I'll share a few things regarding my personal experiences over the last year or so as it pertains to Pre-Diabetes/Diabetes, diet and stuff like that.
For the past several years, although I am and have been a heavy guy, my A1c has remained solidly in the "you're fine" category even though my official fasting glucose was always over 100 (the generally recognized laboratory cut-off for being "high". I have always had a very consistent 105-106 when tested, but in the last 12-18 months that crept up as high 112. In 2021 I gained more weight and my A1c approached then breached the "you're pre-diabetic" zone (I think it was 5.8 at it's highest). So, being a heavy guy who also had marginally high total cholesterol and triglycerides (and an unacceptable hdl/ldl ratio) and a worsening blood sugar situation, I decided to check out some of the resources offered by my insurance.
I should mention, my Doc NEVER mentioned, offered or suggested I speak with a dietician or other such "professional" resource regarding my weight and/or increasing risk of becoming "officially" diabetic. In the end it was my own doing that prompted my beginning an app based program focused on preventing diabetes. The program was pretty much as you'd expect, it focused on "improving" your diet by adhering to the official "my Plate" guidelines promoted by the government and increasing the amount of physical activity. It's not rocket science but if you aren't physically active and you eat like an Ooompa Loompa those changes alone should move the needle in a positive direction. The app was/is integrated with FitBit so it could automatically track activity and weight (also gave a FREE scale and fitbit). The meal tracking tools were horrible but they did offer an option to simply take a photo of what you eat, a feature I resisted with great vigor because I am NOT an Instagram eater (Idon;t allow my family to take photos of what we are eating...it's stupid). Well, as it turned out this program included an actual LIVE nutrition coach, and she actually looked at the photos and because she was very skilled she knew a lot about my eating patterns based on the photos alone.
Fast forward a few weeks and some pounds later. I continued to complain about generalized pain, being tired and just not feeling right even as I ate my vegies, fruits and stuff like that. I HAD lost some weight but not a lot and I wasn't feeling great. SO, when my wife went a on a 7 day cruise without me I bought several BIG rib eyes and that's all I ate while she was gone. ...after about 3-4 days I started to feel better, less pain and I even lost several pounds. The next week when my coach called to check in I mentioned this and... as luck would have it she was calling from her personal phone (from her vacation home in Hawaii) so she was able to speak freely without fear of being recorded by the app. In short, she explained that by avoiding the veggies I was avoiding the Oxalates that had been causing my pain, and by removing all starches and eating only the yummy fatty meat I was doing what my body REALLY wanted. She completely trashed the idea that we should all be eating according to the My Plate guidelines and said that the program required her to push that but when she spoke with us individually she tailored the plate to our personal needs and tolerances. In My case a good 'ol carnivore like diet solved a lot of problems and set the stage for better health. She suggested sticking with "healthy fats" (which means not ALL animal fats/bacon etc) and protein while avoiding starches, grains etc and limitting the vegetables and fruits that are higher in oxalates.
For several months I did very well eating a keto-atkins-carnivor like diet that I rather enjoyed. I stayed mostly in a state of mild ketosis so I was doing well keeping my total sugar intake very low. I lost weight, fast at first then slower and slower. But my diet since February or march was very low carb at minimum and "keto" like at best. I broke my diet restrictions a few weeks ago when I went on a short cruise and everything has gone to hell in a handbasket since.
The punchline:
I found a new doctor (a DO) and had a visit with him a couple weeks ago and a follow-up to discuss labs yesterday. My A1c has dropped WELL into the "you're fine" zone despite once again having a fasting glucose around 112. My cholesterol was modestly high (i stopped taking my cholesterol meds) but he wasn't at all concerned. He WAS somewhat concerned my triglycerides were as high as they are so he suggested a drug focused entirely on bringing that down. He made very clear that loosing weight alone would improve the blood sugar and trigs. He thought my recent return to high sugar foods was a contributing factor if not THE reason my trigs were too high.
For ME the rib eye diet works well when it comes to loosing weight and improving my overall health. Sugar and starches are like crack to me, not only are they hard to keep away from, one hit hooks me strong.
