How to Reverse Peri-Menopausal Pre-Diabetes in 4 Months

A personal journey through fad diets to discover what works

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It was the hunger that was most bothersome. Constant, insatiable hunger, no matter what I ate.

A steak dinner would be devoured, yet within a few hours, there was a nagging urge to eat again. Large meal, small meal — it did not matter. I was eating more protein, like the menopause research recommended, but it wasn’t helping.

Though I didn’t crave sweets, I often had an urge for a spoonful of coconut oil, savoring it while it melted in my mouth.

It was an odd habit that I could not explain, but somehow, it helped curb my hunger.

I chalked it up to hormonal shifts in peri-menopause, but when I had my labs run, there was an alarming surprise.

Pre-diabetes.

Diabetes as a gateway to declining health

With diabetes on my father’s side and Alzheimer’s on my mother’s, a panic washed over me as I sat with the magnitude of what my future might look like if I didn’t get my blood sugar in check.

My maternal grandmother developed Alzheimer’s a few years after retiring. She moved in with us after my parents’ divorce, and within five short years, she no longer recognized my mother or me.

Recent research by Dr. Lisa Mosconi links menopause with a higher risk of Alzheimer’s, now commonly referred to as Type 3 diabetes. Estrogen’s decline accelerates brain aging, making women particularly vulnerable. Among Alzheimer's populations, women outnumber men by 2:1.

When I learned this, I thought of my grandmother, who survived on a steady diet of sugary coffee, cookies, and bread.

If Alzheimer’s wasn’t terrifying enough, there was also Type 2 diabetes to worry about.

In the US, one-third of adults under 65 and half over 65 are pre-diabetic. The vast majority don’t know they have it because they are asymptomatic.

My father has diabetes, and his grandmother and several of her siblings died of it in the early 1900s, twenty years before insulin was discovered.

When you develop diabetes, you’re also at risk for a host of health conditions like heart, kidney, eye disease, and nerve damage. My mother-in-law, now nearing 80, had developed diabetes in midlife, and watching her struggle with the disease taught me that I should fight like hell to avoid it.

Never waste a good wake-up call

The good thing about health scares is that you can channel your fear to radically change your life.

I reached out to Fatima Abbass, a registered dietician, who reassured me that reversing pre-diabetes was possible — often within 90 days. The keys were nutrition and movement.

She explained that as women age, they become more susceptible to insulin resistance, a condition where the body can no longer effectively use insulin, causing blood glucose to rise. Insulin resistance is at the heart of a multitude of chronic health conditions, including metabolic syndrome, diabetes, heart disease, polycystic ovary syndrome (PCOS), and Alzheimer’s.

Instead of my usual workouts 3 times per week, I would focus on increasing my strength resistance with heavier weights 4–5 times weekly. I’d also move more often, and I committed to 5-minute fitness breaks throughout the day (dancing, wall push-ups, squats) and 10-minute walks after meals.

I started a high-protein, low-carb diet with a goal of 100 grams of protein per day. I also restricted eating to a 10–12 hour window, which meant no more late-night snacking.

Research shows that peri-menopausal women need to increase their protein intake. Once we hit 50, experts recommend consuming 0.54–0.72 grams/pound of body weight per day, but an easy rule of thumb is to aim for 30 grams of protein per meal.

For me, that meant my normal two-egg omelet became a four-egg omelet with cottage cheese and turkey bacon.

Yogurt and fruit now included protein powder and collagen peptides, with reduced fruit and added nuts.

Bread, pasta, and sweets were eliminated. For January and February, I also cut alcohol.

Honestly, I expected the diet to transform my life. I had taken the changes seriously — never cheating — and I wanted results.

But that’s not what happened. Even though I lost a few pounds, I still couldn’t shake the feeling of hunger between meals.

Even more discouraging, after three months, my follow-up lab results showed no improvement in my glucose or A1C levels.

I was still pre-diabetic.

The clues I found from fasting

Frustrated, I met with Fatima, my dietician, again. I’d started tracking my moods and symptoms and had noticed heart palpitations that coincided with my hunger.

Another surprising pattern was that the fewer meals I ate, the better I felt. Eating three meals within a 12-hour window made me feel worse (and hungrier), while eating less frequently felt better. Fatima created a monthly schedule of 12-hour and 18-hour fasts for me to try.

Initially, the 18-hour fasts were tough, and I was cranky and irritable. I had trouble focusing and felt weak.

Fatima recommended adding MCT oil to my coffee. MCT oil is a medium-chain triglyceride and the star ingredient in bulletproof coffee. Adding healthy fats to coffee while fasting helps sustain energy, increase satiety, and improve cognitive function.

I’d also add electrolytes and incorporate high-fat-fasting snacks (like olives or almond butter) when I felt hungry.

These tweaks helped stabilize my mood and improved my energy. Most importantly, the hunger disappeared — but only during the 18-hour fasts.

Understanding the hunger

Determined to uncover the cause of my inexplicable hunger, I researched my symptoms and found a condition called reactive hypoglycemia, which causes your blood sugar to drop after eating. Symptoms like shakiness, light-headedness, hunger, and an uneven heartbeat are common.

Like diabetes, the root cause is often insulin resistance.

Since high-carb meals typically trigger hypoglycemia, I could not understand why I would react while eating a balanced diet.

Thinking back, I’d struggled with hypoglycemia since childhood. It was the reason I avoided carb-heavy meals. I thought back to an incident a few months ago when I’d made pancakes for my husband. Instead of making eggs on the side for myself, I had a pancake. Within 90 minutes, I was shaking so badly I had to lie down.

Why would I be having hypoglycemic reactions while eating a healthy diet?

I dug deeper.

Listening to podcasts, I discovered women who’d reversed hypoglycemia, pre-diabetes, and even Polycystic Ovary Syndrome (PCOS).

What the stories had in common was following a ketogenic diet plus intermittent fasting.

Could this be why the 18-hour fasts worked so well for me? Was it higher fats that my body needed?

Dr. Jason Fung’s book The Diabetes Code provided another breakthrough. He argued that most metabolic conditions — including Type 2 diabetes and PCOS — could be reversed with fasting and a low-carb, high-fat diet.

It all clicked. Perimenopause had triggered metabolic changes and insulin resistance, exacerbating my hypoglycemia.

Finding the right balance

Excited, I consulted Fatima again. Based on her experience with reactive hypoglycemia, she recommended I switch to a moderate protein diet, targeting 25 grams per meal. She also suggested adding healthy fats like avocado, nuts, and seeds to every meal, aiming for a 60% fat diet.

I would also incorporate more fermented and bitter foods to support my gut and liver. Finally, I’d continue rotating the longer 18-hour fasts with 12-hour fasts on a fixed schedule.

For the next month, I followed this protocol. Within days, the hunger and heart palpitations subsided.

Recently, I re-ran my labs. Both A1C and glucose levels have returned to normal.

Personalizing your health journey

With so much conflicting dietary advice — high protein, keto, paleo — it’s easy to feel lost.

My key was to listen to my body and work with a professional who understood metabolic health.

In my case, lifelong hypoglycemia resurfaced in a new way, causing metabolic changes in peri-menopause. The solution wasn’t just high protein or low carb — it was a balance of healthy fats, moderate protein, and strategic fasting.

It took 120 days to reverse my pre-diabetes, but the journey has reshaped my approach to nutrition. It isn’t a short-term fix — it’s a long-term lifestyle commitment to maintain these results.

The trade-off? Hopefully, a lifetime of better health, and for me, that’s worth it.

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