Prediabetes and Carb Cravings: Why They Happen and How to Manage Them

We’ve all been told we should “cut carbs”—especially if we have pre-diabetes or are worried about our metabolic health. But what if, no matter how hard you try, your body is constantly craving them?

You may think you’re lacking willpower. But the truth is: you’re not failing—your body is communicating with you.

I’m Dr. Rebecca Berens, a weight-neutral family physician and founder of Vida Family Medicine. In this post, I’ll explain why carb cravings are often misunderstood, what they reveal about your body’s needs, and how to work with your body instead of against it.

Your Body Needs Glucose—That’s Normal

Let’s start with the basics: glucose (sugar) is your brain and body’s preferred source of energy. You can’t live without it!

If there isn’t enough glucose available in your bloodstream, your body responds by increasing hunger—especially for carbohydrates. It’s not a flaw. It’s a survival mechanism.

Unfortunately, many patients with pre-diabetes have been told to cut carbs or calories drastically to manage their condition. But when you’re not eating enough—whether that’s total food intake or carbohydrates specifically—your body goes into hunger mode. It sends signals in the form of cravings. And ignoring those signals can actually lead to worse outcomes, not better ones.

Yes, You Can Be Malnourished and Have Pre-Diabetes

This surprises many people. But the truth is, you can be pre-diabetic and undernourished.

I’ve seen it over and over in my practice. Patients assume they’re overeating when, in reality, they’re not eating consistently or are restricting too much. Our bodies need fuel every few hours—typically every 3 to 4 hours—just to function properly.

So if you’re constantly craving carbs or feeling fatigued, the first step isn’t cutting more out. It’s asking: Am I eating enough? Am I eating regularly?

When It’s Not Just About Hunger—The Role of Insulin Resistance

If you're eating enough and still struggling with intense carb cravings, insulin resistance might be the reason.

Insulin resistance is a condition where your body doesn’t respond well to insulin—the hormone that helps glucose enter your cells. So your pancreas has to pump out more insulin to get the job done.

Here’s the catch: insulin is a storage hormone. It encourages your body to store excess glucose as fat. Later, when your body needs energy, it's harder to access that stored glucose—so you feel hungry again. It’s a frustrating cycle, and it can make cravings feel constant.

This cycle can feed itself. The more insulin your body has to produce, the more fat it stores, and the more insulin-resistant you become.

Balanced Meals Make a Big Difference

One of the best ways to manage these cravings is through balanced meals regularly throughout the day including breakfast within an hour of waking, and lunch, dinner, and snacks as needed every 3hrs or so while awake.

That means meals that include:

• Carbohydrates

• Protein

• Fat

• Fiber
  
  

When you eat carbs with protein and fiber, they’re absorbed more slowly. That means your blood sugar rises more gently—and your body doesn’t have to release as much insulin. Less insulin means less glucose is stored in an inaccessible way, and more glucose is available for longer for your body to use as fuel.

Many patients find that when they adjust the nutrient balance and timing of their meals, their carb cravings decrease and they have more energy throughout the day.

And Sometimes, You Still Need More Support

For some people, balanced meals and consistent eating habits aren’t enough. Even after doing everything “right,” they still struggle with cravings and energy crashes.

That’s when it may be time to talk about medication.

Medications for insulin resistance can help reduce inappropriate cravings, stabilize blood sugar, and reduce risk of progression to type 2 diabetes—but they’re never the first step. First, we focus on nourishment. Consistent, adequate, balanced nutrition is the foundation. Skipping that step in an effort to “be good” or eat less can actually make your symptoms worse.

Final Thoughts

You’re not failing if you crave carbs. Your body is doing its job—telling you that it needs more fuel, or that something deeper (like insulin resistance) is going on.

At Vida Family Medicine, we take a compassionate, science-based approach to care. We work with you—not against your body’s natural signals—to create a plan that actually supports your health.

If you’ve been stuck in the restrict-binge-repeat cycle, let’s break it. You deserve care that honors your body’s needs, without guilt or shame.

Need support with your metabolic health?
Schedule a visit with Vida Family Medicine to get personalized, weight-neutral care.
📞 Call the office or schedule online here.

Want to Learn More? Watch the Full Video
In this video, I explain the science behind carb cravings and how to address them with more clarity and compassion.

👉 Watch the full video here: Prediabetes and Carb Cravings: Why They Happen and How to Cope
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