@djp23 - Hi, and welcome to the forum.
You may or may not get something out of reading my post as mentioned above - initially I had much the same question - I'm at my ideal weight, I'm fit; how on earth can I have hit this blood sugar threshold, and where is the borderline between non-alcoholic fatty liver and diabetes - oh, and what the hell is insulin resistance really?
I now know a whole bunch more, but have many more questions than I have answers, and one thing that repeats over and over is that everyone is different, so what may be an answer for me, may not be for you.
Metabolic syndrome (which used to be called insulin resistance syndrome, so there's that association for a start) is worth just looking at, because it focusses on: -
Waist circumference (really a measure of fat distributed around the central organs, or viscera, rather than under the skin around the body)
Blood glucose (being too high, this obviously overlaps with diabetes)
Blood pressure (being too high - leading to even greater risk of cardio-vascular problems)
High blood triglycerides (in your serum lipid panel, a measure of the amount of fat particles in the fat transport system - clearly a connection with visceral fat)
Low blood HDL (this is a little confusing, and I'll skip the detail, but it's a measure of what is often called "good cholesterol" and within this set of results, low just means that your blood lipids (fats) are out of balance - again, more of a measure that something is not right in the fat surrounding your liver.
Now - given the role that your liver has in regulating glucose - you can see that all of that has a direct link to your liver being under some kind of stress...
The good news is that your liver is a pretty remarkable organ, and all the things you have committed to doing are (in my humble view) the best things you can be doing.
Let me lay out my simplistic view:
You eat food. Food is comprised of Carbs, Fat and Protein
Fat and Protein are digested in the intestine, simple carbs are digested in the stomach. Complex carbs are either digested in the intestine or not at all.
Everything comes back to the liver.
If there are simple carbs in the food, that will trigger insulin (insulin is of course needed to control blood glucose, but that's only it's most famous role, it's really about energy).
Because insulin is high, your liver is under instruction to pack everything it can into storage - sugar is turned into storable fat, fat is turned into storable fat, and even excess protein is turned into storable fat.
Read that last sentence over and over until you understand that this is the key piece of information that nobody has ever told you, and why diets don't work, and why the Eatwell approach brings us to where we are.
Because insulin is high, all your fat which is already in storage must stay there, and you are only able to burn glucose for energy, which is why you get hungry again so soon.
Because insulin is high, over time you need more of it to have the same effect, leading to insulin resistance, and eventually diabetes T2.
Because insulin is high, and every cell has a role with insulin, but not all develop resistance, now that function is on over-speed, disrupting all sorts of fine-tuned hormonal effects.
And because insulin is high, the liver is under orders to store as much of the fat within and around itself, which causes the fat storage cells to expand, leading them to become over-filled, where they leak out the free fatty-acids and essentially call out for help (inflammation).
So - now you have too much glucose and fat in your blood, and where glucose goes, more water goes, and now you have too much volume of fluid in your blood vessels, leading to too much pressure...
.. and so on, and believe me, that's the simple version.
So - what to do?
Give the liver a break.
If you start again:
You do not eat food. Your liver gets a break, and insulin drops.
You start to mobilise fats to burn for energy, and start burning it.
You start to create Ketones to fuel your brain
Your start to clean up old and broken stuff in your cells.
Or:
You eat foods with close to zero carbs.
Fat and Protein are absorbed in the intestine.
Turns out we are really quite efficient at digesting fat and protein together. It all goes to the liver.
Because insulin is low, your liver is under instruction to keep the fats recycling from storage to burning.
Because insulin is low, your liver will create ketones to fuel your brain.
Because insulin is low, your liver will create glucose whenever you need it.
Because insulin is low, your hormonal response to the food is to feel full.
The proportion of your time that you spend eating to not-eating is simply intermittent fasting, but the more time you spend not-eating, the more of a break your liver gets. It uses its own stores first, and so relatively quickly (weeks) you can make a significant difference to the health of your liver and your blood glucose levels - then keep going and you can reverse NAFLD, and T2DM and any of the chronic illnesses that are the result of chronic insulin resistance (at least, that's what I'm doing, and is the only way I have of making sense of all the case studies and personal experiences I've seen over the last year - exactly what you do and exactly the experience you have will be totally personal, but the underlying mechanism is pretty simple - give your liver a break).
None of this relies on counting or cutting calories - and you should strive for full nutrition in whatever eating window and regime works for you. Exercise is great for all sorts of reasons, but nothing beats giving your liver a break.
At least in my personal experience.
But - it sounds like you are doing all of this anyway - this entire wall-o-text is simply to encourage you that (again, only in my humble opinion) you are doing all the right things.
