### Instruction: Polly, a 51-year-old female, visits your fitness facility. Polly has been told she has pre-diabetes. Explain to her what this means. What role can exercise play in reversing this?
### Response: From a scientific point of view, this means that she is insulin resistant, but she does not have hyperglycemia. As a result, she should be concerned; she is at a high risk for developing type 2 diabetes. The health risks are numerous: damage to blood vessels, high blood pressure, obesity, osteoporosis (thinning bones), and even certain types of cancer like colon, breast, and prostate. However, she can lower insulin resistance and mitigate her risk of pre-diabetes by improving her exercise habits. According to ACSM’s Health and Fitness Journal, almost “all physical activity has a positive effect on insulin.” To maximize efficacy, she should focus on moderate to higher intensity physical activities to best enhance insulin action and glycemic control.