[SHOCKING!] THIS diagnosis is a serious SURPRISE to most of its victims

Blindness, amputation, and even early death are common outcomes

According to a brand-new study published in the prestigious Journal of the American Medical Association (JAMA), over 50 percent of the patients who came into a big city emergency room (ER) had a serious clinical condition

Yet were completely UNAWARE.

That’s a HUGE shock… and a big RED FLAG. Especially because the condition could lead to stroke, heart attack, kidney failure, blindness, amputation… and EARLY DEATH.

In fact, the analysis revealed that the patients went to the ER for a completely different medical emergency. Meaning their serious diagnosis probably came as a serious surprise.

Now, I’ve seen many patients over the years. I’ve even worked in bustling ERs that treat the very sickest of patients. And of course, I’m aware that many people aren’t as in tune with their health as I’d like them to be.

But this study is quite the eye-opener. Just think about it…

Say you come into contact with a handful of people each day. It could very well mean that a surprisingly large percentage of them unknowingly suffer from a serious health condition that could slowly and silently kill them.

What’s even more tragic is, the earlier you know about it, the sooner you can take steps—all on your own—to completely turn the prognosis around. Making early detection crucial.

I’ll dive into the steps you can take to prevent, or reverse, this serious condition in just a moment.

But first, let’s take a closer look at the details of this mind-boggling study…

Ticking time bomb

This study began in a busy ER in Chicago. For three months, the staff randomly screened more than 2,000 patients who came in and met certain criteria for Type 2 diabetes.1

Specifically, they gave these at-risk patients a hemoglobin A1C (HbA1C) blood test, which measures their long-term blood sugar control. (More on that test in a moment.)

It turns out, over 50 percent had “abnormal” A1C levels—indicative of prediabetes or Type 2 diabetes. Some even had levels so high, their condition was potentially life threatening!

Worse yet, for the majority of all the patients with abnormal A1C levels—70 percent of them, to be exact—their diagnosis came as a real shock. They didn’t even know they had a blood sugar problem!

Now, here’s the thing…

Type 2 diabetes is dangerous—and even life-threatening—under the best of circumstances. This is true, for example, even when you receive expert care from a doctor; when your condition is well managed; when you follow a healthy, low-carb diet; and when you get regular exercise.

But when you don’t even know you have Type 2 diabetesit’s an absolute ticking time bomb!

In fact, uncontrolled high blood sugar can silently destroy your body years before the most serious (and irreversible) complications noticeably set in. When left untreated, it can lead to stroke, heart attack, kidney failure, blindness, amputation, and early death.

Sadly, that could be the case for many Americans, as we outpace the world in total cases of Type 2 diabetes. But—that doesn’t mean the rest of the world gets off scot-free. Because even globally, about half the people with Type 2 diabetes don’t know they have it either.2

Fortunately, as I mentioned earlier, there’s a lot you can do, starting today, to avoid ever receiving an unexpected Type 2 diabetes diagnosis in the ER…

Learn your numbers… and stay on top of them

When it comes to disease prevention, I’m a firm believer in regular clinical testing. Because the sooner you know something is off, the sooner you can act to correct it.

Plus, since the onset of Type 2 diabetes is gradual, how often you test and how you interpret the results is really important. For example, results that trend in a certain direction over many years (even if they still fall within the “normal range”) could signal trouble ahead. So, it’s important to catch things—and change habits—early.

Of course, many “experts” consider Type 2 diabetes a “silent” disease. But there are some subtle signs to watch out for, including:3

  • Family history of Type 2 diabetes
  • Itching and yeast infections
  • Dark, velvety skin patches
  • Pins and needle sensations
  • Weight gain or weight loss
  • Excess hunger or thirst
  • Urinary tract infections
  • Slow-healing wounds
  • Excess urination
  • Vision problems
  • Sleep problems
  • Cravings
  • Fatigue
  • Obesity

Now, let’s move on to the tests themselves…

First and foremost, you should regularly test your fasting blood sugar as part of a comprehensive metabolic panel (CMP) blood workup. The “fasting” part is critical—so make sure you don’t drink or eat anything (except water) for 12 hours before your blood is drawn.

Here’s what fasting blood sugar results mean:

A healthy fasting blood sugar level is between 70 and 80.

