Hey friends! As I continue with my private practice, I am seeing more and more clients with prediabetes. It has been disheartening to me that so many people receive this diagnosis and are not given any of the tools or nutrition education to help them manage this condition. If you are in this camp then I hope you find this post helpful. If you know someone who has prediabetes then please feel free to share this article.

I should preface this post with a disclaimer: I am a dietitian who sepcializes in working with prediabetes and type 2 diabetes, but I’m not YOUR dietitian. So while I hope you find this post useful, please consult your own registered dietitian nutritionist (RDN) for personalized nutrition advice! This is intended to give a general overview but it is NOT individualized advice. Thanks!

Diagnosis

According to the CDC, 1 in 3 Americans have prediabetes. But their website also states that almost 90% of people don’t know they have it. This makes sense since prediabetes may not have any symptoms.

Prediabetes can be diagnosed with a fasting blood sugar or with a hemoglobin A1c test. Risk factors include:

• physical inactivity
• PCOS
• having immediate family with type 2 diabetes or
• being overweight (okay, we won’t go there right now)

If you meet any of those risk factors then I recommend that you ask your physician for a screening at your next physical.

Diagnostic Criteria

The following would indicate a diagnosis of prediabetes:

• hemaglobin A1c of 5.7% – 6.4%
• fasting plasma glucose test: 100-125 mg/dl
• oral glucose tolerance test: 140-199 mg/dl

Being diagnosed with prediabetes can be really scary. Some of the scariest parts are wondering if the food you’re eating is harming you, worrying about whether you’ll be able to enjoy carbohydrates again, and more importantly trying to prevent the development of diabetes.

Moving Forward

The diagnosis of prediabetes can be the perfect opportunity to re-evaluate your lifestyle and nutrition habits since 70% of those who have pre-diabetes will eventually develop Type 2 Diabetes. Developing diabetes may mean having to take medication (sometimes even giving yourself shots of insulin) as well as increasing your risk of heart disease, stroke, vision problems and neuropathy.

The great news is that you absolutely take steps now to lower your blood sugar, and early prediabetes treatment can actually lower blood sugar levels back to normal levels.

Pre-Diabetes and Weight

Before I get to the nutrition part, I want to touch on prediabetes and weight loss. Anytime you google pre-diabetes, you will see instructions to lose weight. Whenever I work with someone who has been diagnosed with prediabetes, their doctor has usually told them that they need to lose weight. Sometimes that’s literally the only piece of advice they received from their doctors appointment. This can make someone hyper-focused on the number on the scale.

The problem with only focusing on weight is that you can lose sight of changing simple lifestyle choices and rely on trendy diets instead. Focusing on quick weight loss can actually be detrimental in your journey to lowering your A1c level, since 95% of diets fail and most people who diet end up gaining back all of the weight and then some. Yo-yo dieting will not improve your prediabetes long-term.

I know physicians have a limited amount of time to spend with each patient, but I think that simply telling someone to lose weight to lower blood sugars is misguided and non-productive. My number one piece of advice to anyone who is dealing with a prediabetes diagnosis is to stop obsessing about the number on the scale and instead focus on things you have direct control over- as well as how you feel!

What you are eating and drinking and how much you’re moving your body can directly affect your energy levels, your stress levels, how well you sleep, your concentration and even your overall happiness. All of these factors are so much more important than your weight.

The Basics

I know this post is lengthy, so if you don’t feel like reading the whole thing then I hope you can take something about from this section.

We know that consuming a diet rich in plants is optimal for health and is associated with lower blood sugars. Moving your body in any way, including walking, can also lower blood sugars. Poor sleep, getting sick and not managing stress can increase your blood sugars as well.

So what does that mean? Looking at all aspects of life is really important! Making sleep, stress management and body movement priorities should be just as important as what you’re eating.

Pre-Diabetes Diet

I know figuring out what you should be eating with prediabetes can be very confusing. My recommendation is to stick with materials and advice from licensed professionals and organizations who are accredited to help you, (like the American Diabetes Association). Facing such a serious medical issue is not the time to embrace the anecdotal advice that you receive from Aunt Suzy or from a thread in a Facebook group. I just felt the need to say that because I seriously read the craziest things online!

