Built on national standards for diabetes care. Designed for daily life.

Berine is led by Tina Alexander RDN, CDCES, whose clinical experience shapes practical education for the long-term work of metabolic health, designed to carry beyond a single practice.

You should feel good in your skin. That’s the goal.

Berine creates practical, evidence-based education for the long-term work of metabolic health. We are starting with Diabetes Foundations, built for those living with all types of diabetes and available by direct enrollment when it opens.

Explore Diabetes Foundations

Most newly-diagnosed patients walk out of an appointment with a pamphlet and a pharmacy list.

A new diabetes diagnosis often comes with instructions but little time to understand how those instructions fit together. Patients need clinically reliable guidance they can use in daily life, especially in the weeks after diagnosis when questions move from the appointment into meals, medication, movement, and sleep.

Diabetes Self-Management Education and Support (DSMES), recognized by the ADA and ADCES, is designed for that work. In insured cohorts, fewer than 7% of adults newly diagnosed with type 2 diabetes participate during the first year. Berine is building direct-pay education for people who need a structured next step after the appointment.

~40MAmericans living with diabetes
>90%of insured adults newly diagnosed with diabetes don’t participate in first-year DSMES
~1 in 3adults with type 2 diabetes experience diabetes distress

Sources: CDC National Diabetes Statistics Report, reviewed January 2026 (2023 data). DSMES participation (first-year, insured cohorts): Li et al., MMWR 2014; Strawbridge et al., Health Educ Behav 2015. Diabetes distress (type 2): Perrin et al., Diabetic Medicine 2017.

Led by a registered dietitian and diabetes educator.

Tina's career spans the full spectrum of metabolic health: troubleshooting care in acute care hospitals, founding Integralife as an ADA-recognized program, holding national credentialing leadership, and now driving dietitian integration in clinical trials as VP of nutrition research and strategic partnerships at Rapid Trials.

Tina Alexander, Registered Dietitian Nutritionist and Certified Diabetes Care and Education Specialist — Tina AlexanderRDN, CDCESFounder & Clinical Director

ADA-recognized DSMES, Integralife
2,500+ patients served
National credentialing leadership
VP Nutrition Research, Rapid Trials

Tina Alexander is a problem-solver at heart. That drive defined the start of her clinical career in rural hospitals, troubleshooting complex cases, untangling care gaps, and making resources work where they were needed most.

She founded Integralife to bring that same focus to private practice, building an ADA-recognized diabetes self-management program that has cared for more than 2,500 patients. Today, as VP at Rapid Trials, she embeds dietitians into clinical trials where new therapies originate. Combined with her national credentialing leadership with the CBDCE, this multi-level expertise is the foundation Tina built directly into Berine.

I am not your doctor. I’m not your drill sergeant. We’re here to improve your health, at whatever rate you’re willing to go at.

15+ years of experience in nutritional education and diabetes management
Founder, Integralife (ADA-recognized DSMES program)
Vice President, Nutrition Research and Strategic Partnerships, Rapid Trials
Vice President, Arizona Obesity Organization
Credentialing Committee, CBDCE
President, Central Arizona Academy of Nutrition and Dietetics
Nutrition Services Payment Specialist, Arizona Academy of Nutrition and Dietetics
Chair, AZ ADCES

How we teach metabolic health.

Six pillars, each important on its own. The skill we teach is reading how they interact as one system.

Nutrition & Hydration

The solid and liquid inputs that fuel, build, and repair the body. We treat nutrition and hydration as separate behaviors with separate signals; both deserve their own teaching.

What we cover

Macronutrients: protein, carbohydrates, fats
Micronutrients, fiber, and the gut microbiome
Fluid balance: water intake and the electrolytes (sodium, potassium, magnesium, calcium) every cell runs on
Meal timing as nutrient delivery

Hydration earned its own billing because plasma osmolality and urine specific gravity are clinically distinct from eating, and on Diabetes Foundations they directly shape glycemic variability. Pharmacologically-acting supplements live under Substances & Therapeutics; meal timing as circadian entrainment lives under Sleep & Circadian.

Movement & Recovery

Movement is the active stress that drives adaptation. Recovery is where the body responds and becomes stronger, more efficient, more metabolically flexible. Both halves taught together; load without recovery is just damage.

Load

Aerobic work (zone 2, endurance)
Resistance training
NEAT (non-exercise activity thermogenesis)
Daily posture and ambient activity

Recovery

Mobility work
Breathwork as somatic recovery
Thermal stress (sauna, cold exposure)
Soft-tissue work

Sleep handles the unconscious restorative state; this pillar handles what you do awake. Breathwork as emotional regulation lives under Mind & Connection.