If your number is between 80 and 95, consider it a “yellow light.” You need to start taking extra precautions to prevent things from worsening.

If your blood sugar is between 95 and 110, you’re officially prediabetic.

Anything over 110 is diabetic, until proven otherwise.

I say “proven otherwise” because it’s possible to have a high fasting blood sugar and not be diabetic. That’s why I make sure all my patients get a second important blood sugar test… but many doctors still don’t routinely order it.

The number you need to keep
“just right”

The second test I give all my patients—not just the ones who show signs of Type 2 diabetes—is for HbA1C.

This test tells us how well controlled your blood sugar has been for the past six weeks. Because it’s possible to have a high fasting blood sugar reading, yet a normal HbA1C.

The results typically go hand in hand, especially if you’ve had blood sugar problems for a while. But in the very early stages, they may not—since your body is still trying to keep you healthy.

Here’s how to interpret your HbA1C test results:

  • An HbA1C up to 5.7 is healthy.
  • A result between 5.8 and 6.3 indicates prediabetes.
  • You officially become diabetic when this number goes above 6.4.

In the “prediabetes” stage, you want to work toward getting your HbA1C back into the healthy range, at or below 5.7. But if you already have diabetes, aim to keep your HbA1C as close to 7 as possible. Here’s why…

Trying to force HbA1C down too low may be a HUGE mistake in diabetic patients. In fact, some research suggests that diabetics with HbA1C levels under 6 have the highest death risk.4

Of course, frequency of testing is also a key factor. If you have anything but a normal level, or if you’re overweight, you should test your levels every six weeks to three months to monitor your progress.

If it turns out your levels are, indeed, outside of the “healthy” range, it’s time to start looking at some modifiable lifestyle factors that can play a fundamental role in maintaining metabolic health…

Savory diet slashes diabetes risk

First up: Following a healthy diet is the absolute best way to regulate—and improve—your fasting blood sugar and HbA1C. It will also help ward off the possibility of developing Type 2 diabetes down the road.

I’m not talking about eating more rice cakes or bean sprouts. Rather, some of the best foods you can eat to balance your blood sugar are ones that would make mainstream experts’ hair stand on end…

Hearty eggs. Gooey cheese. Creamy avocados. Juicy burgers and steaks. Decadent sweet potatoes drizzled with real butter. All staples of a high-fat, low-carb eating plan, like the Mediterranean diet.

You can—and should—eat these kinds of mouth-watering foods because they’re filled with protein, fat, and complex carbs, which take much longer to break down into glucose in the body. Meaning they won’t cause your blood sugar levels to spike like unhealthy, processed foods.

Plus, following this diet improves your metabolic health LIGHTNING FAST…

In fact, in a brand-new study published in the Journal of the American Medical Association, researchers followed 150 men and women with untreated prediabetes and HbA1C levels between 6.0 and 6.9. 5

First, the researchers randomly divided the participants into two groups. They told the first group to continue following their “usual diet.” But they gave the second group directions for how to adopt a low-carb diet.

Then, after six months, the researchers found the low-carb group had “significantly greater” reductions in fasting blood sugar and body weight compared to the group following their regular diet. Plus, their HbA1C came down by 23 percent! That’s really quite impressive.

Consider this: In another arm of the same study, researchers found that a reduction of just 17 percent of HbA1c (which is six percent less than what the low-carb dieters achieved) slashes your risk of developing Type 2 diabetes over the next two to three years by a staggering 58 percent!

With those results in mind, why WOULDN’T you get yourself on a low-carb diet… PRONTO?

After all, adopting a Mediterranean-style diet may be the ONLY tool you’ll ever need to avoid—and even reverse—Type 2 diabetes.

Granted, there are several variations of it. But they all focus on high-fat, low-carb foods—like lean protein, fresh produce, and nuts.

These foods provide a vast array of vitamins, polyphenols, and carotenoids. They also carry a uniquely therapeutic fatty acid profile—filled to the brim with monounsaturated fats (MUFAs) from sources like olive oil, avocados, and macadamia nuts.

Plus, when you cut out all the white sugar and flour from your diet, your body naturally balances its blood sugar—on its own and without medication—over time.

