Heart and metabolism · Hopkins, Minnesota
Insulin Resistance and Prediabetes: Catch It Early, Plan Well
Your A1c came back in the prediabetes range, and you were told to recheck next year. Or your labs look fine, but afternoon crashes and weight settling around your middle worry you. You don't have to wait for a diagnosis to act. Drs. Haley and Jacob Panka look past a single number and help you build a plan you can keep.
Insulin resistance means your muscle, fat, and liver cells respond less to insulin, so your body makes more to keep blood sugar normal. Glucose can then rise into prediabetes: an A1c of 5.7 to 6.4% or a fasting glucose of 100 to 125 mg/dL. In the Diabetes Prevention Program, steady changes in food, activity, and weight cut new cases of type 2 diabetes by more than half compared with placebo.
How we approach this at Panka Natural Health
Your first visit runs two full hours, and you see the same two doctors at every visit. Dr. Haley provides holistic diabetes care, with a focus on weight and reducing insulin resistance. Dr. Jacob focuses on cardiovascular and metabolic health. We read your A1c, fasting glucose, and lipids through a functional lens, as trends over time rather than one result. We may add fasting insulin to see how hard your body works to keep glucose in range. We also look at what you eat on a normal day, how you move and sleep, your stress, family history, and everything you take. You leave with a step-by-step plan and a date to recheck. Messaging between visits is included, with no membership.
Insulin resistance and prediabetes: what the numbers mean
Those A1c and fasting glucose cutoffs come from the American Diabetes Association. A 2-hour glucose tolerance result of 140 to 199 mg/dL also counts. If you're in that range, the ADA recommends retesting every year. The CDC estimates more than 2 in 5 U.S. adults have prediabetes, and 8 in 10 don't know it, because it rarely causes symptoms. Insulin resistance is often the earlier step. Fasting insulin isn't part of the standard diagnosis, so we read it through a functional lens, as one clue alongside glucose, A1c, triglycerides, waist size, and trends. For example, a fasting insulin that keeps climbing while glucose stays flat may deserve a closer look.
Lifestyle has the strongest evidence
The advice to eat better and move more has strong evidence. In the Diabetes Prevention Program, more than 3,000 adults with blood sugar above normal were split into three groups: placebo, metformin, or a lifestyle program. The lifestyle goals were to lose at least 7% of body weight and get 150 minutes of activity a week. Over an average of 2.8 years, that group developed type 2 diabetes 58% less often than the placebo group, and it beat metformin. Other things raise risk too: sitting most of the day, sleep apnea, steroid medicines such as prednisone, and polyendocrine metabolic ovarian syndrome (PMOS, previously known as PCOS). We check each. With food, we start with meals you already eat and make them steadier. That means protein and fiber at breakfast, fewer refined carbs eaten on their own, and a plan for the afternoon slump. Sustainable beats perfect.
Why muscle matters so much
Working muscle pulls glucose out of your blood. The American Diabetes Association notes that during and right after a workout, aerobic exercise can make your muscles take up as much as five times more glucose, without needing extra insulin. For prediabetes, it recommends at least 150 minutes of activity a week, along with food changes that lead to 5 to 7% weight loss. For diabetes, it adds strength training 2 to 3 days a week, not back to back, and light movement every 30 minutes you sit. We aim for these with prediabetes too. Dr. Jacob, a former collegiate athlete, helps you build a routine that fits your joints and schedule. Muscle matters even more as you lose weight, because some of the loss can be muscle. That's a known concern with GLP-1 medicines, and expert groups advise strength training and enough protein to protect it.
Supplements, medications, and your other doctors
You may have read that magnesium lowers blood sugar. In a 2026 trial, 247 adults who had lived with type 2 diabetes for years took magnesium or a placebo pill for a year. Their A1c didn't drop significantly more than the placebo group's. A small group who started low in magnesium did a little better, but that result wasn't firm. So we check your magnesium intake and levels before you reach for a bottle, and screen everything you take for interactions. Minnesota naturopathic doctors don't prescribe drugs such as metformin or GLP-1 medicines. If you take one or are thinking about it, we work alongside your prescriber. We share results, help with nutrition through side effects, and leave medication changes to you and that clinician.
This visit may fit if…
Your A1c or fasting glucose is in the prediabetes range and you want a real plan, not just a recheck.
Your glucose looks fine, but family history, belly weight, or crashes after meals worry you.
You have PMOS/PCOS or sleep apnea and want your metabolic picture reviewed as a whole.
You take or are starting a GLP-1 medication and want help with food, protein, and strength.
See someone else first if…
Strong thirst, frequent urination, blurred vision, or sores that won't heal: see your primary care clinician soon for diabetes testing.
Fruity-smelling breath, trouble breathing, belly pain with vomiting, or fainting can signal diabetic ketoacidosis, an emergency. Call 911.
On insulin or a sulfonylurea pill and feeling shaky, dizzy, or confused: your blood sugar may be low. Treat it right away, and call 911 if someone passes out.
Chest pain, or sudden weakness, numbness, or trouble speaking: call 911.
Bring a clearer picture to your visit
A1c, fasting glucose, lipid, kidney, and liver results, ideally from several years.
Your medications and supplements with doses, including anything sold for blood sugar.
Two ordinary days of meals, snacks, and drinks, with the times you ate.
Home glucose readings, glucose monitor reports, or sleep study results.
Common questions
Do you test fasting insulin?
When it helps answer a question about you, yes. Your other providers may be able to order some tests through insurance, or you can pay cash for testing through us. We read it alongside your other results and watch the trend.
Do you take insurance?
We're direct-pay and out-of-network with all insurers. We provide a superbill for possible out-of-network reimbursement and accept HSA and FSA. Medicare and Medicaid don't reimburse naturopathic services in Minnesota. Current fees are on our scheduling page.
Can I do this by telehealth?
Yes, by video across Minnesota and Wisconsin, as long as you're physically in one of those states during the visit. Our office is in downtown Hopkins if you'd rather meet in person.
Real doctors. Real time with you.
Panka Natural Health is a family-owned clinic in downtown Hopkins, led by Drs. Haley and Jacob Panka since 2018. You see the same doctor at every visit.
Your first visit
1. Book a visit or a free 10-minute intro call. The intro call is a short conversation about fit, not a medical visit.
2. Time for your whole story. Adult first visits run two full hours; children's visits are shorter. Bring prior labs and the bottles or photos of what you take.
3. A written plan. What to try, what to test if anything, and when to reassess. We coordinate with your other clinicians.
4. Support between visits. Secure messaging with your doctor is included, with no membership.
Direct-pay practice: out-of-network with all insurers, superbills for possible reimbursement, HSA and FSA accepted. Medicare and Medicaid do not reimburse naturopathic services in Minnesota. Current fees are on our scheduling page. Telehealth for patients located in Minnesota or Wisconsin at the time of the visit (virtual only in Wisconsin). Ample parking in front of and behind the building; the entrance is up four steps with handrails; the office is not wheelchair accessible, and virtual visits are an alternative.
Dr. Haley Panka, ND: Women's health and hormones, pediatrics, holistic diabetes care, and supportive care for breast cancer patients and survivors.
Dr. Jacob Panka, ND, MS: Brain and neuroendocrine health, cardiovascular and metabolic health, gut–brain physiology, and men's health.
Sources and further reading
General education, not a diagnosis. We work alongside your primary care clinician and specialists, not instead of them. Care and testing depend on your history and clinical needs.
Your questions are a good place to start.
Book a visit, or begin with a free 10-minute call to see whether we're the right fit.