Medically reviewed by Crea Rose, FNP-BC, APRN-FPA
· NPI 1366184053
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Metabolic health is about how your body handles fuel — glucose, fats, and stored energy. When metabolism is off, the consequences accumulate quietly for years before they show up as type 2 diabetes, fatty liver disease, cardiovascular events, or persistent fatigue. At Revival Health & Wellness Clinic, Crea Rose, FNP-BC offers a structured metabolic health program for adults who want to address insulin resistance, prediabetes, or related conditions before they progress.
The clinical syndrome called metabolic syndrome is defined by having at least three of:
- Increased waist circumference (≥40 inches men, ≥35 inches women)
- Elevated triglycerides (≥150 mg/dL)
- Low HDL cholesterol (<40 mg/dL men, <50 mg/dL women)
- Elevated blood pressure (≥130/85 or treated)
- Elevated fasting glucose (≥100 mg/dL or treated)
Metabolic syndrome roughly doubles the risk of cardiovascular disease and quintuples the risk of type 2 diabetes. The good news: it is largely reversible with structured lifestyle change, and it responds even better when caught early.
CONDITIONS WE MANAGE IN THIS PROGRAM
- Prediabetes (HbA1c 5.7–6.4%) — the window where remission is most achievable
- Type 2 diabetes — primary management when not requiring specialist intervention
- Insulin resistance without yet meeting diabetes criteria
- Fatty liver disease (MASLD/MASH — metabolically associated steatotic liver disease)
- Polycystic ovary syndrome (PCOS) — the metabolic dimension of PCOS
- Metabolic syndrome — multiple components co-occurring
- Weight regain after prior weight loss when underlying metabolic factors are at play
WHAT THE PROGRAM INCLUDES
Initial assessment
- Full medical and family history
- Body composition measurements (weight, waist, height)
- Blood pressure trending
- Comprehensive metabolic labs — fasting glucose, fasting insulin, HOMA-IR, HbA1c, comprehensive lipid panel including apoB, hs-CRP, liver enzymes, kidney function, thyroid panel, vitamin D
Continuous glucose monitoring (when indicated)
For some patients we recommend a 14-day or longer CGM (continuous glucose monitor) trial. Wearing a CGM — even for someone without diabetes — reveals which of your meals, snacks, and stressors actually move blood sugar, which often reshapes nutrition decisions in ways that lab snapshots can’t. CGM technology has become increasingly accessible to non-diabetics through over-the-counter products and prescription options.
Treatment plan
Depending on findings, the plan may include:
- Specific dietary modifications targeted at insulin resistance — typically a lower-carbohydrate, higher-protein, fiber-rich approach
- Resistance training and movement guidance
- Sleep optimization (poor sleep is a major driver of insulin resistance)
- Medications when indicated — metformin for prediabetes/diabetes, GLP-1 medications for combined obesity and metabolic syndrome (see our medical weight loss page)
- Targeted supplementation when labs identify deficiencies
- Coordination with cardiology, hepatology, or endocrinology when complications require specialist input
Follow-up cadence
- First reassessment at 6–8 weeks — symptom check, weight, BP
- Lab re-check at 3 months — full panel; HbA1c often shows meaningful change by this point
- Continued visits every 3 months until metabolic markers are in target range, then every 6 months for maintenance
REALISTIC EXPECTATIONS
Metabolic improvements are cumulative, not instant. HbA1c reflects the prior 90 days, so it takes about that long to see meaningful change in the number. Insulin resistance often improves faster than HbA1c — patients commonly notice better energy and reduced afternoon cravings within 4–6 weeks of consistent change.
Roughly half of people with prediabetes can return to normal glucose tolerance with structured lifestyle change. Most others can hold steady, avoiding progression to type 2 diabetes for many years. Once type 2 diabetes is established, “remission” (HbA1c below 6.5% off medication for 3 months) is achievable for some — particularly with significant weight reduction — but not for everyone, and we are clear about what’s realistic for your situation.
RISKS AND CONSIDERATIONS
This program emphasizes lifestyle change, lab monitoring, and judicious medication use. Specific medications used in metabolic management have their own risk profiles:
- Metformin — generally well-tolerated; common GI side effects in the first few weeks; rare lactic acidosis in patients with significant kidney disease
- GLP-1 medications — see our medical weight loss page for full risk discussion
- Continuous glucose monitors — minor skin reactions or sensor issues; rarely, infection at the application site
We discuss the specific medication options that fit your situation — including the option of no medication, just structured lifestyle work — at consultation.
INSURANCE AND COST
Office visits and standard lab panels for diabetes/prediabetes management are insurance-covered in most plans. CGM coverage varies — some plans cover CGM for diabetes only, while OTC CGMs (Stelo, Lingo) are self-pay. GLP-1 coverage is highly plan-specific. We help navigate prior authorization and tell you up front about expected out-of-pocket costs.
FREQUENTLY ASKED QUESTIONS
I’m not diabetic — is this program for me?
If you have any combination of: prediabetes, family history of type 2 diabetes, abdominal weight, fatty liver on a recent ultrasound, abnormal lipid pattern, or persistent post-meal energy crashes — this program is for you. Catching insulin resistance before it becomes diabetes is much more effective than treating diabetes after it develops.
Do I have to take medication?
No. Many patients improve significantly with lifestyle and structured monitoring alone. Medication is an option, not a requirement, and the decision is yours after we walk through the trade-offs.
Can my prediabetes be reversed?
About 50% of people with prediabetes can return to normal glucose tolerance with sustained lifestyle change. The earlier we start, the better the odds. The Diabetes Prevention Program (the largest U.S. study on this question) showed a 58% reduction in progression to type 2 diabetes with structured lifestyle intervention — better than metformin alone.
Should I wear a CGM if I don’t have diabetes?
It can be a useful 2–4 week experiment. The data tends to drive changes you might not have made otherwise — like discovering that the granola you thought was healthy spikes you to 180. Whether to continue beyond a trial period depends on whether you keep finding the data useful.
How does this differ from your weight loss program?
There’s substantial overlap. Many patients fit both — addressing insulin resistance and weight together. The metabolic program is appropriate even if weight loss isn’t the primary goal (e.g., a normal-weight patient with prediabetes or PCOS). For patients whose primary issue is weight, we usually start there. See our Medical Weight Loss page.
SCHEDULE A METABOLIC CONSULTATION
Call (618) 740-2240 to schedule with Crea Rose, FNP-BC.
SOURCES AND FURTHER READING
- Diabetes Prevention Program Research Group. Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin. NEJM. 2002;346(6):393–403.
- American Diabetes Association. Standards of Care in Diabetes — 2025. diabetesjournals.org
- Rinella ME et al. Multisociety Delphi consensus on the new fatty liver disease nomenclature (MASLD). Hepatology. 2023;78(6):1966–1986.
- Lean ME et al. Primary care–led weight management for remission of type 2 diabetes (DiRECT). Lancet. 2018;391(10120):541–551.