Prediabetes and Insulin Resistance
The window to reverse the risk of diabetes
What it is
Insulin resistance happens when cells respond less to this hormone and the pancreas has to produce more and more of it to keep glucose normal. Over time, this effort wears out and glucose starts to rise, characterizing prediabetes: levels above normal but still below the threshold for a diabetes diagnosis. This phase tends to be silent and is linked to abdominal fat accumulation, a sedentary lifestyle, polyendocrine metabolic ovarian syndrome (SOMP) and family history. The good news is that this is a window of opportunity: with guided lifestyle changes and follow-up, most patients normalize their glucose and avoid progressing to type 2 diabetes.
Most common symptoms
- Usually no noticeable symptoms
- Increased fat in the abdominal area
- Darkening of the skin on the neck and underarms
- Drowsiness and fatigue after meals
- Frequent cravings for sweets
- Irregular periods and acne
Causes and risk factors
- Excess weight, mainly abdominal fat
- A sedentary lifestyle and a diet high in sugar and ultra-processed foods
- Family history of type 2 diabetes
- Polyendocrine metabolic ovarian syndrome (SOMP)
- Previous gestational diabetes
- Insufficient sleep and chronic stress
How it is diagnosed
Prediabetes is identified through blood tests: fasting glucose between 100 and 125 mg/dL, HbA1c between 5.7% and 6.4%, or glucose between 140 and 199 mg/dL two hours after a glucose load. Insulin resistance is assessed through a combination of clinical findings, such as waist circumference, blood pressure and acanthosis nigricans (a darkening of the skin in body folds), plus tests such as fasting insulin, triglycerides and HDL. In women, the endocrinologist also looks for signs of polyendocrine metabolic ovarian syndrome (SOMP), which often occurs alongside insulin resistance. Body composition testing by bioimpedance rounds out the evaluation.
How we treat it at Femi Saúde
Treatment is based on lifestyle change, which is the most effective intervention at this stage: a 5% to 7% weight reduction, a diet with less sugar and fewer ultra-processed foods, at least 150 minutes of physical activity per week, and regular sleep. In higher-risk patients, such as those with HbA1c closer to the threshold, a history of gestational diabetes, or SOMP, medication may be added as a complement. Tests are repeated every six to twelve months to track the response, and the endocrinology team at Femi Saúde adjusts the plan according to each patient's routine and results.
When to see a gynecologist
See your endocrinologist if a test showed glucose or HbA1c slightly above normal, if you have increased abdominal fat, dark patches on your neck or underarms, or if there is diabetes in your family. It's also worth a visit if you have SOMP, have had gestational diabetes, or have altered blood pressure, triglycerides or cholesterol along with weight gain.
What we offer
Endocrinology specialists
Endocrinology treatments at Femi Saúde
Metabolic and Hormonal Assessment
A complete check-up of metabolism and hormones
Medically Supervised Weight Loss
Safe, science-based weight loss
Hypothyroidism
When the thyroid works too slowly
Hyperthyroidism
When the thyroid produces too much hormone
Thyroid Nodules
Careful evaluation, without alarm
Hashimoto's Thyroiditis
The most common autoimmune cause of hypothyroidism
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