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Reversing the Diabetes Epidemic: Functional Medicine Insights into Early Detection and Intervention

Writer's picture: Gemma Westfold Gemma Westfold


Type 2 diabetes is a growing health concern among those I work with, and it often creeps up on people without warning. Standard tests like glucose or HbA1c usually only flag a problem when it’s well advanced. But the good news is that insulin resistance—the precursor to type 2 diabetes and what used to be termed 'pre-diabetes' —starts much earlier, and you can catch it by looking at a few key markers that often get missed in routine tests.


By understanding these markers and taking action, you can turn things around before it’s too late.


Key Markers to Spot the Early Warning Signs


1. Fasting Insulin

Fasting insulin is one of the first markers to show that your body might be struggling. If it’s raised, it means your pancreas is working overtime to keep blood sugar levels normal, even if your glucose or HbA1c levels look fine. Ideally, fasting insulin should be below 6 μU/mL. Unfortunately, this test isn’t part of standard NHS checks, but it’s included in my Wellness Checks and can be added to my programmes.


2. HbA1c

HbA1c shows your average blood sugar levels over the past three months. Think of it as a snapshot of how much sugar has been "sticking" to your red blood cells. While the NHS considers levels between 42-47 mmol/mol as prediabetes, functional medicine flags anything over 37 mmol/mol as worth addressing. The sooner you take action, the better! I have seen time and time again how powerful simple nutritional changes can be in lowering HbA1c and transforming health.


3. Fasting Glucose

This measures your blood sugar at a single point in time, like first thing in the morning before eating. Ideally, levels should be between 4.0 and 5.4 mmol/L. If it’s between 5.5 and 6.9 mmol/L, that’s a red flag for prediabetes. But on its own, fasting glucose doesn’t tell the whole story, which is why combining it with other markers is so important.


4. Continuous Glucose Monitors (CGMs)

CGMs like the FreeStyle Libre track your blood sugar levels in real time throughout the day. They’re brilliant for seeing how your body reacts to meals, exercise, and stress. When combined with fasting insulin and HbA1c results, CGMs provide an incredibly clear picture of your metabolic health. I love using these in clinic and am wearing one right now to monitor my own blood sugar.


Symptoms to Watch Out For

Often, insulin resistance develops quietly, but there are some tell-tale signs to keep on your radar:


1. Abdominal Weight Gain

  • What it looks like: Gaining fat mostly around your waist, giving you an “apple-shaped” figure.

  • Why it happens: Insulin, a hormone that helps manage blood sugar, also tells your body to store fat. When there’s too much insulin, your body tends to store fat in the belly area.


2. Fatigue

  • What it looks like: Feeling tired all the time, even if you’re getting enough sleep.

  • Why it happens: When your cells stop responding to insulin properly, they can’t absorb enough sugar (energy). Without enough fuel, your body feels drained and sluggish.


3. Carbohydrate Cravings

  • What it looks like: Constantly wanting sugary snacks or starchy foods like bread, pasta, or chips, even after eating.

  • Why it happens: Insulin resistance can cause your blood sugar levels to rise and fall quickly. When blood sugar dips, your brain tells you to grab quick-energy foods to bring it back up.


4. Excessive Thirst

  • What it looks like: Feeling thirsty all the time and drinking lots of water.

  • Why it happens: When blood sugar levels are high, your body pulls water from your cells to try to flush out the extra sugar, making you feel dehydrated.


5. Frequent Urination

  • What it looks like: Running to the bathroom more often than usual, even waking up at night to pee.

  • Why it happens: High blood sugar spills into your urine, which pulls water along with it. This means your body is losing more water, making you pee more often.


6. Excess Hunger

  • What it looks like: Feeling really hungry, even after eating a full meal.

  • Why it happens: If your cells aren’t getting enough sugar (energy) because of insulin resistance, your body thinks you’re starving and signals you to eat more.


7. High Blood Pressure

  • What it looks like: Blood pressure readings that are consistently high. You might also notice headaches or feel lightheaded.

  • Why it happens: Too much insulin causes your body to hold on to more salt and water, which raises blood pressure. It also stiffens your blood vessels, making it harder for blood to flow smoothly.


8. Skin Changes

  • What it looks like:

    • Dark patches: Thick, velvety skin, often on the neck, armpits, or groin.

    • Skin tags: Tiny, soft skin growths on the neck or underarms.

  • Why it happens: High insulin levels can overstimulate skin cells, leading to these changes.


These symptoms are like warning signs from your body. They’re often tied to how your body processes sugar and insulin. The good news is that with the right changes to diet and lifestyle, you can manage these symptoms and get your health back on track.


These symptoms collectively reflect the widespread metabolic disruption caused by insulin resistance. Addressing the root causes through nutrition, exercise, and targeted interventions can help mitigate these signs and prevent progression to conditions like Type 2 diabetes.


Why Act Early?

Functional medicine - which is what Nutritional Therapists like me practice - tackles insulin resistance before it spirals into full-blown diabetes. We intervene when markers like HbA1c reach 37 mmol/mol, stopping the progression early. This is so important because type 2 diabetes can lead to serious complications like heart disease, nerve damage, and kidney problems—but it’s preventable with the right support.


Lifestyle Changes That Work

  • Nutrition: A lower-carb, high-fibre, Mediterranean-style diet works wonders. Research shows how it can reduce fasting insulin and HbA1c, often helping people come off medication.

  • Exercise: A mix of strength training and cardio helps your muscles use glucose more efficiently, improving insulin sensitivity.

  • Weight Loss: Shedding even 5-10% of your body weight, especially around your middle, can make a massive difference.

  • Stress and Sleep: Poor sleep and chronic stress can worsen insulin resistance. Prioritising rest and managing stress with techniques like mindfulness can help.


Your Next Steps

If any of this sounds familiar—fatigue, weight gain, cravings, or frequent loo trips—it’s time to take control of your health. Don’t wait until it’s too late. By testing key markers like fasting insulin, HbA1c, fasting glucose, and using CGMs, you can get a full picture of your metabolic health and make changes that truly work.


I offer personalised testing, expert guidance, and tailored plans to help you feel your best again. Why not book a free 20-minute health review call with me? Together, we can assess your risk and create a plan to reverse any early warning signs. Don’t let diabetes sneak up on you—take action today.

 


I'm Gemma Westfold, BANT registered Nutritional Therapist.





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