Diabetes affects a huge number of Americans — and the risk climbs sharply with age, especially for those of us with a family history of it. If that’s you, you’ve probably wondered whether it’s just a matter of time. Here’s the good news: it’s not inevitable. Diet and lifestyle can prevent it, and in many cases, reverse it too. I believe in knowledge as power, so let’s talk about how this actually works.
How Blood Sugar Goes Off the Rails
For a lot of people, the first sign of trouble isn’t high blood sugar — it’s low blood sugar, or hypoglycemia. Here’s why: your body regulates glucose through hormonal signals, and insulin is the big one. Insulin tells your cells — muscles, organs, all of it — to open up and let glucose in for energy.
Early on, those cell receptors start getting less responsive to insulin’s signal. So your pancreas compensates by pumping out more and more insulin to get the same job done. That’s insulin resistance. Eventually, your pancreas overshoots trying to keep up, and blood sugar starts swinging — high, then low, then high again. If you’ve ever felt shaky, sweaty, or like your heart is racing about two hours after a carb-heavy meal, that’s the swing you’re feeling.
Here’s the tricky part: at this stage, a standard fasting glucose test usually looks completely normal. Your pancreas is still keeping up — barely — so the test misses it. But the underlying changes are already happening, and diabetes is already progressing.
The Test I Actually Recommend
When patients come to me worried about blood sugar, I don’t lead with fasting glucose. I go straight to Hemoglobin A1C. It measures how much sugar has attached to your red blood cells over time, which reflects your average blood sugar — not just a snapshot. In my experience, it catches blood sugar problems far earlier than fasting glucose does, which means we can act while there’s still time to turn things around.
Left unaddressed, your pancreas keeps overworking itself to keep up with rising insulin resistance. Eventually it can’t keep pace, insulin production starts to decline, and that’s when fasting glucose finally starts to climb too. But here’s what matters most: up until that point — and even after — these changes are reversible.
A Family History Isn’t a Life Sentence
Having diabetes in your family doesn’t mean you’re destined for the same diagnosis. I see it as an opportunity — a reason to make the lifestyle changes now that will protect your health for decades to come.
When I work with patients on blood sugar, I start in two places: exercise and diet.
Exercise does more to reduce insulin resistance at the cellular level than almost anything else. I recommend 30 to 45 minutes of aerobic exercise, five days a week. If you’re just getting started, don’t jump straight to 45 minutes — start with 15 minutes a day and build from there.
Diet means cutting back on carbohydrates significantly, and when you do eat them, choosing whole grain, high-fiber sources. When it comes to fruit, reach for lower glycemic options like berries, apples, and citrus instead of tropical fruits, which tend to spike blood sugar more.
When You Need Extra Support
For patients who need more than diet and exercise alone, I turn to herbs and nutrients that support healthy blood sugar — Devil’s Club, Gymnema, and Bitter Melon are a few of my favorites.
It’s genuinely rewarding to watch patients take charge of their health, reverse the changes that were pointing toward diabetes, and feel in control again. It really does just take the knowledge and the willingness to make the changes.
— Dr. Faith Christensen