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Adult

- Adult, pre-menopausal (ages 18-40 years) men and women - Known prediabetes (Hemoglobin A1c 5.7-6.4% or fasting glucose 100-125) OR have a family history of type 2 diabetes AND have one other risk factor (elevated weight, high cholesterol, or high blood pressure) - Obese (BMI 30-40) - Not currently physical active Inclusion criteria: i. Age 20-40 years. ii. Biologically female participants with regular menstruation iii. Body mass index (BMI) 30.0 to 40.0 kg/m2 iv. Prediabetes as defined by the American Diabetes Association (HgbA1c 5.7% to < 6.5% or fasting glucose 100 to < 126 mg/dL) v. Physically inactive (<100 min/wk of regular exercise) vi. No contraindications to exercise or limitations on ability to be physically active vii. Weight stable (weight change <5kg in past 3 months) viii. Not currently pregnant or lactating, not pregnant within the past 6 months or planning to become pregnant in the next 6 months. Exclusion criteria: i. History or symptoms suggestive of cardiovascular disease or congestive heart failure ii. Diastolic blood pressure >100 mmHg, systolic blood pressure >160 mmHg, or resting heart rate >100 bpm iii. History of type 1 or type 2 DM (or fasting glucose126 mg/dL or Hemoglobin A1C 6.5% on screening labs) iv. Current use of medications that effect SI (oral steroids, metformin, GLP1 receptor agonists, etc). v. Chronic kidney disease (CKD, stage 4 or higher) vi. TSH, electrolytes, hematocrit, white blood cell count, or platelets significantly outside the normal reference range on screening labs vii. Triglycerides >400 or LDL >200 on screening labs viii. Clinically significant abnormality on resting ECG, presence, or history of any other metabolic or chronic health problems which would affect appetite, food intake, energy metabolism, or ability to participate in exercise, ix. History of obstructive sleep apnea, primary insomnia, night-time shiftwork, rotating work, or other atypical sleep patterns. x. Current or recent (within 1 month) zero or very low carbohydrate diet (<10% daily calories from carbohydrates).