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 ‘I am a healthcare assistant at HIYOS Practice and I see patients with pre-diabetes and diabetes and give lifestyle advice including diet.

We have many group sessions to give patients personalised advice and discuss their plans to empower them on living their best life.’

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Understanding Pre-Diabetes and Why Your Diet Matters

If you’ve been told you have pre-diabetes, you’re not alone. Pre-diabetes affects millions of people in the UK and is characterised by blood glucose levels that are higher than normal but not yet high enough to be classified as type 2 diabetes. The good news? Pre-diabetes is often reversible through dietary changes.

Research shows that three out of five cases of type 2 diabetes can be prevented through lifestyle changes. If you’re overweight, losing just 5% of your body weight can reduce your risk by 50%. This means that for someone weighing 90kg, losing just 4.5kg can make a substantial difference. The key message is simple: you have the power to change your health trajectory, and it starts with what’s on your plate.

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A Personal Story 

In my clinic, I see patients from different ethnic backgrounds who need extra help and guidance on changing perceptions about nutrition. For example, some cultures may normally incorporate high amounts of carbohydrates, but this needs to be adjusted for many individuals in order to meet their long-term health requirements. 

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What Should You Eat? The Fundamentals of a Pre-Diabetes Diet

There’s no special “pre-diabetes diet” requiring expensive foods or complicated meal plans. The NHS and Diabetes UK recommend a diet that’s high in fibre from vegetables, fruits, whole grains, and pulses, whilst keeping saturated fat, sugar, and salt to a minimum. These same principles help the whole family eat more healthily.

Think of your diet as a long-term investment in your health rather than a restrictive regime. The principles that help manage pre-diabetes also reduce your risk of heart disease, stroke, and many other conditions.

Understanding Carbohydrates: The Blood Sugar Connection

Carbohydrates have the biggest impact on blood glucose because they break down into sugar during digestion. However, you don’t need to eliminate them entirely. Understanding which carbohydrates to choose makes all the difference.

Many people are surprised to learn how starchy foods affect blood sugar. A small 30g slice of white bread raises blood sugar like nearly four teaspoons of table sugar, whilst a 150g bowl of rice equals ten teaspoons. By contrast, 150g of broccoli has less effect than half a teaspoon of sugar.

The NHS recommends eating regular meals with a maximum of one fist-sized portion of starchy carbohydrates at each meal. When you do include them, choose wholegrain, high-fibre options. Wholemeal bread instead of white, brown rice instead of white rice, and whole wheat pasta are simple swaps that slow digestion and prevent sharp blood sugar spikes.

Low glycaemic index (GI) foods digest more slowly, causing gradual blood sugar rises rather than spikes. Pulses like lentils, chickpeas, and kidney beans are excellent choices, as are most vegetables, whole grains, and berries.

Fruit and Vegetables: Your Five-a-Day and Beyond

Aim for at least five portions of fruit and vegetables daily, but remember that vegetables generally have less impact on blood glucose than fruits. Berries are your best choices for fruit – strawberries, blueberries, raspberries, and blackberries all have lower blood sugar impact. Apples, pears, and plums are also excellent. Bananas, pineapples, and grapes are best enjoyed in moderation.

Fruit juice and smoothies, even unsweetened varieties, cause rapid blood sugar spikes because the fibre has been broken down. Limit these to 150ml per day. Eating whole fruit is always better.

Vegetables should be the star of your plate. Try to “eat a rainbow” with different colours: green options like spinach and broccoli, red and orange choices like peppers and tomatoes, purple vegetables like red cabbage, and white options like cauliflower. Replace half the rice or pasta on your plate with extra vegetables, or try cauliflower rice or courgette noodles as affordable alternatives.

Protein: Building Blocks for Better Health

Including protein at every meal helps you feel fuller for longer with minimal effect on blood glucose. A portion of meat or fish should be about palm-sized.

Eggs make an excellent breakfast choice, whether boiled, poached, or as an omelette with vegetables. Oily fish like salmon, mackerel, and sardines provide protein alongside heart-healthy omega-3 fatty acids. Aim for two portions weekly.

Consider replacing some meat meals with plant-based proteins. Lentils, chickpeas, and beans provide protein plus substantial fibre, beneficial for blood glucose control. Tofu works brilliantly in stir-fries and stews. Nuts and seeds make excellent snacks – keep pre-portioned amounts handy for convenient, healthy snacking.

Dairy and Alternatives: Making Healthier Choices

Dairy products provide calcium and protein but can be high in saturated fat. Semi-skimmed or skimmed milk contains the same nutrients as full-fat versions with fewer calories. Natural or Greek yoghurt makes an excellent breakfast or snack, particularly with berries. Always check labels for added sugar.

Cottage cheese provides a lower-fat alternative to hard cheeses. When using hard cheese, grate rather than slice it – you’ll naturally use less. If you prefer dairy alternatives, choose unsweetened versions fortified with calcium.

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Diet Composition

Some patients may think that because fruits are generally considered healthy, they end up eating large amounts of fruit-based foods in a day. While many fruit taste good and are healthy, they contain a lot of sugar, especially if condensed in juice form. Fruit should be used in moderation, especially if high in sugar such as bananas, mangoes, or pineapple. 

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Foods to Limit or Avoid

Sugar provides “empty calories” with no nutritional value whilst causing rapid blood glucose spikes. Sugary fizzy drinks deliver large amounts of sugar very quickly – switch to sugar-free versions or water. Biscuits, cakes, sweets, and sweetened cereals should become occasional treats.

