How to Manage Prediabetes with Food (What Actually Works)

Being told you have pre-diabetes can feel overwhelming, but there’s good news: food is one of the most powerful tools you can use to manage your blood sugar. The key? Small, sustainable changes that work with your body—not against it.

At Vida Family Medicine, I’ve helped hundreds of patients improve their blood sugar without extreme dieting or cutting out the foods they love. In this post, I’ll explain what pre-diabetes really means and how eating balanced meals can support your body in managing blood sugar more effectively.

What is Pre-Diabetes?

Pre-diabetes is a condition where your blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes. The main culprit? Insulin resistance.

Insulin is a hormone released by your pancreas when you eat. Its job is to transport sugar from your bloodstream to the cells that need it—like your brain, muscles, or liver. When you’re insulin resistant, your body still produces insulin, but your cells don’t respond to it properly. This means sugar stays in your bloodstream longer, raising your blood sugar levels.

Over time, this can increase your risk for serious health conditions like heart disease, stroke, and type 2 diabetes. But catching it early—when you're in the pre-diabetic stage—gives us the chance to make meaningful changes that can prevent progression.

Why Balanced Meals Matter

Let’s talk about what happens when we eat.

When we consume carbohydrates, they break down into sugar and enter our bloodstream. This triggers insulin to help move the sugar into our cells. The speed at which sugar enters your bloodstream matters—a lot. If it happens too quickly (like when you eat a high-carb meal with little else), your blood sugar spikes. This is particularly problematic for someone with insulin resistance.

This is where balanced meals come in.

A balanced meal includes:

• Carbohydrates – our primary fuel source

• Protein – helps slow digestion and keeps you full

• Healthy fats – also slow digestion and aid in nutrient absorption

• Fiber – found in fruits, vegetables, whole grains; helps regulate digestion and blood sugar

When all four are present in a meal, digestion slows, and sugar enters the bloodstream more gradually. This helps you avoid the dramatic spikes (and crashes) in blood sugar that can make you feel tired, foggy, anxious, or sluggish.

Should You Cut Carbs? No.

One of the biggest myths about managing pre-diabetes is that you need to cut carbs entirely. That’s simply not true.

Carbohydrates are the body’s preferred energy source—especially for your brain. When you eliminate them, your body starts craving them more intensely. This often leads to the restrict-binge cycle: you restrict carbs, then binge on them later, causing huge blood sugar spikes that are difficult for an insulin-resistant body to handle.

Instead of cutting out carbs, focus on pairing them with protein, fat, and fiber to slow absorption and support more stable blood sugar levels.

What If You’re Still Struggling?

Nutrition is powerful—but it’s not the whole story.

There are many factors that contribute to insulin resistance: genetics, environment, stress, sleep, and more. You could be doing everything “right” with your food and still struggle with blood sugar. That doesn’t mean you’ve failed—it means your body may need additional support, and that’s okay.

In these cases, medications can be helpful, and we’re here to guide you through that decision.

Working with a registered dietitian can also be transformative. If you didn’t receive education about nutrition growing up, or if you’ve experienced food insecurity or difficulty with meal planning, a dietitian can help create realistic strategies that work for your life.

Final Thoughts

Managing pre-diabetes doesn’t require perfection or punishment. It starts with gentle, sustainable habits—like eating regular, balanced meals and avoiding restriction. These changes support both your physical health and your mental well-being, and can often help prevent the need for medication.

If you’re looking for guidance, you’re not alone. We’re here to support you every step of the way.

Need support managing pre-diabetes?
Schedule a visit with Vida Family Medicine to get personalized, compassionate care that puts you at the center of the plan.

You can call the office or schedule a consultation here.