Role Of Nutrition In Reversing Prediabetes

Introduction

Prediabetes is a condition that affects millions of people worldwide, yet many may not even recognize the warning signs their body is giving them. It occurs when insulin levels are very high, but blood sugar levels remain normal—because the body is producing excessive amounts of insulin to keep blood sugar under control. Over time, this balance may fail, and insulin may no longer be able to maintain normal blood sugar levels.

Prediabetes doesn’t develop overnight; it takes around 10 to 15 years to progress. This gradual onset is largely the result of poor dietary choices, an unhealthy lifestyle, excessive sugar intake, and frequent eating—all of which contribute to a condition known as hyperinsulinemia.

Why does the body start making more insulin?

Insulin is an important hormone that not only regulates blood sugar but also plays a vital role in protein and fat metabolism. However, due to an unhealthy lifestyle, the body’s cells can become resistant to insulin. This resistance forces the pancreas to produce increasing amounts of insulin to maintain normal blood sugar levels. Despite this compensatory response, the cells’ glucose uptake remains impaired, leading to blood sugar levels that are higher than normal—but not yet high enough to be classified as diabetes.

Key risk factors for Prediabetes

• Overweight / Obesity especially around the belly

• Physically inactive/ Sedentary lifestyle

• Erratic sleep cycle/ Sleep deprivation

• Family history of Diabetes

• Gestational Diabetes

• PCOS

Quiet Symptoms of Prediabetes

• Acanthosis Nigricans (Dark & velvety dark skin patches around the neck, groin & armpits)

• Unexplained fatigue

Dietary Intervention in Prediabetes

The American Diabetes Association (ADA) recommends that individualized Medical Nutrition Therapy (MNT), designed and implemented by qualified dietitians, can effectively help achieve treatment goals in individuals with prediabetes. There is strong evidence supporting the efficacy of dietary interventions as a key component of comprehensive health care, complementing medical management in prediabetes. It is essential for all individuals with prediabetes to understand and embrace the benefits of evidence-based dietary interventions.

Nutrition plays a vital role in improving or maintaining glycemic (blood sugar) targets, achieving weight management goals, and reducing cardiovascular risk factors such as hypertension and high cholesterol. Since diet and nutrition are key factors in preventing prediabetes from progressing to diabetes, it is important to understand their effectiveness. The primary goal of a prediabetes diet is to regulate blood sugar levels and enhance insulin sensitivity—both of which largely depend on achieving and maintaining a healthy body weight.

Dietary choices directly influence carbohydrate intake and its impact on blood sugar levels. A well-balanced meal plate, mindful portion sizes, and the inclusion of complex carbohydrates, moderate protein, and adequate fiber are essential. Complex carbohydrates help prevent rapid blood sugar spikes and provide sustained energy.

A hallmark of prediabetes is insulin resistance, a condition where cells do not respond effectively to insulin. Research shows that even a modest weight loss of about 5% can significantly improve insulin sensitivity.

Key dietary focuses include:

• Replacing refined grains with whole grains

• Filling 40–50% of the meal plate with non-starchy vegetables

• Including lean protein sources such as eggs, fish, legumes, nuts, seeds, and dairy instead of processed meats

• Choosing healthy fats from nuts, seeds, olive oil, avocado, and fatty fish while avoiding saturated and trans fats from baked or fried foods

• Avoiding sugary foods and beverages such as candies, cookies, cakes, sodas, and energy drinks

• Practicing portion control using the plate method—half the plate with non-starchy vegetables, one-fourth with lean protein, and one-fourth with healthy carbohydrates

• Avoiding overeating, especially large portions of carbohydrate-rich foods

In summary, nutritional intervention is the cornerstone of prediabetes management. It helps stabilize blood sugar, improve insulin sensitivity, and significantly lower the risk of progression to type 2 diabetes. Consulting a qualified dietitian is highly recommended to develop an individualized, effective, and sustainable meal plan.

References:

1. Evert A.B, Dennison M. et.al. Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report. Diabetes Care. 2019. 42(5):731–754. https://pmc.ncbi.nlm.nih.gov/articles/PMC7011201/

2. Yau J.W, Thor S.M, & Ramadas A. Nutritional Strategies in Prediabetes: A Scoping Review of Recent Evidence. Nutrients 2020, 12(10), 2990. https://www.mdpi.com/2072-6643/12/10/2990#sec1-nutrients-12-02990