Welcome back, health champions!👋

I finally sat down for my Q1 2026 goal review last week — four weeks behind schedule, but I got there! Some goals had shifted, a few I'd made real progress on, and others I'd simply forgotten. The ones that slipped all shared a pattern — good intentions, but not all the necessary pieces kept in motion long enough to compound into real change.

That maps directly onto prediabetes management. When you don't bring all the necessary components together — or don't stay the course long enough — it feels like an uphill battle where you keep ending up back at the starting line. Each A1C appointment becomes an emotional event, every food choice carries anxiety, and the numbers don't budge in any lasting way. Today's newsletter is a mid-year check-in on the goals and approaches that actually matter — so that by end of 2026, you're celebrating real results instead of riding that same rollercoaster.

🚨 Enrollment is open — and seats are intentionally limited. 

The 21-Day Prediabetes Reset is now accepting its first cohort. Small group, on purpose. Science-backed, led by me and a registered dietitian, designed to address what's actually driving your prediabetes: insulin resistance, liver fat, and a metabolism that's lost its signaling precision. Three weeks. Real mechanisms. Habits that move your numbers — for good.

Full details at the end, but if you're already ready: Reserve your spot →

BEST FINDS

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Tip: If a recipe includes honey or maple syrup, you can usually reduce it or skip it entirely — the flavor still holds up.

Your 2026 Prediabetes Upgrade Guide

Alright, back to your health. Below are five areas where the standard prediabetes advice needs an upgrade — and what the science actually supports instead. These are the goals worth setting, the ones worth rethinking, and a few things most people with prediabetes have simply never been told.

Upgrade #1: Your Goal Should Be Normal Blood Sugar, Not Just "Don't Get Diabetes"

What you've been told: Prevent or delay progression to type 2 diabetes.

The science-backed upgrade: Aim for normoglycemia — actual normal blood sugar.

The original Diabetes Prevention Program (DPP) was a landmark study showing lifestyle changes could cut type 2 diabetes risk by 58%. Building on that, the CDC established the National Diabetes Prevention Program in 2010 — a nationwide network now accessible to millions. Their goal: prevent or delay progression to type 2 diabetes. The American Diabetes Association, which sets the clinical standards most doctors follow, also defines success in prediabetes as preventing or delaying progression to type 2 diabetes.

That's a meaningful and important goal — but it stops short of asking whether normal blood sugar is achievable, and that gap is rarely discussed. A 10-year cohort study found ~40% of individuals with prediabetes reverted to normoglycemia, particularly with lifestyle changes (Frontiers in Endocrinology, 2022), and meta-analyses of randomized trials show lifestyle interventions can increase rates of return to normoglycemia in addition to reducing diabetes risk.

Normoglycemia is rarely discussed as a goal because the system is built around preventing diabetes—not restoring normal glucose. For many people, that sets the bar too low.

Upgrade #2: Fixing Your Blood Sugar Now Protects Your Heart for Decades

What you've been told: Prevent diabetes because diabetes has serious complications.

The science-backed upgrade: Improving your blood sugar now dramatically lowers cardiovascular risk for the next 20–30 years — whether or not you ever develop diabetes.

A systematic review of seven studies with over 73,000 participants found that people who reversed prediabetes to normal blood sugar were associated with 22–50% lower risk of cardiovascular disease and death, tracked over 5–12 years (Acta Endo, 2024). Two people, same starting A1C — five years later, the one who returned to normal glucose may have dramatically lower cardiovascular risk.

Part of the mechanism is glycation. When blood sugar stays chronically elevated — even in the prediabetes range — glucose attaches to proteins and fats throughout the body, forming Advanced Glycation End Products (AGEs). AGEs stiffen arteries, promote inflammation, damage kidney tissue, and accelerate the plaque buildup behind heart attacks and strokes. Research found AGE-related arterial stiffness already present in people with prediabetes — not just full diabetes — and many of these changes are difficult to reverse once accumulated. Getting to normal blood sugar is about stopping this slow, silent damage as early as possible.

