A common recommendation for preventing diabetes is “eat healthy and lose weight.” But that advice is extremely broad. What does that even mean? One person’s interpretation of how to eat healthy could be entirely different from the next. And some tactics people might try in order to lose weight can be counterproductive and increase the risk of diabetes instead.
Regular exercise is an equally important part. Not only can it help you maintain your ​ideal body weight, it can have a direct impact on your blood glucose control. This is because insulin resistance is closely linked to increased fat and decreased muscle mass. Muscle cells use insulin far more efficiently than fat, so​ by building muscle and burning fat, you can help lower and better control your blood glucose levels.
The theory behind a ketogenic diet for prediabetes is that when your body is in ketosis, you can be sure that you do not have excess carbohydrates in your diet. Since carbohydrates in your diet are broken down into glucose that goes into your bloodstream, being in ketosis assures that you are not inundating your bloodstream with excessive amounts of glucose due to the foods you eat.

Cut back on added sugar. Read nutrition facts and ingredient lists to help with this. If sugar is one of the first 3 ingredients- the product may have too much sugar. Use fresh or frozen (without added sugar) fruit to flavor or sweetened things instead of buying things already flavored with less healthy sugars or flavorings. For example: instead of buying strawberry yogurt. Buy plain yogurt and add fresh berries. You will not only be cutting back on added sugars, but you will be adding fiber and volume which can help fill you up and control your blood sugar.
The majority of our dialysis patients lose kidney function completely – in other words they no longer urinate. So imagine what happens when they eat salty foods (not salt) – they get thirsty and drink – Then the dialysis treatment must try (only try) to remove the fluid they accumulate. It is true that high blood sugar also causes thirst – which I must keep in mind. I have many patients who rely on their PCP for advice with their insulin. They take the same amount of insulin regardless of their blood sugar – and the A1C remains elevated – I can’t change how they administer the insulin – but only recommend asking for a referral to an endocrinologist.
Here’s another big plus to our Shopping List for Diabetics. In addition to icons that are diabetes-focused like “sugar free,” this list uses icons like “low cholesterol” and “low sodium” because many people with diabetes are working to control not just diabetes but related conditions like high cholesterol levels and high blood pressure.  This list can help you identify those foods most advantageous in helping you reach your personal health goals.
Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.
Although sugar does not cause the blood sugar to rise any higher than other carbohydrates, it should be eaten along with other healthy foods. If you choose to drink a 12-ounce can of a sugar-sweetened soft drink, that would use up about 45 grams of carba, and you wouldn't have gotten any nutrition (protein, vitamins, or minerals). What a waste of calories!
The attempts to adhere to the conventional food measurements in order to comply with prescriptions of the so-called ‘diabetic diet’ usually result in unnecessary restrictions, overindulgence, or monotonous consumption of certain food items, e.g., unripe plantain/beans. This is a consequence of illiteracy, poverty, and cultural misconceptions about the role of diet in the management of diabetes. This is usually the most problematic aspect of diabetes care. The usually recommended daily energy intake for the non-obese diabetic patient is between 1500 and 2500 calories per day, the average allowance being 2000 k calories per day. The recommendation for the overweight diabetic patient is between 800 and 1500 k calories per day, while the underweight (including growing children and adolescents) should be allowed at least 2500 k calories/day.[16,17]
Diabetes can cause serious health problems, such as heart disease, stroke, and eye and foot problems. Prediabetes also can cause health problems. The good news is that type 2 diabetes can be delayed or even prevented. The longer you have diabetes, the more likely you are to develop health problems, so delaying diabetes by even a few years will benefit your health. You can help prevent or delay type 2 diabetes by losing a modest amount of weight by following a reduced-calorie eating plan and being physically active most days of the week. Ask your doctor if you should take the diabetes drug metformin to help prevent or delay type 2 diabetes.1
Regular exercise is an equally important part. Not only can it help you maintain your ​ideal body weight, it can have a direct impact on your blood glucose control. This is because insulin resistance is closely linked to increased fat and decreased muscle mass. Muscle cells use insulin far more efficiently than fat, so​ by building muscle and burning fat, you can help lower and better control your blood glucose levels.
