Prediabetes is a condition where blood sugar levels are higher than normal but not high enough to indicate diabetes. More than one in three Americans has prediabetes, but 80 percent do not know it.

Prediabetes affects how the body uses insulin, the hormone that allows blood sugar into the cells. The pancreas has to produce more insulin to get the cells to respond until it eventually cannot keep up, leading to elevated blood sugar. Many people see prediabetes as a warning sign to make diet and lifestyle changes to prevent the development of type 2 diabetes and other serious health problems, and some of these efforts can have a positive effect.

Effects of Dietary Changes

Doctors typically recommend dietary changes to prevent prediabetes from advancing to type 2 diabetes. Research indicates that multiple diets may be effective for diabetes prevention, including the Mediterranean diet, low-fat diet, or vegetarian diet.

Some studies show that eating a Mediterranean diet can reduce the risk of prediabetes developing into type 2 diabetes by 30 percent. One extensive and lengthy study comparing a Mediterranean diet to a low-fat diet showed that, after four years, people on a Mediterranean diet had better blood sugar management and needed fewer glucose-lowering medications.

Does this mean that a Mediterranean diet is the best for prediabetes? Not necessarily.

person checking their blood sugar level at kitchen table with healthy food


Ketogenic Diet Cautions

Some studies looked at whether a high- or low-carbohydrate diet is better for blood sugar control, focusing specifically on the popular ketogenic diet. Results show that people following a low-carb ketogenic diet lost weight compared to those on a baseline diet, but there was no significant difference in body fat.

Lab tests show that this weight loss was most likely due to loss of water weight or skeletal muscle. Further study results show reduced-fat diets resulted in more significant fat loss than ketogenic ones, suggesting that eating more carbohydrates than a keto diet calls for may be beneficial to helping prevent diabetes.

keto diet friendly meal with low carb plate


High Carb vs. Low Carb

Low carbohydrate eating patterns have been extensively studied as beneficial for people with prediabetes and type 2 diabetes, but the results are not straightforward. One analysis compared low-carbohydrate diets (less than 45 percent carbs) to high-carbohydrate diets (more than 45 percent carbs) and found that blood sugar control was best in very low carbohydrate diets (less than 25 percent carbs) but only for the first three and six months.

Another analysis comparing high- and low-carb diets showed that the larger the carbohydrate restriction, the greater the initial blood sugar control, but the results for the groups were similar after one year.

a variety of foods that suit a low-carbohydrate diet


Carbohydrate Type and Quantity

Carbohydrate control is essential to preventing diabetes, but the type and quantity of carbs are what matter the most. Sugars, starches, and fiber are all carbohydrates, but sugars and starches raise blood sugar, while fiber does not.

The best carbohydrates for people with prediabetes have a low glycemic load, which factors in fiber to account for how the food affects blood sugar levels. Studies show that people eating lower-glycemic foods has a lower risk of developing diabetes than those who eat foods with higher glycemic loads.

variety of high-carbohydrate foods with fiber


Weight Loss

Losing weight is a crucial strategy for preventing diabetes and other serious health problems, but the point of a prediabetes diet is not weight loss. Not everyone with prediabetes needs to lose a significant amount of weight, and often small losses paired with positive dietary changes and increased exercise can prevent type 2 diabetes.

One study showed that people with prediabetes who lost between only five and seven percent of their body weight cut their risk of type 2 diabetes by 58 percent.

smiling woman eating a salad in the kitchen


A Personalized Plan

There is no gold-standard diet when it comes to a prediabetes diet. The most important thing is to base your diet on healthy foods and find something that works for you.

Some people eat more protein to stay fuller, while others cut back on sugar and eat extra vegetables. What ultimately matters is figuring out something you can stick with to get long-term results.

woman and daughter choosing food at the grocery store


Cut Out Added Sugar

Many people with prediabetes choose to cut out added or excess sugar. Avoiding simple sugars in candy, cookies, cakes, and other sweets is an easy way to prevent blood sugar spikes, as can giving up regular soda, fruit juices, sweet tea, and lemonade.

Diet sodas are okay, but plain water, unsweetened tea, and sparkling water are better.

Selection of food high in sugar


Make Smart Substitutes for Carbohydrates

You do not have to avoid carbohydrates altogether if you have prediabetes, but you have to make more nutritious choices.

Always talk to your doctor to determine the ideal carbohydrate limits for your body, but here are some general suggestions:

  • Find alternatives to pretzels, chips, and crackers at snack time.
  • Swap white rice, white pasta, and white bread for brown or wild rice, whole wheat bread, and bean-based pastas.
  • Try beans, quinoa, farro, barley, and bulgar to change up your diet.
  • Limit your carbohydrate intake to about one cup with every meal.

wild rice dish with salmon


Fruits, Vegetables, and Proteins

You should also include fruits, vegetables, and proteins in your diet if you have prediabetes. Eat fruit in moderation, and remember that protein slows how quickly carbohydrates enter the bloodstream.

Pair fruit and protein to prevent blood sugar spikes. Try Greek yogurt with strawberries or peaches and part-skin cottage cheese. Consume green leafy vegetables and high-fiber options like carrots, celery, beets, and cucumbers when possible.

paper bags of healthy fruits and vegetables


Other Tips For Prediabetes Diets

There are other things you can do to make a prediabetes diet easier to follow. Plan your meals a few days ahead of time, and seek out and learn new recipes so you don't get bored.

Try new vegetables and grains, and commit to Meatless Mondays to increase consumption of healthy beans and lentils over more problematic red meat. Swap zucchini noodles for pasta, and try new herbs and spices to keep things exciting.

Superfood salad, avocado, beetroot, roasted chickpea, sweet potatoe, beluga lentil and blood orange


Popular Now on Facty Health


This site offers information designed for educational purposes only. You should not rely on any information on this site as a substitute for professional medical advice, diagnosis, treatment, or as a substitute for, professional counseling care, advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional.