Growth Hormone Resistance of Beta-cells

Inclusion Criteria: * body mass index \>18.5kg/m2 and \<45.9kg/m2 * impaired fasting glucose \>/= 100mg/dL, \</= 126mg/dL or impaired glucose tolerance on 75g oral glucose tolerance test (blood glucose 140 to 199mg/dL at two-hours) Exclusion Criteria: * pregnant, planning to become pregnant during the study, or breastfeeding * current diagnosis or history of type 1 or type 2 diabetes * use of medications that can impact the study outcomes (e.g., GLP-1 receptor agonists) * history of bariatric surgery * known, uncontrolled hypothyroidism * history of intracranial hypertension, including papilledema, or a condition that increases the risk of developing intracranial hypertension, such as Turner Syndrome, Prader-Willi Syndrome, or renal impairment * current cancer or cancer that has been in remission less than 5 years * first degree relative with type 1 diabetes * evidence of anemia or significant end organ dysfunction (e.g., liver, kidney, heart disease) * alcohol use disorder, use of controlled substances, or smoking \>2 cigarettes per day * greater than 3% weight loss within three months of screening or engaged in regular (\>/= 3 days per week), continuous moderate- or high-intensity exercise of \>/= 30 min duration * mentally disabled persons, prisoners, and persons with inability to grant voluntary informed consent