An individual with prediabetes has high blood sugar levels, but not yet within the diabetes range. There is always time to monitor the levels and to stop the onset of diabetes.
According to research published in the Lancet in 2012, 5–10% of people with prediabetes develop diabetes every year worldwide, and up to 70 % of people with prediabetes continue to develop diabetes.
This risk can be decreased by between 40 and 75 percent by taking preventive measures, such as dietary changes. Indeed, the study says that between 5 and 10 percent of individuals with prediabetes go back to normal levels each year.
There is a strong possibility that if a person with prediabetes knows what action to take, they will avoid the development of diabetes.
Two main lifestyle factors are commonly included in preventive plans: a balanced diet and daily exercise.
Prediabetes diet: Foods to eat and avoid
Results of the Diabetes Prevention Program in the United States have proposed that every 2.2 pounds (1 kilogram) they lose in a year in people who are overweight will reduce their risk of developing diabetes by 16%.
This will be equivalent to a 58-percent risk reduction after 3 years.
A diet that can aid in weight loss and prediabetes treatment will usually contain foods that include:
- low in fat
- low in calories
- high in fiber
The person should eat plenty of:
- vegetables
- whole grains
- lean meats
- protein-packed legumes
In order to prevent added sugar, they should be careful. Fruits contain sugar, but they also provide fiber and other nutrients. For this reason, in their diet, a person may include a limited amount of fruit.
Glycemic index
The glycemic index ( GI) is a useful tool to calculate carbohydrate types and to select those that are safe. It is dependent on how easily food sugar is going to reach the bloodstream.
People with diabetes need to take care of the amount of carbohydrates they ingest, and particularly added sugar.
Any meal containing carbohydrates or sugar, however, is not necessarily bad. Natural sugars are found in vegetables, and whole grains are high in carbohydrates, but they also provide fiber and other nutrients. This make them acceptable, with moderation, for a person on a diet for prediabetes.
An index, or list, of foods is the GI. It rates foods by the rate at which they influence the amount of blood sugar. The highest score is 100, while the lowest score is 0.
It does not measure amounts of anything, but compares the forms in which food causes sugar levels to increase in the blood, with the highest level being 100.
Some foods that contribute to an unusually high spike in blood sugar can have a value above 100. Russet potatoes have a score of 111 on the GI, according to Oregon State University.
Sample GI values
Here are some more sample values:
- fruit roll-ups: 99
- plain white baguette: 95
- whole-grain bread: 51, depending on the type
- cornflakes: 93
- muesli: 66
- natural oatmeal: 55 on average
- white rice: 89
- brown rice: 50
- full-fat milk: 41
- skim milk: 32
- watermelon: 72
- banana: 62
- apple: 39
- unsweetened apple juice: 42
- white spaghetti: 58
- wholemeal spaghetti: 42
- baked beans: 40, but check the brand
Depending on the individual item, the carb amounts can also differ. For instance, some apples are sweeter than others, and different ingredients are used by manufacturers.
The values are shown by a study published in Diabetes Treatment, with variations. These values were set by researchers in 2008, and checked from time to time.
What makes a low or high GI score?
Slowly, the body digests whole grains and high-fibre foods. Their sugars gradually reach the bloodstream. Foods which contain fiber will have a lower GI than those made with refined ingredients, such as fruit and whole grains.
Sugars and refined carbs are easily absorbed by the body. This triggers a sudden increase in blood sugar levels and a “sugar spike,” or elevated blood glucose levels. A high GI score would be obtained for foods containing refined carbs and added sugars.
This is why the GI value of white bread is greater than that of wholemeal bread.
An individual with prediabetes needs a sugar spike to be prevented.
- foods with a GI value of 55 or less raise blood sugar levels those with GI values between 56 and 69 raise blood sugar levels at a moderate rate
- those with a GI value of 70 or above raise blood sugar levels rapidly
Some GI tips
It is not easy to tell a food’s GI value simply by looking at it.
Here are some tips that may help:
- Foods that contain refined sugars usually have a higher GI value than foods that contain natural sugars, such as fruit.
- Whole foods tend to have lower GI values than products made with refined grains, such as white bread or rice.
- Sweet potatoes, most vegetables, whole fruit, and legumes have lower GI values than white starchy vegetables, such as potatoes.
- As most fruits and vegetables ripen, their sugar content increase and their GI value goes up.