Upgrade #3: Don't Just Lose Weight — Lose Fat and Build Muscle

What you've been told: Lose weight.

The science-backed upgrade: Lose fat, build muscle.

Some people have achieved normal glucose regulation without losing much scale weight — simply by improving body composition and insulin sensitivity.

What drives lasting blood sugar improvement is losing visceral fat — the metabolically active fat around your organs — while building muscle. Research found that adding exercise to weight loss plan produced more than double the improvement in insulin sensitivity compared to diet-only weight loss (Nature Metabolism, 2023). A landmark NHANES III analysis of 13,644 people found every 10% increase in skeletal muscle mass was associated with an reduction in insulin resistance (Srikanthan & Karlamangla, JCEM, 2011). Skeletal muscle is your body’s largest site of insulin-mediated glucose disposal — more functional muscle means more capacity to clear blood sugar after meals, and that capacity stays with you.

Losing weight in a way that depletes muscle rather than fat can produce a temporary A1C drop — and then plateau or creep back up. The goal is body recomposition, not just a lighter number on the scale.

Upgrade #4: It's Not Just 150 Minutes — It's What Kind of Exercise

What you've been told: Get 150 minutes of moderate exercise per week.

The science-backed upgrade: What you do in those 150 minutes matters as much as the number.

Walking is beneficial, but relying on it alone tends to produce improvements that plateau — it doesn't meaningfully increase muscle mass. Research confirms that resistance training can be as effective as aerobic exercise for improving insulin sensitivity, and combining both is superior to either alone. Your 150 minutes needs to include intentional strength work, not just steps.

Upgrade #5: Track Your Full Metabolic Picture, Not Just A1C

What you've been told: Watch your A1C and blood sugar numbers.

The science-backed upgrade: Fixing your blood sugar while worsening other metabolic parameters is not a win.

Diabetes complications are driven by high glucose — but outcomes are dramatically worsened by what travels alongside it: elevated triglycerides, chronic inflammation, low HDL, poor fiber intake. A plan that drops your A1C but raises LDL, spikes inflammation, or erodes muscle is trading one problem for another. Many popular internet-recommended diet approaches do exactly this — improving blood sugar short-term while leaving the underlying drivers (insulin resistance, visceral fat, liver fat) untouched. Real, lasting remission requires restoring insulin sensitivity and rebuilding your body's actual capacity to process glucose.

Track: A1C, fasting glucose, 2-hour post-meal glucose, triglycerides, HDL/LDL, hs-CRP, and fasting insulin.

Action Steps: What to Discuss With Your Doctor or Nutritionist

1. Discuss possibility of normoglycemia as your target — and request A1C, fasting glucose, and 2-hour post-meal glucose tracking.

2. Request a full metabolic panel — triglycerides, HDL/LDL, hs-CRP, and fasting insulin to reveal your insulin resistance status.

3. Ask about body composition — a DEXA scan gives the clearest fat vs. muscle baseline. A bioelectrical impedance scale (under $50) is less precise but useful for tracking trends at home.

4. Bring up resistance training — ask for a referral to an exercise physiologist or certified diabetes care educator who includes muscle-building in the plan.

5. Talk about fiber — target 25–35g per day. Many people cutting carbs for blood sugar accidentally cut fiber too, which matters for inflammation and insulin sensitivity.

You now know more about prediabetes than most people sitting in a waiting room. The next move is yours.

Have questions? We got answers. Email [email protected]

Ready for a Structured Reset?

Everything above — targeting normoglycemia, improving body composition, building the right exercise foundation, protecting your full metabolic picture — is exactly what the 21-Day Prediabetes Reset was built around. You'll have an expert scientist decoding the research and a registered dietitian personalizing it into a plan that works for your life — so the results you hit at your next appointment keep showing up, year after year.

Our newsletter reaches thousands of readers. This cohort is small on purpose. We plan to run more in the future — but we can't tell you when, and this round fills from the waitlist.

The program page covers everything: what each week looks like, what to realistically expect, and what makes this different.