Diet tips for people with high blood sugar (prediabetes)
Prediabetes means your blood sugar is higher than normal, but not yet high enough to be called diabetes. It is very common in Pakistan and India, and most people do not know they have it. The good news: it can often be turned around with food and lifestyle changes.
Quick answer
- Prediabetes is usually found with an HbA1c of 5.7 to 6.4 percent, or a fasting sugar of 100 to 125 mg/dL.
- In large studies, losing 5 to 7 percent of body weight and walking 150 minutes a week cut the risk of getting diabetes by more than half.
- An Indian study found that lifestyle changes alone lowered diabetes risk by about 28 percent in Asian Indians with prediabetes.
- Focus on smaller portions of rice and roti, more daal, vegetables and protein, no sugary drinks, and a walk after meals.
What do the numbers mean?
| Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| HbA1c (average sugar over 3 months) | Below 5.7% | 5.7% to 6.4% | 6.5% or more |
| Fasting blood sugar | Below 100 mg/dL | 100 to 125 mg/dL | 126 mg/dL or more |
| 2 hours after a glucose drink (OGTT) | Below 140 mg/dL | 140 to 199 mg/dL | 200 mg/dL or more |
These are the American Diabetes Association values, which are used by most labs and doctors in Pakistan and India. The WHO uses slightly different values for fasting sugar (110 to 125 mg/dL). Your doctor will decide which applies to you. A diagnosis of diabetes needs a doctor and usually two tests.
Why South Asians should get tested early
South Asian people tend to develop type 2 diabetes at a younger age and at a lower body weight than many other groups. Pakistan has one of the highest rates of diabetes in the world. Get your blood sugar checked if you:
- Are over 30 to 35 years old
- Have a BMI of 23 or more, or a large waist (see BMI for South Asians and belly fat and waist size)
- Have a parent, brother or sister with diabetes
- Had diabetes in pregnancy, or have PCOS
- Have high blood pressure or high cholesterol
The 7 food changes that matter most
1. Drop the sugary drinks
Cold drinks, packet juices, sherbets and sweet lassi send sugar into the blood very fast. Replace them with water, lemon water without sugar, plain lassi or green tea. Cut the sugar in chai step by step. See chai with sugar.
2. Smaller portions of rice, roti and naan
Carbs raise blood sugar the most. You do not need to stop eating them, but the amount matters. Try 1 to 2 small rotis, or one cup of rice, per meal. Choose whole wheat atta, mix in some besan, jau or bajra, and choose brown rice or a smaller portion of basmati.
3. Fill half your plate with vegetables
Sabzi, salad and kachumber are low in carbs and high in fibre, which slows down how fast sugar enters the blood. Good choices: lauki, tori, karela, bhindi, palak, gobhi, beans, cucumber and tomatoes. Potatoes, arvi and sweet potatoes count as carbs, not vegetables.
4. Add protein to every meal
Eggs, daal, chana, dahi, chicken and fish slow down the sugar rise and keep you full. Read how much protein do I need.
5. Eat in a better order
Studies show that eating vegetables and protein first, and the rice or roti last, gives a smaller sugar spike than eating the same food in the opposite order. Start your meal with salad and salan, then have the roti.
6. Choose whole fruit, not juice
Whole fruits have fibre and are fine in normal amounts: 1 to 2 servings a day, like an apple, guava, orange, pear or a slice of papaya. Very sweet fruits like mango, chikoo, grapes and banana are fine in small portions. Avoid fruit juices and fruit chaat with added sugar.
7. Cut down on mithai and fried snacks
Keep mithai, jalebi, halwa and fried snacks for special days. See healthy swaps for fried snacks.
A sample day for better blood sugar
| Meal | What to eat |
|---|---|
| Breakfast | 2-egg omelette with vegetables, 1 small whole wheat or missi roti, chai with no sugar |
| Mid-morning | 1 guava or apple, a few almonds |
| Lunch | Salad first, then 1 bowl daal, 1 bowl sabzi, 1 roti, dahi |
| Evening | Roasted chana and green tea, then a 15 minute walk |
| Dinner | Salad, chicken or fish salan with little oil, sabzi, half cup rice or 1 roti, then a 10 to 15 minute walk |
Our diet plan maker includes a low-carb option and can build a full day at your calorie target.
Beyond food
- Lose a little weight. If you are overweight, losing even 5 to 7 percent of your weight (about 4 to 5 kg for a 70 kg person) makes a big difference.
- Walk after meals. A 10 to 15 minute walk after lunch and dinner helps your muscles use the sugar. See walking for weight loss.
- Aim for 150 minutes of activity a week, plus 2 days of simple strength exercises.
- Sleep 7 to 8 hours. Poor sleep raises blood sugar.
- Stop smoking. Smoking increases the risk of diabetes and its complications.
- Get tested again every year, or as your doctor advises.
Common questions
Can prediabetes be reversed?
In many people, yes. Weight loss, healthier food and regular activity can bring blood sugar back to the normal range. It needs to be kept up, as sugar can rise again if old habits return.
Can I eat rice if I have prediabetes?
Yes, in smaller portions. Have half to one cup with plenty of vegetables and protein, and choose brown rice sometimes.
Is karela or methi good for blood sugar?
Karela and methi seeds are healthy foods, and some small studies show a little effect on blood sugar. They can be part of a healthy diet, but they do not replace weight loss, activity or medicine.
Is jaggery (gur) or honey okay instead of sugar?
No. Gur and honey raise blood sugar in much the same way as white sugar. It is better to slowly reduce sweetness overall.
Sources
- American Diabetes Association Professional Practice Committee. Diagnosis and classification of diabetes: Standards of Care in Diabetes, 2024. Diabetes Care, 2024;47(Suppl 1):S20-S42. doi.org/10.2337/dc24-S002
- Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 2002;346:393-403. doi.org/10.1056/NEJMoa012512
- Ramachandran A, Snehalatha C, Mary S, et al. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia, 2006;49:289-297. doi.org/10.1007/s00125-005-0097-z
- Shukla AP, Iliescu RG, Thomas CE, Aronne LJ. Food order has a significant impact on postprandial glucose and insulin levels. Diabetes Care, 2015;38:e98-e99. doi.org/10.2337/dc15-0429
- World Health Organization. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia, 2006. www.who.int/publications
- International Diabetes Federation. IDF Diabetes Atlas, 10th edition, 2021. diabetesatlas.org
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