Most people think pre-diabetes is just a waiting room for Type 2 diabetes — something you manage, not something you fix. Turns out, that thinking is out of date.Brand new data published in one of medicine's most respected journals shows that people who reversed their pre-diabetes had about half the rate of heart attacks, heart failure, and cardiovascular death over the following decades. In this episode:Episode Highlights- Pre-diabetes can be fully reversed in most people- Reversal cuts heart disease risk by nearly 50%- Just 5–7% weight loss reverses it in 4 in 10 people- Trained muscles pull sugar from blood more efficiently- Where you store fat matters more than how muchChapters:0:00 Intro0:39 What is pre-diabetes?1:17 Key studies2:03 Results: 50–60% lower heart risk2:56 Weight loss3:20 Strength training3:39 Body fat distribution4:15 GLP-1 medications4:46 RecapStudies & Resources:The Lancet Diabetes and Endocrinology (2026) — re-analysis of two decades-long trials showing cardiovascular benefits of pre-diabetes reversalNature Medicine (2025) — found that reducing visceral fat (even without weight loss) reversed pre-diabetes in about 1 in 5 peopleDPP-OS (Diabetes Prevention Program Outcomes Study)Da Qing Diabetes Prevention StudyIf this was useful, subscribing is the best way to support the channel and help it reach more people.Listen & Follow:Spotify: https://podcasters.spotify.com/pod/show/sterlingmdphd/Apple Podcasts: https://apple.co/3y438C9Social & Website:Instagram: https://www.instagram.com/sterlingmdphdX: https://x.com/sterlingmdphdFacebook: facebook.com/sterlingmdphdNewsletter: http://eepurl.com/hQpdqTReferences & Show Notes: http://www.nicksterling.com/Disclaimer:This content is not medical advice, is for general information purposes only, and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.

In this episode, we cover why early atherosclerosis is essentially universal by young adulthood and tests that tell us about cardiovascular risk—beyond a standard lipid panel. We walk through ApoB (and why it can outperform LDL-C in some circumstances), Lp(a) and the case for checking it at least once, inflammation markers like hs-CRP and GlycA, the triglyceride–HDL relationship and TG/HDL ratio, omega-3:omega-6 balance (including an important atrial fibrillation caveat), blood pressure and endothelial stress, plus quick thoughts on homocysteine and coronary calcium scoring.Chapters:00:00 — Why almost everyone has early plaque00:01:01 — ApoB explained 00:02:12 — ApoB vs LDL-C: discordance00:02:38 — Lp(a)00:04:34 — Inflammation: hs-CRP & GlycA00:05:44 — Triglycerides & HDL00:07:19 — Omega-3:6 ratio & Atrial Fibrillation caution00:08:14 — Blood pressure & endothelial stress00:10:03 — Homocysteine & CACSpotify Channel:https://podcasters.spotify.com/pod/show/sterlingmdphd/Social & Website:Instagram - https://www.instagram.com/sterlingmdphdX - https://x.com/sterlingmdphdFacebook - / sterlingmdphdNewsletter - http://eepurl.com/hQpdqTApple Podcasts: https://apple.co/3y438C9References & Show Notes:http://www.nicksterling.com/This content is not medical advice, is for general information purposes only and does not constitute the practice of medicine or any other healthcare professional services. No doctor-patient relationship is formed. This content is not a substitute for medical evaluation or treatment and does not take precedence over information provided to you by your healthcare provider or official public health sources. Please visit http://nicksterling.com/terms for full Terms of Use.