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Fasting Insulin Changes Decades Before Diabetes Diagnosis Comite Says

Feel Better, Live More with Dr Rangan Chatterjee · The 5 Most Important Biomarkers That Influence Your Health & How To Live Better For Longer with Dr Florence Comite #666 · June 16, 2026
Fasting Insulin Changes Decades Before Diabetes Diagnosis Comite Says
Feel Better, Live More with Dr Rangan Chatterjee
Feel Better, Live More with Dr Rangan Chatterjee
The 5 Most Important Biomarkers That Influence Your Health & How To Live Better For Longer with Dr Florence Comite #666
"The reason why fasting insulin was so critical is it changes decades before we get diabetes. And I have yet to find a person with 5 biomarkers that are optimal."
Dr. Comite explained that fasting insulin levels rise decades before type 2 diabetes becomes clinically apparent, yet this marker is almost never measured in routine medical care. She stated she has never found a patient with all five of her key biomarkers in optimal range, suggesting widespread undiagnosed metabolic dysfunction across the population.

About this episode

On this episode of Feel Better Live More, host Dr. Rangan Chatterjee interviewed Dr. Florence Comite, a US endocrinologist and longevity expert with 30 years of clinical experience at Yale and the National Institutes of Health. The conversation centered on Comite's new book Invincible and her paradigm-shifting approach to preventative medicine, which treats patients proactively before disease manifests rather than reactively after diagnosis. Comite revealed that none of her patients have experienced a heart attack while on her protocol, a remarkable claim that underscores her focus on early intervention. The core of her methodology involves tracking five key biomarkers—fasting glucose, hemoglobin A1C, fasting insulin, cholesterol risk ratio, and free testosterone—which she argues can predict and reverse chronic disease decades before symptoms appear. She made the controversial assertion that fasting insulin, a marker almost never checked in routine care, changes decades before diabetes diagnosis and that she has never found a patient with all five biomarkers in optimal range. Comite challenged conventional medicine's reliance on population averages and normal ranges, advocating instead for individualized N=1 medicine that tracks personal trends over time. She argued that virtually everyone will develop carbohydrate metabolism disorders as they age due to declining testosterone and muscle mass, and that lifestyle optimization alone cannot restore hormones to optimal levels. The discussion covered her extensive use of testosterone replacement in both men and women starting in their 30s, including HCG peptide therapy to stimulate natural production, and her advocacy for continuous glucose monitors as essential tools for personalized health data. Comite also critiqued current healthcare systems in both the US and UK as disease-management models rather than health-creation systems, and shared her vision for virtual medicine delivered through apps that provide credentialed, scientific guidance at scale. The episode concluded with her call for individuals to take ownership of their health trajectory by understanding their biomarker trends and making proactive changes to defy their genetic destiny.

Key takeaways

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