Sleep & Circadian

Sleep is the unconscious restorative state. Circadian is the 24-hour rhythm that organizes nearly every physiological process. Inseparable, but they run on different machinery. You can sleep eight hours and still be circadian-disrupted (shift work, jet lag), or be aligned to the light and still sleep-deprived.

What we cover

Sleep duration, architecture (REM, deep, light), and quality
Light exposure as a circadian cue
Meal timing as a circadian cue
Shift work and travel patterns
Clinical sleep disorders (apnea, insomnia)

Both halves matter metabolically and both deserve their own teaching. We don’t collapse one into the other.

Mind & Connection

Mind is the inner psychological world. Connection is the outer relational world. The research literature treats them as two separate metabolic variables, each with its own evidence base.

Mind

Stress response
Mood, anxiety, and emotional regulation
Purpose and meaning
Mindfulness and contemplative practice

Connection

Social integration and loneliness
Community and intimate relationships
Belonging
Population-level levers (built environment, third places, workplace design)

Holt-Lunstad and Berkman, the Blue Zones literature, and the American College of Lifestyle Medicine framework all make the case for naming these separately. Breathwork as emotional regulation lives here; breathwork as somatic recovery belongs under Movement & Recovery.

Substances & Therapeutics

Exogenous chemicals that affect metabolism: prescribed, over-the-counter, recreational, or supplemental. The distinction between alcohol and metformin is regulatory, not mechanistic, so we teach them as one landscape.

What we cover

Modern metabolic pharmacology: GLP-1 receptor agonists, metformin, statins, insulin, antihypertensives
Pharmacologically-acting supplements: berberine, creatine, melatonin
Alcohol and its metabolic consequences
Tobacco and nicotine
Caffeine and other stimulants

Nutritional supplements that function as food belong under Nutrition & Hydration. Therapeutics is named neutrally because the GLP-1 era is real and patients deserve a clinical, non-moralizing teaching.

Signals & Interoception

The feedback layer of metabolic health. External signals are objective data: labs, wearables, imaging. Interoception is subjective; the body’s own felt sense. Reading both is the meta-skill the other pillars rely on.

External signals

Lab biomarkers (HbA1c, fasting glucose, lipids, comprehensive metabolic panel)
Wearable and device data (CGM, heart rate variability, sleep tracking)
Imaging where clinically relevant (DEXA, CAC)

Interoception

Hunger and satiety
Energy and fatigue
Pain
Emotional signals from the body

Lifestyle medicine frameworks don’t carry an equivalent feedback pillar. In the CGM era, naming the feedback layer explicitly is both forward-looking and clinically distinct.

On the name ‘Berine’

Berine is short for berberine, a compound from the barberry plant.

Botanical illustration of Berberis vulgaris (common barberry). Above a horizontal soil line, paired oval spiny-toothed leaves and a small drooping cluster of red berries on a slender stem. Below the soil line, a dense fanned fibrous root system radiates outward: the part of the plant where berberine concentrates. — Berberis vulgarisCommon barberry. Berberine concentrates in its root.

Berberine is one of the oldest metabolic herbs we have. It has been used across folk medicine for centuries for blood-sugar problems, long before anyone had the language for insulin resistance. People did not have that language. They just knew the plant did something for the sugar problem.

Insulin helps glucose move from the bloodstream into cells for energy. In type 2 diabetes, the body may not make enough insulin or use it effectively, so more glucose remains in the blood. Insulin resistance is one part of that process, alongside genetics, beta-cell function, environment, and other factors.

Insulin sensitivity is one useful lens for understanding metabolic health. Food, sleep, movement, stress, medication, and other factors can affect glucose regulation in different ways. The six-pillar framework helps people see those relationships together.

That history gave Berine its name. It also points toward a broader commitment: clinical education designed to travel, grounded in current evidence, and built to serve more people over time.

The name gives the work room to grow beyond one person.

A standard that travels

The six-pillar system behind Diabetes Foundations is the basis for Berine’s next work: more conditions, clinic use, and wider access.

More conditions, same system

Diabetes Foundations is the first course. The same six-pillar model can support future education for PCOS, autoimmune conditions, and GLP-1 care.

PCOSAutoimmuneGLP-1 support

Built for clinic use

Berine is exploring how practices, community health centers, and employer programs could use structured education in the first weeks of care.

Independent practicesCommunity healthEmployers

Explore partnership options

Wider access over time

Berine aims to add language access, regional pricing, and scholarships so more patients can use the same course.

LanguagesRegional pricingScholarships

Ready when you are.

Join the waitlist for the first patient course, or bring our clinical team into your practice.

Join the course waitlist Work with our clinical team