In recent times in Saudi Arabia, food choices, size of portions and sedentary lifestyle have increased dramatically that resulted in high risk of obesity. Unfortunately, many Saudis are becoming more obese because of the convenience of fast foods, and this adds to the scary diabetes statistics.45 On the other hand, Saudis drink too many high-sugar drinks. In addition, Backman46 reported dietary knowledge to be a significant factor that influences dietary behaviors. In another study conducted by Savoca and Miller47 stated that patients’ food selection and dietary behaviors may be influenced by the strong knowledge about diabetic diet recommendations. Significant positive relationship was observed between knowledge regarding diabetic diet and the amount of calorie needs (r = 0.27, p < 0.05).48 The study concluded that knowledge regarding diabetic diet is essential and is needed to achieve better dietary behaviors. Results of study conducted in Saudi Arabia25 reported that more than half of the diabetic patients denied modifying their dietary pattern, reduction in weight and perform exercise.
As a bonus, stress relief may help you sleep better, which is important because studies show that not getting enough sleep can worsen type 2 diabetes. Sleeping less than six hours a night has also been found to contribute to impaired glucose tolerance, a condition that often precedes type 2 diabetes. In fact, a review published in 2015 in Diabetes Care analyzed 10 studies that involved more than 18,000 participants combined and found the lowest risk of type 2 diabetes in the group of participants that slept seven to eight hours per day. That’s the minimum recommended amount of sleep for most adults, according to the National Sleep Foundation.
The theory behind a ketogenic diet for prediabetes is that when your body is in ketosis, you can be sure that you do not have excess carbohydrates in your diet. Since carbohydrates in your diet are broken down into glucose that goes into your bloodstream, being in ketosis assures that you are not inundating your bloodstream with excessive amounts of glucose due to the foods you eat.
Activity – so important to keep busy – mentally as well as physically. Find an activity that you really WANT to do. I like to garden and now that I am tracking my activity, I find it gives me an excuse to go out and putter. Since I enjoy it and accomplish something good, it satisfies me. I have discovered that with some practice I can read while walking on the treadmill. If the book engrosses my mind, I will walk much longer than if I am just watching the timer.
Sit Less, Move More. Aim for some daily physical activity. Exercise is important to help prevent type 2 diabetes and has so many other benefits. It can help you keep lost weight off, and improve your heart health, and if you’re insulin resistant, it can help increase your body's response to insulin (exercise so you will have better blood glucose control. Plus, exercise promotes better sleep, and can even reduce the symptoms of depression, helping put you in a better mood. 
For most people with type 2 diabetes, the general guideline for moderate alcohol consumption applies. Research shows that one drink per day for women and two a day for men reduces cardiovascular risk and doesn't have a negative impact on diabetes. However, alcohol can lower blood sugar, and people with type 2 diabetes who are prone to hypoglycemia (such as those using insulin) should be aware of delayed hypoglycemia.
Rather than following a specific diabetes prevention diet, the greatest impact in prevention has occurred with weight reduction. Consequently, there is no single recommended diabetes prevention diet. The American Diabetes Association recommends goals of modest weight loss (5%-10% of body weight) and moderate exercise as primary interventions for preventing type 2 diabetes.
Another area that I focus on is portion sizes. With the increase in portion sizes in our society, it can be hard to manage food intake. I recommend listening to your body and identifying your needs by being aware of your hunger and fullness. If you are feeling hungry, it is an indicator to eat, and once you start to feel satisfied, it is an indicator to stop eating, knowing that you can eat again later. This small change where someone begins to leave food on their plate or stops eating when feeling satisfied and not overly full can make a big difference in overall health.
A study was conducted which included the diabetic patients with differing degrees of glycemic control. There were no differences in the mean daily plasma glucose levels or diurnal glucose profiles. As with carbohydrates, the association between dietary fats and T2DM was also inconsistent.34 Many of prospective studies have found relations between fat intake and subsequent risk of developing T2DM. In a diabetes study, conducted at San Louis Valley, a more than thousand subjects without a prior diagnosis of diabetes were prospectively investigated for 4 years. In that study, the researchers found an association between fat intake, T2DM and impaired glucose tolerance.35,36 Another study observed the relationship of the various diet components among two groups of women, including fat, fiber plus sucrose, and the risk of T2DM. After adjustment, no associations were found between intakes of fat, sucrose, carbohydrate or fiber and risk of diabetes in both groups.37
Eat healthy foods. Plan meals that limit (not eliminate) foods that contain carbohydrates, which raise your blood sugar. Carbohydrates include starches, fruits, milk, yogurt, starchy vegetables (corn, peas, potatoes) and sweets. “Substitute more non-starchy vegetables into your meals to stay satisfied for fewer carbohydrates and calories,” Compston says.

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Even if you have not been told that you have prediabetes, you could be worried about it, since 90% of the people with prediabetes are unaware that they have it. You are at higher risk if you are over 45 years old, do not get much exercise, have a family history of diabetes, or are African American, Native American, Hispanic/Latino, or Pacific Islander.
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