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.
Get moving
2. Get moving. Even without weight loss, exercise improves insulin resistance for two to 72 hours! That means that every single time you walk briskly, swim some laps, bike around your neighborhood or play tennis, you are doing your body good and working to prevent diabetes. Exercise improves blood glucose control, reduces 
cardiovascular risk factors, enhances well-being and so much more. Try not to think of exercise simply as weight loss tool. View it for what it is: a quality of life tool. Federal guidelines recommend adults engage in at least 150 minutes of moderate-intensity aerobic activity each week. The American Diabetes Association (ADA) notes that to maximize the insulin-sensitizing effects of regular exercise, you should go no more than two consecutive days without exercising.
Strength training also helps, and the ADA advises people with type 2 diabetes to engage in at least two sessions weekly. Strength training increases insulin action in the muscle. Plus, the more muscle you have, the more glucose it withdraws from the bloodstream.
3. Don’t sit too much. Regular exercise is critical, but what you do the other 23 or so hours each day matters too. Excessive sedentary behavior—watching TV, surfing the Internet, driving, reading and more—has only recently been recognized as a potential contributor to ill health. The more time you sit, the greater the likelihood you’ll develop abnormal glucose levels and cardiovascular risk factors. The ADA recommends breaking up periods of sitting for more than 90 minutes with brief bouts of standing or walking, such as taking a stroll to the water cooler or standing up during television commercials.
4. Eat a wholesome diet. Although there is no singular diet to defeat diabetes, there are steps you can take to help your body better use insulin and 
process glucose. It starts with eating a diet with ample health-boosting plants, including fruits, vegetables, whole grains, beans, nuts and seeds—all in appropriate portion sizes. Research suggests that a Mediterranean-style diet—with its olive oil, nuts, vegetables, berries, other fruits and fiber-rich foods—can stave off type 2 diabetes. Trimming calories matters, too, so it’s not just about being choosy about foods. Keep a keen eye on your portion sizes, too.
5. Get to bed on time. Researchers in the Netherlands found that even a single night of sleep deprivation impairs insulin sensitivity by as much as 25 percent. Aim for seven to eight hours of sleep nightly.
A place for medications and supplements?
Some people in the DPP took the drug metformin, an insulin sensitizer commonly prescribed to people with type 2 diabetes. This group also reduced their risk of developing type 2 diabetes. Though the results were not as impressive as for those in the lifestyle-change program, taking metformin dropped participants’ risk by 31 percent in the first three years and by 18 percent after 10 years.
Though the ADA does not recommend supplements for managing diabetes or insulin resistance, many people choose to use aloe, bitter melon, ginseng, nopal and others. Although some supplements may contain helpful ingredients, they may also cause unwanted side effects and interactions with drugs or other supplements. It’s prudent to discuss options with your health care provider before starting a new blood sugar management supplement.
