Dear Food Speak: Is the diet for pre-diabetes different than the one for diabetes?



There is no one-size-fits-all diet for diabetes or pre-diabetes.

Diabetes is a group of diseases characterized by high blood-sugar levels, resulting from defects in the body's ability to make and/or use insulin. Insulin is a hormone that helps transport blood sugar to the body's cells where it becomes energy. There are two major types of diabetes: type 1 and 2.

Type 2 diabetes, which accounts for most cases, can be prevented or delayed with healthy eating, physical activity and modest weight loss. For many years, healthy eating for diabetes was referred to as a diabetic diet or ADA (American Diabetes Association) diet.

This standardized diet includes pre-determined meal plans with calorie levels translated into food group exchanges. The ADA no longer endorses this outdated diet because it lacks the individualization that's needed for people to successfully improve their nutrition status.

Today, diabetes educators, especially registered dietitians, strive to personalize meal planning for people with, or at risk for, diabetes. After all, people's reaction to foods can vary widely. So while consuming a consistent amount of carbohydrates can improve blood sugar control, everyone has their own individual response to carbohydrates.

Since having diabetes raises a person's risk for heart disease, it's essential to think cardio-protective by getting in adequate fiber and healthy fats, as well as limiting unhealthy fats and sodium. Additional nutritional goals for people with or at risk for diabetes may include monitoring protein for those with kidney problems or calories for those overweight.

In the end, whether a diabetes-friendly meal plan is lower in carbohydrates, lower in fat, styled after the Mediterranean diet or a combination of any of these, the best option is one that is adhered to -- for good!

People with, or at risk, for diabetes should work closely with their health care team to monitor and evaluate the effectiveness of any diet or lifestyle changes. Even with the best dietary adherence, some people may not be able to achieve blood-sugar control without medication.

For you or someone you care about who may be at risk for diabetes, ADA's Diabetes Risk Test is available on ADA's Facebook page, at, or by calling 1-800-DIABETES.

The ADA is promoting this test especially on March 27, American Diabetes Alert Day, as a wake-up call to raise awareness about the disease. We know that nearly 26 million Americans have diabetes -- one quarter of who are not even aware they have it. Another 79 million Americans have pre-diabetes, putting them at a high risk for type 2 diabetes. The test is free and includes preventative tips like encouraging those at risk for diabetes to consult with their doctor since early diagnosis is critical to successful treatment.

Courtney Sansonetti is a medical nutrition therapist and certified diabetes educator for Rehabilitation Associates Inc. Her Food Speak column appears monthly. Email your questions to