Managing glycemic control and insulin sensitivity can be tricky. Some guiding principles:

  • achieve and maintain a healthy body composition (adequate muscle, little fat — especially visceral fat)
  • healthy nutrition (avoiding persistent calorie excess, minimising processed carbohydrates and fructose, eating high soluble and insoluble fibre and healthy protein sources low in saturated fat)
  • exercise — muscles become more insulin sensitive and need to replace glycogen lost during exertion (exercised muscles act like a sponge, sucking up blood glucose); regular exercise also increases daily calorie expenditure and can help prevent small daily calorie excesses 
  • sleep — good quality, adequate sleep is now known to be crucial for preventing insulin resistance. Those who consistently get less than 7 hours of sleep each night (on average) show significant reductions in glucose disposal and are predisposed to hyperglycaemia
  • stress — chronically increased cortisol levels increase appetite, blood pressure and blood sugar, among other things
  • medications — a large array of well-studied medications with a proven track record of safety, efficacy and improved cardiovascular outcomes is available to treat impaired glucose tolerance