There are so many misconceptions about nutrition changes that should be made when you’ve been diagnosed with this disease, and I hope this post clears some of them up for you!

First, you can breathe a sigh of relief. There’s no such thing as a prediabetes diet. You don’t need to completely cut out carbs or start following crazy restrictions.  Balance and taking care of yourself are both the key to lowering blood sugars.

Here are 3 nutrition changes you can make TODAY to lower your blood sugars:

#1 – Beverage Intake

When it comes to hydration, what are you drinking? Beverages are a really great thing to evaluate when it comes to blood sugars, and decreasing sugary beverages can definitely lower blood sugars. Many of my clients who have been through this process of decreasing sugary beverages say that in addition to lowering their blood sugars, they have less headaches and joint pain and their energy levels are noticeably improved. It is so important to focus on how your feel and how your blood sugars react when you make dietary changes!

Here are some common sugary beverages:

• Fruit Juice (yep, even 100% fruit juice)
• Regular Soda
• Tonic Water
• Sweet Tea
• Sports Drinks
• Vitamin Water

If you find yourself consuming a lot of these but aren’t sure where to start with lowering your blood sugars then try adding some non-sugary beverages into your day. Some great examples are increasing your water intake, drinking a Spindrift in place of fruit juice, using G2 in place of gatorade, or mixing your tea 1/2 sweet and 1/2 unsweet tea. Diet sodas are controversial, but I think drinking them in place of regular soda can be a good stepping stone to decreasing regular soda intake, especially if you’re drinking a lotof regular sodas.

Decreasing sugary beverage intake is also associated with decreased cholesterol and blood pressure.

Am I saying NEVER drink a sugary beverage again? Of course not. Just make sure the foundation of your hydration is coming from sources that keep your blood sugar at bay and help you feel your best.

#2- Carb Intake: Quality Over Quantity

You can breathe a sigh of relief because I’m not going to tell you that you need to eliminate carbohydrates or that you have to follow the ketogenic diet. BUT what you should be doing is incorporating carbs that are naturally rich in fiber. Fiber slows down the digestion of carbohydrates in your body, so it’s great for stabilizing blood sugar.

There are 2 types of fiber, soluble and insoluble. Soluble fiber especially helps to slow down the digestion of sugar in your body, which may improve blood sugar levels. Soluble fiber can be found in apples, blueberries, citrus fruits, oats, peas, beans, nuts, and barley.

Again, this post is not about creating food rules or making a list of things you’re not allowed to eat. You can absolutely still enjoy white pasta or a baked potato. But you may notice if you go from eating a really low fiber diet to increasing fiber that you feel different! Choosing high-fiber carbohydrates will help with satiety, so you will be less likely to feel hungry right after a high-fiber meal. It’s also a great way to regulate your GI system. Eliminating fiber-rich carbohydrates is a common culprit of constipation! There is an association between increased fiber intake and decreased cholesterol and blood pressure.

Note: increase fiber slowly in the diet to avoid GI upset!

#3- Fats and Proteins

A great way to stabilize blood sugars are to include fats and proteins with meals. This helps so much with satiety!

We used to be scared of fats and thought low-fat diets were the way to go, but what happened was that food manufacturers just started adding sugar into products instead to compensate for the taste. We know better now that including fats is an important part of our diets, especially if you have prediabetes. Some great fat sources are nuts and peanut butter, seeds, fish, olive oil, canola oil, and flax seeds.

Examples of foods higher in proteins include meat, dairy, beans, lentils, nuts, and seeds.

If you are getting extremely hungry throughout the day then it is a good idea to ask yourself if you’re including fats and proteins with your meals and snacks.

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Woo- okay, I got going on this post and it really turned out longer than expected! If you are feeling overwhelmed with sorting through all of the information online then I highly, highly recommend seeking the help of someone who can work with you 1-1. Nutrition advice is so dependent on the individual person!

Have a great day!