Don’t be fooled by foods labelled “suitable for diabetics.” These offer no special benefits and are often expensive and high in calories. The NHS doesn’t recommend them.

Highly processed foods typically contain refined carbohydrates, unhealthy fats, salt, and sugar. Minimise ready meals, takeaways, processed meats, fast food, and pre-packaged snacks. When you cook from scratch, you control what goes into your food.

Reducing salt helps lower blood pressure. Remove the salt shaker from the table and use herbs and spices for flavour instead. Choose low-salt stock cubes and sauces, and cook from fresh ingredients when possible.

Practical Portion Control Strategies

Even healthy foods can contribute to weight gain if portions are too large. Use smaller plates to naturally reduce serving sizes. Fill half your plate with vegetables before adding other foods. Drink one or two glasses of water fifteen minutes before meals.

Eat slowly – it takes twenty minutes for your brain to register fullness. Focus solely on your meal without distractions like television or phones. Wait twenty minutes before considering seconds.

Helpful portion references: 30g cheese (matchbox size), palm-sized meat or fish, 2-3 tablespoons of rice or pasta, one slice of bread. Three heaped tablespoons of vegetables or one medium fruit counts as one portion.

Sample Daily Meal Plan

Breakfast: Two-egg omelette with mushrooms, tomatoes, and spinach, plus one slice of wholemeal toast

Mid-morning snack: Small apple with a handful of almonds

Lunch: Large mixed salad with grilled chicken and a small portion of quinoa

Afternoon snack: Carrot and cucumber sticks with hummus

Dinner: Grilled salmon with roasted Mediterranean vegetables and a small portion of brown rice

Evening: Small pot of natural Greek yoghurt with berries

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Sustainable Choices

Some patients when newly diagnosed with pre-diabetes make extreme and unsustainable dietary choices and crash-diets. The most important thing to remember is to start with small, gradual changes which will build on each other over time.

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Your Action Plan: Getting Started

Making all these changes at once feels overwhelming, so take a gradual approach.

Week 1: Switch to wholemeal bread, add an extra vegetable to dinner, replace sugary drinks with water

Week 2: Plan meals for the week, start measuring portions, try one new vegetable or whole grain

Week 3: Batch cook healthy meals, try plant-based proteins twice weekly, eat slowly and mindfully

Week 4: Review what’s working, meal prep lunches, explore new healthy recipes

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The takeaway

The main goal should be to prevent diabetes and take steps to assess your diet, maintaining regular exercise, and aiming for a healthy weight. Some changes may be difficult, but are worthwhile investments into your long-term health.

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The Importance of Weight Loss If You’re Overweight

If you’re carrying extra weight, losing just 5-10% brings significant benefits: improved blood glucose control, reduced blood pressure, better cholesterol levels, and reduced risk of heart disease and type 2 diabetes progression by up to 50%.

The method matters less than finding an approach you can sustain long-term. Choose strategies that fit your lifestyle so you can maintain them over months and years.

Additional Lifestyle Factors

Physical activity is vital alongside diet. The NHS recommends at least 150 minutes of moderate exercise weekly (like brisk walking) or 75 minutes of vigorous exercise (like running). Include muscle-strengthening activities twice weekly.

Walking is free and effective. Try parking further away, taking stairs instead of lifts, or walking during lunch breaks. Find activities you enjoy so exercise becomes something you want to do.

When to Seek Additional Support

Your GP practice is your first contact for regular check-ups and advice. Practice nurses can provide detailed dietary guidance. The NHS Diabetes Prevention Programme offers structured support for people at higher risk. Registered dietitians can create personalised meal plans tailored to your circumstances.

Don’t hesitate to ask for support – it’s a sign of taking your health seriously.

Take Control of Your Health Today

Pre-diabetes is often reversible, and the power to change your health trajectory lies in your hands. Every positive choice today is an investment in your healthier tomorrow. You don’t need perfect choices every time, but consistent improvements add up to significant health benefits.

Start with one or two manageable changes and build on your successes. Focus on whole, unprocessed foods like vegetables, fruits, whole grains, and lean proteins. Carbohydrates affect blood glucose most, so choose high-fibre, low-GI options in moderate portions. Even 5% weight loss can reduce diabetes risk by half.

Portion control matters as much as food choices. There’s no such thing as special “diabetic foods.” Small, sustainable changes are more effective than dramatic overhauls you can’t maintain.

Ready to take the first step? Choose one change from this guide to implement this week. Whether it’s switching to wholemeal bread, adding an extra vegetable to dinner, or drinking more water, every positive step moves you closer to better health.

Contact us today to discuss your pre-diabetes management plan and access the resources you need to succeed. Our practice offers personalised support, regular monitoring, and referrals to specialist services when needed. We can help you access the NHS Diabetes Prevention Programme and connect you with registered dietitians for tailored advice.

Your journey to better health starts now, and we’re with you every step of the way. Book an appointment with our diabetes care team or speak to your GP at your next visit to create your personalised action plan.

Key Resources

Diabetes UK: www.diabetes.org.uk – Comprehensive information, recipes, and peer support

NHS Website: www.nhs.uk/conditions/pre-diabetes – Official NHS guidance

British Nutrition Foundation: www.nutrition.org.uk – Evidence-based nutrition information

HIYOS Practice: Contact us for personalised advice and support services