- Pastas tend to be low-GI foods because of the way their starches are bound.
- Parboiled rice, basmati, and brown rice all have lower GI values than short-grain or jasmine rice.
- Homemade oatmeal or stone-cut oats have a lower GI count than packaged oatmeal.
However, it is best to ask a doctor or dietitian for advice that suits your situation.
Counting carbs
Some people think that carbohydrate counting helps to ensure an adequate quantity of carbohydrates.
It is not inherently safe to cut carbs entirely. Some high-carb foods provide other nutritional benefits, such as potatoes and peas.
The same nutrients can, however, be given by many low-carb foods. An simple way to minimize carb consumption may be to substitute high- for low-carb options.
For example:
The following starchy vegetables are high in carbs:
- potatoes
- peas
- corn
It is necessary to monitor portions to prevent a spike in blood sugar while consuming these carbohydrates. Around 30 grams of carbohydrates are found in one cup of potatoes, peas or corn.
Fewer carbs per portion have the following and are high in fiber and other nutrients:
- asparagus
- broccoli
- carrots
- celery
- green beans
- lettuce other salad greens
- peppers
- spinach
- tomatoes
- zucchini
45 to 65 percent of a person’s diet can consist of carbohydrates, the National Institute of Health suggests.
Eat regular meals
An individual with prediabetes needs to maintain as steady a level of blood sugar as possible.
Fasting may cause drastic changes in blood sugar levels, but it can help to control glucose levels by consuming small meals at regular intervals.
Experts recommend:
- eating three properly-portioned meals regularly throughout the day, no more than 6 hours apart
- ensuring meals that are balanced, with each containing a source of protein, fat, and carbohydrates
To check whether a meal is correctly portioned, a person might use the plate method.
The plate method
The Diabetes Society recommend that each meal should consist of:
- one-half vegetables, at least two servings
- one-quarter meat, fish, or an equivalent
- one-quarter carbs, for example, rice, pasta, bread or potatoes
- a drink of water, low-fat milk, or other healthful options
- a piece of fruit
In addition, each meal should include at least three out of the four key food groups.
The four groups are:
- fruit and vegetables
- grain products, preferably whole grains
- milk or an alternative
- meat, fish, lentils, or an alternative
Studiesa have found that for people who need or want to lose weight, using a smaller plate can encourage people to eat less.
The DASH diet
For better health , health authorities, including the National Institutes of Health, recommend adopting the DASH diet. It can assist people with prediabetes in conjunction with carb counting and knowledge of the GI.
The emphasis of this diet is not on eating less calories, but on making healthier decisions.
People are encouraged to eat:
- vegetables
- fruits
- whole grains
- fat-free or low-fat dairy products
- fish
- poultry
- beans
- nuts
- vegetable oils
People should avoid foods that are high in saturated fats and sugar, such as:
- fatty meat
- full-fat dairy products
- coconut, palm, and other tropical oils
- sweets
- sugary drinks
Eating out
It does not mean that a person should not eat out or enjoy their food with prediabetes, but they need to be aware of decisions.
Here are some tips for eating out:
- Encourage friends and family to eat with you at restaurants that have healthful options.
- Choose a salad and ask to have it without dressing, or ask for a little olive oil or lemon juice to dress it with.
- Avoid buffets if it is too tempting to have more than one plate.
- Go for quality—such as fresh ingredients—rather than quantity.
- See if the menu lists the calories for a dish.
- Opt for sparkling water with ice and a slice of lemon, instead of soda or alcohol.
Meal planning
You might be wondering what you should eat if you have just been diagnosed with prediabetes.
Here are several suggestions during the day for meals.
| Meal | What to eat | What to avoid |
| Breakfast | Rolled or whole oatsWholemeal breadWhole peanut butter without added sugarFruitUp to 4 ounces of 100% fruit juice with no added sugarCoffee or tea with low-fat milk and no sugar | White bread and bagelsSweetened breakfast cerealSweetened juicesMany “specialty” coffees from coffee shops contain sugar, so check before buying |
| Lunch | Baked beans on wholemeal toastBrown rice, lentils, and salad with a little olive oilHome-made vegetable soupsAn apple or pear, or a cup of melon or berries | Bagels, baguettes, and other white or refined breadsBurgers and many fast-food itemsSalad dressings and ketchup with added sugar |
| Dinner | Yam or sweet potato with chicken, broccoli and asparagusWholemeal pasta with home-made tomato sauce and saladFruits, ice-cream made with fruit and yogurt without added sugar | PizzasReady-made saucesFatty meats |
| Snack | Nuts, fruit, low-fat, natural yogurt | Candies and ready-made “health” bars, unless the details on the label show they are really low in added sugar |
Fruit is highly nutritious in moderation, and contains fiber, water, vitamins , and minerals.
