February 1, 2026, 7:22 am | Read time: 8 minutes
The chief physician for orthopedics and trauma surgery at GFO Kliniken Bonn, longevity expert and author of the bestseller “LNGVTY“, Prof. Dr. med. Thomas Kälicke, considers insulin resistance the “silent killer” of our time and an underestimated accelerant of aging. For 20 years, he has lived by seven fixed metabolic rules for better blood sugar levels. Here, he reveals them.
Why Insulin Resistance Is a Societal Problem
Diabetes mellitus and prediabetes are among the most widespread diseases of our time. But the real problem starts much earlier: with insulin resistance. It develops gradually, causes no clear symptoms for a long time, and often goes undetected for many years or even decades. During this phase, processes are already underway in the body that are the starting point for numerous diseases and significantly accelerate aging in general.
Permanently elevated blood sugar levels lead to two central problems. First, they promote chronic, low-grade inflammation—a phenomenon known as inflammaging, considered a major driver of age-related diseases. Second, they increase glycation, the binding of glucose to body proteins.
This results in so-called Advanced Glycation Endproducts (AGEs), which alter the structure and function of proteins. Collagen is particularly affected, playing a central role in vessels, tendons, bones, and skin, as well as many other tissues. Since collagen is crucial for elasticity, stability, and resilience, it explains why metabolic disorders are closely linked to premature aging and structural damage in the body.
Also interesting: 150 minutes of exercise per week can reverse prediabetes
What Insulin Is Supposed to Do—and Why the System Fails
Carbohydrates provide quick energy. After consumption, blood sugar levels rise, prompting the pancreas to release insulin. This hormone acts like a key: It opens cells so glucose can be absorbed from the blood into our cells.
As long as this system functions flexibly, everything is fine. Excess glucose is stored as glycogen in the liver and muscles—about 1,500 to 2,000 kilocalories. This is enough for about two hours of intense physical activity.
Problems arise when carbohydrates are constantly consumed, little exercise occurs, insulin remains elevated, glycogen stores are chronically overloaded, and excess carbohydrates repeatedly need to be converted into inflammation-promoting fat. As a result, cells respond increasingly poorly to insulin. Sugar remains in the blood longer, insulin levels continue to rise—a vicious cycle known as insulin resistance develops.
Also interesting: Endocrinologist: “It’s not the weight that matters, but where the body stores fat”
Recognizing Insulin Resistance: The HbA1c Value
An important marker for metabolic health is the HbA1c value (HbA1c stands for Hemoglobin A1c). This value indicates how much hemoglobin in the blood has been glycated in recent weeks—and serves as a reliable indicator of whether glucose has remained in the vascular system for an extended period and whether other proteins in the body may also be increasingly affected by glycation processes. Values below 5.4 percent are considered metabolically healthy. A range between 5.7 and 6.4 percent indicates prediabetes, and from 6.5 percent, diabetes mellitus is present.
Many people are already in the borderline range without knowing it. During this phase, glucose remains in the vascular system longer, promoting chronic inflammation and driving AGE formation to undesirable levels—long before a manifest disease is diagnosed.
Why Medications Can’t Replace Lifestyle
In traditional medicine, elevated blood sugar levels often quickly lead to medication therapy. This can be sensible and necessary in individual cases. However, insulin resistance is mostly a result of our lifestyle and does not need to be primarily treated with medication.
The key approach lies in restoring metabolic flexibility—the body’s ability to efficiently absorb and utilize glucose and balance energy supply and demand. These processes can often be more sustainably influenced by targeted changes in daily life than by medication alone.
It’s not just what we eat that matters, but also when, how often, and what we do around mealtime. This is where the following plan comes into play.
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My 7-Point Plan for Better Blood Sugar Levels
1. Only Two to Three Meals a Day
The body needs periods without food intake to lower insulin levels again. Constant eating keeps the metabolism in a state of emergency.
During the day, energy metabolism dominates—carbohydrates can have their place here. In the evening, the building metabolism begins: regeneration, repair, and muscle and tissue building. Proteins are more important than sugar during this phase.
Regardless of meal timing, attention should be paid to consuming preferably multi-branched, complex carbohydrates that cause blood sugar to rise more slowly and evenly. Highly processed foods with a high proportion of quickly available sugars lead to rapid blood sugar spikes and a pronounced insulin response and should be avoided as much as possible.
A meal composition with sufficient proteins and healthy fats can further flatten the blood sugar rise and contribute to a more stable metabolic situation.
Also interesting: The effect of black coffee on insulin levels
2. No Snacking Between Meals
Every meal leads to insulin release. Constant snacking prevents the necessary recovery of the system.
Sugar and insulin should remain in the vascular system for as short a time as possible. Frequent snacking ensures that both remain elevated—negatively affecting vessels, organs, and cells.
3. Kitchen Closes Three Hours Before Bedtime
Late, carbohydrate-rich meals significantly increase the risk of insulin resistance. The body needs little quick energy at night, but rather rest and regeneration.
Additionally, late eating inhibits autophagy, the cellular “spring cleaning” that primarily occurs at night. Those who eat earlier often sleep more peacefully—and support metabolic recovery.
Also interesting: Stimulating autophagy with fasting mimicking—how does it work?
4. Move After Eating—At Least 10 to 20 Minutes
Exercise after eating acts as a natural blood sugar reducer. Muscle work increases glucose uptake independently of insulin and trains the insulin sensitivity of cells.
A walk is sufficient. The key is not to sit or sleep directly afterward.
5. Get “Out of Breath” Once or Twice a Week
Intense exertion—such as sprints or short, high-intensity intervals—releases the messenger LAC-Phe. This has been shown to suppress appetite and is also supposed to improve insulin sensitivity.
It’s not about sprint training in the strict sense, but about deliberately reaching very high intensity levels where the body is temporarily highly challenged. This form of exertion requires little time; it is naturally strenuous but evidently comes with pronounced metabolic adaptations.
6. One Fasting Day Per Week
A regular fasting day lowers basal insulin levels, reduces total calorie intake, activates autophagy, and regulates stress hormones like cortisol.
For many, a quiet workday or the weekend is suitable. Regularity is key, not perfection.
7. Preferably Exercise in the Morning
Morning exercise depletes glycogen stores. This creates metabolic room for carbohydrates during the day without derailing the metabolism.
Evening exercise, on the other hand, can increase hunger and disrupt sleep—both unfavorable for stable blood sugar regulation.
Those Who Follow the Rules Extend Their Healthy Lifespan
Insulin resistance is neither inevitable nor a fate. Under physiological conditions, it doesn’t have to develop and is often preventable. Even if it already exists or prediabetes or age-related diabetes mellitus has developed, the metabolism can usually be stabilized without medication through targeted lifestyle changes.
Those who follow the basic rules not only protect their blood sugar but also their vessels, bones, tendons, muscles, and brain—thus extending their healthy lifespan. The presented 7-point plan offers clear guidance and targets the mechanisms that cause or maintain insulin resistance.
The silent killer loses its power—through knowledge, movement, and structure.
About the Author: Prof. Dr. med. Thomas Kälicke is a specialist in surgery, orthopedics, and trauma surgery with additional qualifications in special trauma surgery, hand surgery, and physical therapy. In early 2011, at the age of 38, he became chief physician at GFO Kliniken Bonn. Since 2025, he has also been the chief physician of general surgery at CURA Hospital in Bad Honnef. In addition to his clinical work, he has been advising and supporting people for many years who want to change their lifestyle and stay healthy long-term. As a sought-after speaker, he conveys scientifically sound insights into longevity in an understandable and practical way.