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[quote=Anonymous]I've been pre-diabetic for 19+ years now, never obese, always exercise, previous marathoner - but terrible genetics.  I keep my A1C in a good range.   Pregnancies were gestational but diet/exercise helped manage it.   Siblings the same.   I work with my internist on plan.   Overtime, it becomes a bit more difficult as what worked before, takes a little more effort to keep fasting blood sugars in check, but in general, its manageable.

- Exercise daily.  When I was younger, ran a lot (marathon runner), but then shifted over time bc of injuries.  Shifted  to peloton and longer walks with some runs.   For me, its non-negotiable that I have Some sort of daily exercise even if brisk longer walk.

- 99% of the time, I fast at least 12 hours and try to fast 14 hours.  Dr. Fung's book is helpful, but I don't do the extreme.   I feel so much better with fasting this moderate amount.  When I go off for a few days, my blood sugars feel terrible.   Fasting was a real gamechanger when diet and exercise were not enough.    This was a real gamechanger also for my siblings too or could reduce metformin because of this.

- For over 20 years, Generally, try to be moderate carb, not higher carb like american diet.  I'm not perfect, but helps.  Some things, I never do - like juices etc.  Have family members with GI health issues so never eat heavily processed, more fruits & veggies - but not sure that impacts the diabetes.   I do still like my chocolate - can't lie, but in balance / moderation, it's still possible

- I do a regular check ever few weeks on my fasting blood sugars to make sure they have not creeped up.

All of this, I feel has been very sustainable and doesn't take much discipline when you make a habit.

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