More than 8 million Americans have type 2 diabetes and don’t know it. Another 77 million are unaware that they have prediabetes. In all, the Centers for Disease Control and Prevention (CDC) estimates that 29.1 million Americans have diabetes and 86 million have prediabetes.

Insulin resistance, which often has no outward symptoms, is a hallmark of both prediabetes and type 2 diabetes. When muscle, fat and liver cells ignore insulin’s signals, blood sugar levels rise. Before people develop type 2 diabetes, they almost always have prediabetes, defined as having blood sugar levels higher than normal but below the level of diabetes. And before developing prediabetes, they typically have insulin resistance with normal blood sugar levels. Enabling your body to become more sensitive to insulin can help you prevent type 2 diabetes and manage it better if you already have the disease. Without lifestyle changes, those with prediabetes are likely to progress to full-blown diabetes within 10 years.

With each birthday, your risk for developing type 2 diabetes increases. You are also at higher-than-average risk if you have family members with type 2 diabetes, if you are a woman who had gestational diabetes or has polycystic ovary syndrome (PCOS), or if you are of particular race: Black, Hispanic/Latino, Asian, Native American or Pacific Islander. You can do nothing about these risk factors, but there are some you can control: being overweight or obese, eating an unhealthy diet and not engaging in regular exercise.

5 steps to improve insulin response

Whether you have diabetes or prediabetes, or are at risk for developing them, there are several natural ways to increase your body’s insulin sensitivity and improve the way your body responds to this critical hormone.

1. Drop a few pounds. Specifically, aim to lose 5 to 7 percent of your body weight if you’re overweight. Body fat, especially fat around the waist, is not inert. It produces hormones and other compounds that are released into the blood and cause or exacerbate insulin resistance and inflammation; it may lead to type 2 diabetes, heart disease and some types of cancer. The good news is that losing even a little weight makes your cells more sensitive to insulin and reduces your health risks.

The Diabetes Prevention Program (DPP), a study of more than 3,000 people at risk for developing type 2 diabetes, found that a healthful lifestyle can delay or prevent the onset of type 2 diabetes. Participants in the DPP’s lifestyle-change group aimed to lose 7 percent of their body weight (14 pounds for someone starting at 200 pounds) and to exercise for 150 minutes each week. In this three-year study, participants reduced their risk of developing type 2 diabetes by 58 percent. Even 10 years after the start of the study, the lifestyle interventions lowered the risk by 34 percent. If you already have type 2 diabetes, weight loss may not cure it, but it might lessen insulin resistance and improve your blood glucose levels, perhaps with fewer medications, with lower costs and less risk for side effects.