Enjoy fruit with protein or healthy fats such as nut butter, a small handful of nut seeds, or avocado to reduce the effect on blood sugar and keep you full for longer.
Check with your doctor or dietitian to see how many of your favorite things are suitable.
To prevent sugar spikes, you should aim to even out your carb intake during the day. Eating a lot of sweet foods for breakfast and then skipping them for the rest of the day would not help.
Alcohol
Consumption of alcohol can increase weight and the risk of diabetes as well.
One study showed that “risky” alcohol use in men increased their chances of developing diabetes significantly.
Limiting or avoiding the intake of alcohol can also enable a person to regulate their level of blood glucose and lead to weight loss.
Stop sugar mixers, such as soda, when drinking alcohol.
Other strategies
Diet alone does not prevent the development of prediabetes into diabetes. Other strategies include exercise and medication.
Exercise
Physical exercise can help an individual lose weight and regulate the amount of sugar in their blood. Exercise utilizes excess blood sugar for energy and can increase the sensitivity of insulin.
An article published in Exercise and Sports Science Australia recommends 210 minutes of moderate-intensity exercise or 125 minutes of intense exercise per week for individuals with prediabetes.
30 minutes of physical exercise, such as brisk walking, is recommended by the American Diabetes Association at least five days a week, preferably every day. One advantage of exercise is that it can help reduce levels of blood glucose.
Activities that could assist include:
- swimming
- brisk walking
- running
- strength training
- flexibility
Housework, gardening, and other activities can all contribute. The American Diabetes Association recommends that every 30 minutes, individuals working in a sedentary job can get up and walk around.
Medications
A physician may prescribe metformin to help regulate blood sugar levels for some people with prediabetes.
This can help, but it does not seem to be as successful as lifestyle interventions, and metformin may have side effects, like all medications.
For this reason, physicians advise most individuals to use lifestyle interventions to the greatest extent possible.
A research published in the Annals of Internal Medicine found that less than 4 percent of people with prediabetes were given the medication metformin by American doctors.
At least one study published in 2014 reported that dietary improvements and exercise are successful in preventing diabetes progression.
RECALL OF METFORMIN EXTENDED RELEASE
In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.
What is prediabetes?
Diabetes and prediabetes are metabolic disorders. The condition may be caused by actions and health conditions that impair the ability of the body to metabolize, consume, or store energy.
Why do blood sugar levels rise?
Factors that can cause blood sugar levels to rise include:
- insufficient insulin production
- impaired insulin expression
- the cells not responding properly to insulin
Prediabetes can affect anyone, but some people are more likely to experience it.
Factors that increase the risk include:
- being over the age of 40 years
- having low activity levels
- carrying excess weight
Other factors include:
- family or genetic traits, including having a direct relative with diabetes or being from certain ethnic or racial groups, including Pacific Islanders and African Americans
- having high blood pressure, heart disease, or both
- having high levels of triglyceride and “bad” cholesterol, or high-density lipoprotein (LDL)
- having low levels of “good” cholesterol, known as high-density lipoprotein (HDL)
- having excess belly fat or carrying extra weight around the middle, rather than the hips
- having another specific condition, such as polycystic ovary syndrome (PCOS), gestational diabetes, and low testosterone in men
Warning signs
The symptoms of prediabetes, if there are any, may be hard to spot.
A person may notice:
- increased thirst and urination
- tiredness
- difficulty concentrating
- unexpected weight changes
On different parts of the body, such as the neck, elbows, knuckles, and knees, skin darkening, called acanthosis nigricans, may also occur. It may take more time than usual for daily wounds to heal.
A glucose monitor can be used by people to check their blood sugar levels.
Takeaway
Prediabetes can develop into diabetes if a person does not take care of their diet and exercise regime.
However, a person with this diagnosis has a decent chance of avoiding a more severe condition in the future by taking the right action.
There is no one-size-fits-all diet for prediabetes. Anyone who gets a diagnosis should ask for advice from their doctor or healthcare provider.
