Metabolic conditions, explained plainly.
Five conditions I see every week: what the diagnosis means, which numbers matter, and where food fits alongside your medical care.
Many of these share one root.
Often first
Insulin resistance
Cells respond less to insulin, so the pancreas makes more to compensate.
Then
Pre-diabetes
Glucose starts to rise above normal as compensation falls behind.
Without change
Type 2 diabetes
Glucose stays high enough to meet the diagnostic threshold.
PCOS and insulin resistance frequently occur together, which is why cycles and blood sugar often improve with the same changes. Hypothyroidism works through a different route, slowing metabolism, but it often shows up alongside the others and changes what a sensible plan looks like.
Not everyone moves along this path. Pre-diabetes can stay stable or return to normal, and that is exactly where nutrition care earns its keep.
Pre-diabetes
- A1C
- 6.0–6.4%
- Fasting glucose
- 6.1–6.9 mmol/L
- 2-hr glucose test
- 7.8–11.0 mmol/L
What it is
Blood glucose is higher than normal but not high enough for a diabetes diagnosis. It rarely causes symptoms, so it is usually found on routine bloodwork. It is a warning, not a verdict.
What we work on
- Understanding which of your numbers matter and how often to recheck them
- Carbohydrate quality, portions and timing across the day, without cutting out food groups
- Meals that fit your culture and your family, not a separate plate for you
Type 2 diabetes
- A1C
- 6.5% or higher
- Fasting glucose
- 7.0 mmol/L or higher
- 2-hr glucose test
- 11.1 mmol/L or higher
What it is
The body no longer keeps blood glucose in range on its own. It is managed with some mix of food, activity, medication and monitoring, and the right mix changes over time.
What we work on
- Reading your glucose meter or CGM data and connecting it to what you ate
- Carbohydrate distribution that works with your medication, including insulin
- Eating out, celebrations, travel and fasting periods such as Ramadan
- Protecting heart and kidney health alongside blood sugar
“Before working with Noura, I struggled to manage my blood sugar levels and felt overwhelmed by all the conflicting nutrition advice. My energy levels have improved, and my A1C has gone down significantly! More importantly, I feel confident in managing my diabetes every day.”
Insulin resistance
- Fasting glucose
- Often normal
- Triglycerides
- Often raised
- HDL cholesterol
- Often low
- Your lab’s ranges
- see your report
What it is
Your cells respond less to insulin, so your body makes more of it to keep glucose normal. There is no single standard test; it is usually inferred from a pattern of results and history.
What we work on
- Building meals around fibre, protein and minimally processed carbohydrates
- Sleep, stress and activity as part of the plan, not an afterthought
- A realistic way to track progress beyond the scale
PCOS
- Cycles
- Irregular or absent
- Androgens
- Clinical or lab signs
- Glucose / insulin
- Often affected
What it is
Polycystic ovary syndrome is a hormonal condition. It is usually diagnosed when two of three are present: irregular or absent ovulation, signs of higher androgens, and polycystic ovaries on ultrasound. Insulin resistance is common with it.
What we work on
- Eating patterns that support blood sugar and cycles together
- Moving on from the extreme diets and intense exercise that haven’t worked
- Weight changes approached without blame, crash diets or punishing routines
Hypothyroidism
- TSH
- Above your lab’s range
- Free T4
- Low or low-normal
- Cholesterol
- Often raised
What it is
The thyroid makes too little hormone, which slows metabolism. Medication replaces the hormone; nutrition helps with the symptoms and risks that often remain, such as fatigue, weight change and higher cholesterol.
What we work on
- Timing food, coffee and supplements around your thyroid medication
- What the evidence says, and doesn’t, about iodine, selenium, gluten and soy
- Energy, weight and cholesterol, especially when PCOS or diabetes is also present
Nutrition works alongside your medical care.
If you take insulin or a medication that can cause low blood sugar, changes to how you eat can change what you need. I’ll flag that early and coordinate with your prescriber so adjustments are made safely.
Diagnostic thresholds on this page follow the Diabetes Canada Clinical Practice Guidelines. Your own targets may differ; your care team sets them with you.
Bring your bloodwork to a free call.
We’ll look at where you are, what’s changed, and whether one-to-one counselling is the right next step.
Book a free discovery call