a muscle. When you stimulate... that inflammatory response by creating little micro tears in muscle fibers when you lift weights, your body enters muscle protein synthesis mode. It activates structural proteins like actin and myosin, and with a little adequate rest, that

muscle grows back bigger and stronger. Now, the reason this matters for blood glucose is because the more muscle you have, the more ability you have to control blood glucose. Muscle is incredibly greedy for glucose. It's a natural glucose vacuum. And the more muscle that you carry, the more glucose uptake occurs from your bloodstream. And here's the really cool part. When you contract a muscle, like during a pull-up or a push-up or a squat, you don't need insulin to uptake glucose.

This means your pancreas can remain in a docile tranquil state while your muscles vacuum up glucose from your bloodstream. That's why muscle development is so powerful for metabolic health.

Aside from diet and exercise, there are a few supplemental approaches that may help with blood glucose management. So let's start with apple cider vinegar. There's been a lot of talk about that. That's some small but... Consistent studies have shown that the acetic acid in vinegar may help reduce post-meal blood glucose spikes by improving insulin sensitivity and slowing down carbohydrate absorption. So if you can handle the taste, take about a teaspoon.

diluted in water before meals. It's not a cure, but it can be a very helpful adjunct for some people. And then there's berberine, a plant compound found in herbs like barberry and goldenseal. You can just buy it as a supplement. There's moderate clinical evidence suggesting that berberine can help lower fasting blood glucose and improve insulin sensitivity. And in some studies, showing effects comparable to common diabetes medications.

Now, personally, it's hard for me to isolate how much berberine helps on its own since I use it within a larger matrix of other lifestyle protocols. But the research overall does suggest very good potential benefits okay let's talk about the tools available to discover whether you're pre-diabetic As I mentioned earlier in the episode, CGMs are commercially available devices that provide a pretty good proxy for metabolic health. You insert a small sensor.

A little disc on your triceps that measures glucose from your interstitial fluid and sends that data to an app. So you can see your glucose levels moment to moment and learn what spikes your blood glucose and what doesn't. These devices were previously only prescribed for diabetics, but now they're commercially available to anyone. Companies like Dexcom and Habit make the hardware.

and various apps integrate with them now unfortunately they're still pretty expensive but hopefully mass adoption will drive prices down and increase insurance coverage but if you have the means it's definitely worth trying even if you just put one on every three or four months standard blood panels are another option there are numerous blood panel services available now like function health or inside tracker and others these aren't cheap either

But even a regular blood panel from your primary care physician covered by most insurance policies will give you a hemoglobin A1C readout. You'll want to familiarize yourself with the pre-diabetic ranges, right? So when you get your A1C results, you'll be able to... to see if you're creeping towards the higher end of the pre-diabetic range. Now, I know I just threw a lot of information at you. Here's the essential takeaway. Blood sugar exists on a spectrum and small consistent changes

and protocols and lifestyle can make a huge difference. The key is addressing it before it's too late. Now, the protocols I've laid out in this episode, better food choices, moving more, building muscle, and some testing are simple, free, or relatively inexpensive, and remarkably effective at keeping you in the healthy range.

Much of what I've shared comes from my own personal experience, which I address in detail in my book, Good Stress. I went from being right on the edge of diabetes to completely reversing my prediabetes through all of these protocols and approaches that I just talked to you about. And prediabetes doesn't have to be your destiny. With awareness, knowledge, and consistent action, you can take control of your health. Okay, thanks for listening. And seriously, go out for that post-podcast walk.

For more of my protocols, you can pick up a copy of Good Stress, my book where I go into great depth about reversing my prediabetes and generally about getting uncomfortable for the sake of health. Yes, stress can be good in the right dose. As always, feel free to reach out to me directly with questions, feedback, or constructive criticism at jeffk at onecommune.com. Okay, that's all from the Commune for today. My name is Jeff Krasnow. And I'm here for you.

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