Of course, I can’t wrap up an article on diabetes prevention without mentioning another important lifestyle habit…

“Run” away from a diagnosis, for good

I’m talking about exercise. Because any type of physical activity is great news for metabolic health… even in obese men and women.

In a study published earlier this year, researchers randomly divided obese men and women into three groups. The first group began a high-intensity exercise regimen with no dietary changes whatsoever. The second group began a moderate-intensity exercise regimen, again with no dietary changes. The third group did not get any regular exercise.

When researchers followed up with all the participants 10 years later, both exercise groups saw improvements in their waistlines and their HbA1C. Not only that, but the obese individuals in the vigorous exercise group reduced their risk of developing Type 2 diabetes by 49 percent. And the moderate group did even better—they enjoyed a 53 percent reduction in Type 2 diabetes risk!

Wow! I’d say those results are quite encouraging.

The bottom line? Diet and exercise really can help you AVOID a surprising and potentially deadly diagnosis in the ER. So, make the decision RIGHT NOW to start fresh and renew your commitment to following a healthy lifestyle.

For some dietary inspiration, check out my cooking show, Cooking with Dr. Fred, on Instagram (@DrFredNYC) and YouTube (“The Dr. Fred Show”). And for some personalized guidance into adopting a Mediterranean-style diet, check out my book The A-List Diet, which you can order under the “Books” tab of my website,

When it comes to exercise, try mixing a few new activities into your routine—like yoga or Tai Chi. As for myself, I regularly indulge in Soul Cycle classes. It’s like going to a nightclub in the middle of the day—and I find it downright addicting. But the key is to find something that YOU enjoy… and makes YOU happy.

Other parameters of good
metabolic health

I always test vitamin D levels every three to six months in all my patients—and especially those who show any signs of prediabetes.

I consider “optimal” levels to be between 80 and 100 ng/mL. To get to that healthy range, you’ll likely need a substantial therapeutic dosage. I typically recommend taking between 125 to 250 mcg (5,000 and 10,000 IU) of vitamin D per day. And remember, always take vitamin D3, as other forms of the nutrient just aren’t as effective.

Of course, there are numerous other blood tests that help fill in the complete picture of your metabolic health. Those include a complete blood count (CBC) test, an erythrocyte sedimentation rate (ESR), which measures inflammation, and a test for homocysteine, which is an amino acid linked to metabolic syndrome and heart disease.

Having your blood tested and analyzed regularly means you’ll find out right away if anything is out of whack. Not to mention, it gives you the chance to do something about your metabolic health before it’s too late! (No surprise diabetes diagnoses on my watch!)

If your doctor doesn’t mention your bloodwork results and just has the office assistant call to say “everything’s fine,” make sure to ask for a copy of the report. After all, it’s critical, life-saving information that you deserve to know. And always schedule a follow-up visit to discuss any questions you may have.


  1. Prevalence of Undiagnosed Diabetes Identified by a Novel Electronic Medical Record Diabetes Screening Program in an Urban Emergency Department in the US.” JAMA Netw Open. 2023;6(1):e2253275. doi.org/10.1001/jamanetworkopen.2022.53275 

  2. “Half of people who have diabetes don’t know it.” Pan American Health Organization, 11/14/13. (paho.org/hq/index.php?option=com_content&view=article&id=9157:2013-half-people-who-have-diabetes-dont-know-it&Itemid=0&lang=en#gsc.tab=0)
  3. “What are the early signs of Type 2 diabetes?” Medical News Today, 9/22/22. (medicalnewstoday.com/articles/323185)
  4. “Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study.” Diabetes Care. 2011 Jun;34(6):1329-36. doi.org/ 10.2337/dc10-2377. 
  5. Effects of a Low-Carbohydrate Dietary Intervention on Hemoglobin A1cA Randomized Clinical Trial.” JAMA Netw Open. 2022;5(10):e2238645. doi:10.1001/jamanetworkopen.2022.38645 

  6. “Effect of Moderate and Vigorous Aerobic Exercise on Incident Diabetes in Adults With Obesity: A 10-Year Follow-up of a Randomized Clinical Trial.” JAMA Intern Med. 2023;183(3):272–275. doi:10.1001/jamainternmed.2022.6291