Take Control of Prediabetes with an Insulin Resistance Diet

Insulin resistant diet

If you’ve been diagnosed with prediabetes, you may feel overwhelmed. Getting a new medical diagnosis is often confusing and scary. You’re probably experiencing a range of emotions as you process this new information. Read on to learn all about prediabetes: what causes it, how to work with your doctor to manage it and how to reverse it.  

What is prediabetes?

Prediabetes diagnosis occurs when your blood sugar levels are higher than normal but not high enough to be considered type 2 diabetes. There are about 96 million adults in the U.S. with prediabetes, nearly 40% of the adult population.

Prediabetes is a serious health problem and it can progress to type 2 diabetes if not addressed right away. But there is also good news associated with this condition: it can be reversed. In this prediabetes guide, you’ll learn what this diagnosis means, how to talk to your doctor about it and what steps you can take to reverse it.  

What are the warning signs of prediabetes?

Most people with prediabetes show no signs or symptoms, which is why it’s important to get regular diabetes screenings from your doctor if you’re at risk. Symptoms tend to show when you progress from prediabetes to type 2 diabetes, which has symptoms like:

  • Frequent urination
  • Fatigue 
  • Unquenchable thirst

Some of these symptoms may show up in people with prediabetes.  

Some people with prediabetes develop a skin condition called acanthosis nigricans, which causes dark patches of skin with a thick, velvety texture. These patches sometimes itch or smell bad. Contact your doctor right away if you suspect you have this condition. They can recommend steps to take for acanthosis nigricans self-care.

Understanding blood sugar  

When you eat carbohydrate-containing foods (like potatoes or rice), your body breaks down the carbohydrates into sugar, which enters the blood. This is called blood sugar, or blood glucose, and it is your body’s main source of energy.


Ideal blood sugar levels range from 80 to 130 mg/dL before a meal; after a meal, the target is below 180 mg/dL. When your blood sugar levels are too high, it’s called hyperglycemia. A blood sugar level between 100 and 125 after fasting for eight hours usually means you have prediabetes.

Early signs and symptoms of hyperglycemia include:

  • Increased thirst and/or hunger
  • Frequent urination 
  • Blurred vision. 

If left untreated, you can develop long-term symptoms like:

  • Weight loss
  • Yeast infections
  • Blurred vision 
  • Wounds that take a long time to heal

What is insulin resistance?

Insulin is a vital hormone that regulates your blood sugar. It is stored in the pancreas and is released when blood sugar enters your bloodstream. Insulin helps your body both convert blood sugar into energy and store it in the liver for later use. Think of insulin as the key that unlocks the cells and escorts glucose in.

Insulin resistance happens when you have consistently high blood sugar levels, causing your pancreas to release more and more insulin. Over time, your cells stop responding normally to insulin and become insulin resistant. To continue the metaphor, normal amounts of insulin no longer unlock the doors to your cells.  

What is a healthy A1C level?

An A1C test (also known as an HbA1c), is a blood test that measures the average level of blood sugar in your body over the last few months. It is an important tool in detecting diabetes and prediabetes. A normal A1C level is less than 5.7%, a level between 5.7% and 6.4% indicates prediabetes and levels above 6.5% indicate diabetes.  

The relationship between prediabetes & Type 2 diabetes

People with prediabetes have a high risk of developing type 2 diabetes in the next five years. Type 2 diabetes is a serious, but manageable illness and is associated with severe complications, including high blood pressure, heart disease, stroke, blindness and amputations.

Is prediabetes always caused by diet?

The exact cause of prediabetes is unclear, but several risk factors have been identified. These factors can also increase your risk of developing type 2 diabetes. Below is a list of the most common prediabetes risk factors:

  • Being overweight or obese
  • A waist size over 35 inches for women and over 40 inches for men
  • An immediate family member with type 2 diabetes
  • Not getting enough exercise
  • History of diabetes during pregnancy (gestational diabetes)
  • Being of African, Hispanic or Latino, Indigenous or Asian descent  

Lifestyle factors

Certain lifestyle factors are known to contribute to the risk of developing prediabetes. The major ones are lack of physical activity, being overweight or obese and eating a diet high in carbohydrates or sugar. If one of these three factors describes you, it can greatly benefit your health if you make changes.

Lifestyle changes  

For many of us, our body weight is a sensitive subject and may be a source of embarrassment. It can be hard to talk about if you are overweight or obese, but it is especially important to address it if you have prediabetes. You may take comfort in knowing that 69% of Americans are overweight or obese. In other words, most people today struggle with their weight.  

To reverse your prediabetes and prevent type 2 diabetes, you will likely need to make some major lifestyle changes like losing weight, adopting a healthy diet and exercising regularly. These changes are not easy and will not be accomplished overnight. In order to reverse prediabetes and prevent it from coming back, you will need to change your lifestyle in the long term.

Insulin-resistance diet

Insulin resistance is a hallmark of prediabetes and type 2 diabetes and develops when you’ve had consistently high blood sugar levels over time. For many people with prediabetes, the main cause of high blood sugar is a diet that contains a high amount of carbohydrates. On the flip side, a diet low in carbohydrates can lower your blood sugar and increase your overall health.  

Many doctors and experts recommend adopting what’s known as an insulin resistance diet. An insulin-resistance diet is a set of guidelines for choosing food that won’t raise your blood sugar. You do not have to stick to a strict meal plan, count calories or subscribe to a special service to eat an insulin-resistance diet.  

Foods to eat:

  • Vegetables: broccoli, brussels sprouts, spinach
  • Lean protein: chicken, turkey
  • Fruit: berries, apples, grapes
  • Fiber-rich foods fruits, vegetables and many whole grains
  • Foods to eat less of or avoid:
  • Processed food: cookies,  
  • Pastries
  • Candy
  • Red meat
  • Saturated and trans fats
  • High fat dairy
  • Soda and juice

How to talk to your doctor about prediabetes  

Prediabetes and type 2 diabetes are stigmatized by society, as some people erroneously think that these conditions are always caused by a poor diet and obesity and that the diseases are the patient’s “fault.”  

Because doctors hold a position of authority over us, it can be intimidating to bring up sensitive topics like weight with them.

Taking time to prepare before your appointment can help build your confidence and ensure you cover everything you need to. Here are some tips:

Be completely honest with your doctor

Sometimes, it’s tempting to be less than truthful with our doctors when it comes to fraught topics like diet, exercise and weight. It’s understandable to feel embarrassed or even guilty if you struggle with things like obesity, binge eating or addiction. Smoking, obesity and a poor diet are all risk factors for diabetes, so it is important to tell your doctor if you struggle with any of them (and you won’t be their first patient to struggle with these!). You can also communicate to your doctor that you are anxious or embarrassed about these topics and that you could use reassurance.  

Make a list of your questions and concerns.

It’s easy to forget important questions at doctor visits, especially if your appointment is short or rushed. A simple solution is to write out your questions and concerns ahead of time. You could even keep a list on your phone or a pocket notebook and add to it whenever you think of something else you want to bring up. If you are planning to start or have already started major lifestyle changes, make sure to check with your doctor that they are safe and appropriate for you. Good general questions to ask include:

  • What steps do you recommend for managing my prediabetes?  
  • How often do I need to get blood tests or other tests done?
  • Do you have patients who successfully reversed their prediabetes?
  • Is there a prediabetes medication I should try?
  • Are there prediabetes books, podcasts or literature I should check out?
  • How much should I weigh?
  • What is your experience with insulin-resistance diets?

Bring a spouse or trusted friend.

Not everyone knows that you are allowed to bring someone with you when you go to the doctor. Having a confidante by your side can make you feel more secure and help you remember what you want to talk about with your doctor. It also shows your doctor that you have a strong support system, and research has shown that strong social and emotional support are associated with better health.

Take notes.

Doctor’s appointments can be overwhelming. In order to remember your doctor’s recommendations, it can be helpful to take notes during your appointment. If you bring someone with you, you can ask them ahead of time to take notes for you. You should also get a visit summary from your doctor after each appointment. If you are not sure how to access this summary, ask your doctor or a member of your doctor’s staff.

FAQ about Prediabetes

Can prediabetes be reversed?

Yes, it is possible to reverse prediabetes. Research from the CDC found that losing a modest amount of weight — approximately 5-7% of your body weight — cuts your type 2 diabetes risk by more than 50%. For someone weighing 180 pounds, 5-7% is just 9 to 12 pounds.

How long does it take to reverse prediabetes?

The amount of time it takes to reverse prediabetes is different for everyone, and could take weeks, months or years. Much of this depends on what modifications to your lifestyle and body weight you’re able to accomplish.

Will insurance cover Ozempic for prediabetes?

Many insurers cover Ozempic for diabetes treatment, and some also cover it for prediabetes. Contact your insurance provider to find out if your plan covers it.

Does drinking water lower blood sugar?

Several studies have found that staying hydrated can help lower blood sugar. Staying well-hydrated helps with kidney function, which contributes to flushing the sugar out of your system. However, drinking more water will not cancel out the effects of a poor diet or sedentary lifestyle and will not reverse prediabetes by itself.

Does stevia raise blood sugar?

Pure stevia has no effect on your blood sugar; it does not raise or lower it. However, stevia sometimes contains additives that can raise your blood sugar, like maltodextrin and dextrose. Read the list of ingredients on foods that contain stevia to find out. Other additives that do raise blood glucose levels may also be masquerading under different names on food labels.  

Does diabetes cause weight gain?

Type 2 diabetes and insulin resistance can cause weight gain. This can be avoided by keeping your blood sugar levels in check and by maintaining a healthy lifestyle that includes eating a healthy diet and exercising regularly.  

More than one in three U.S. adults have prediabetes. If you have been diagnosed with this condition, you are not alone, and you have lots of options. By working closely with your primary care doctor to make lifestyle changes, you may be able to reverse prediabetes and lead a healthier life.  

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Prediabetes Linked to Cognitive Decline / Janet Tiberian, MA, MPH, CHES / April 17, 2021
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