Health and Wellness

Stop and Treat Your Prediabetes Using the Ketogenic Diet


by Tiffany Joy Yamut, RN

Do you or someone you love have prediabetes? Did you know that one in three US adults and most of them are unaware of it? It is useful to view prediabetes as a metabolic imbalance that develops over years into the more significant disease state diabetes. If you have a high-risk for prediabetes and diabetes, it is recommended that you check in with your physician and receive a screening test. Fortunately, these conditions are completely preventable or treatable with optimizing dietary intake. This article, written by nurse and health writer Tiffany Joy Yamut, concisely addresses how the ketogenic diet can help prevent and treat prediabetes (and diabetes!).

Christopher M. Cirino, DO MPH

Founder Your Health Forum


Stop and Treat Your Prediabetes Using the Ketogenic Diet

Can you imagine yourself being on a diet without bread, flour, pasta, tropical fruits, fruit juices, potatoes — basically anything that’s considered carbohydrate-rich? Most people would probably answer NO.

Carbs are abundant in nature. Grocery shelves are stocked with carbs. In fact, the Dietary Guidelines for Americans recommends that 45% to 65% of our calories should come from carbs. For someone consuming 2,000 calories per day, the recommendations translates to 225 to 325 grams of carbs. Although these are recommendations, it is likely that a lower amount would be more beneficial.

Instead of labeling this macronutrient as “good” or “evil”, the follow-up questions to ask would be, “Is the recommended carb intake even accurate and does it benefit everyone? Are there certain health conditions that may benefit more from fewer carbs?”

In this article, we’re going to touch on prediabetes and the ketogenic or “keto” diet. Is this low-carb diet just another fad or is it proven to help manage blood sugar levels?

Personal note: As someone with a family history of diabetes (from my great grandmother to father), who’s been on a keto diet for almost 2 years now, and healed from polycystic ovary syndrome (PCOS) — I feel this is an important topic to discuss. I hope that you’ll get value from this article, whether you have prediabetes yourself or have a loved one who does. Know that you can take control of your health and inspire others to do it!


What Is Prediabetes?

Prediabetes is when a person has high blood glucose (sugar) levels. However, these glucose levels are not yet high enough to be diagnosed by your doctor as Type 2 Diabetes.

Just because this condition has the word “pre” doesn’t mean you shouldn’t take it seriously. If left unmanaged, it develops into Type 2 Diabetes. Furthermore, you become at risk of developing heart disease and stroke, according to the CDC.


Signs and Symptoms of Prediabetes

Do you suspect that you have Prediabetes? Watch out for the following:

  • Increased thirst
  • You’re peeing more often
  • Blurred vision
  • Tiredness and fatigue

Note that these signs and symptoms also appear in those with Diabetes, both Type 1 and Type 2. A definitive way to tell that you have Prediabetes is to see a doctor who can order you some blood glucose tests. See the section “How Prediabetes Is Diagnosed” below.

Risk Factors for Prediabetes

Individuals are more likely to develop Prediabetes if they are or have:

  • Overweight – You have a body mass index (BMI) of 25 or higher and excess fat in your abdominal area.
  • Polycystic ovary syndrome (PCOS) – Most women with PCOS are insulin-resistant. Insulin resistance is a risk factor for Prediabetes.
  • Aged 45 years or older – Older adults are more at risk, including those with existing medical conditions or comorbidities.
  • Family history of Diabetes – This is a strong risk factor due to the transmission of genetic information from parents to offspring. A study involving 8,000 participants showed that a family history of diabetes increases your risk of Prediabetes by 26%.
  • Less active – Sitting for long hours and not exercising makes you prone to Prediabetes. This is especially true if you eat high-calorie junk foods at the same time.
  • Diet that’s high in added sugar and carbs – The amount of carbohydrates you consume affects your blood sugar levels. Too many carbs, no matter the type, can lead to weight gain and elevated blood sugar in people who are more sensitive to them.
Prediabetes Risk Factors

6 Risk Factors for Prediabetes


How Prediabetes Is Diagnosed

All it takes is a visit to the doctor to get an accurate diagnosis. Standard Prediabetes tests include:

  • A1C Test – This test, otherwise known as Hemoglobin A1C,  measures your average blood glucose for the past 2-3 months. A result of 5.7% to 6.4% is indicative of Prediabetes. Greater than 6.4 is consistent with Diabetes.
  • Fasting Plasma Glucose (FPG) – This checks your blood sugar levels after you’ve fasted (not eaten anything) for 8 hours. Prediabetes has a reading of 100 mg/dl to 125 mg/dl.
  • Glucose Tolerance Test – This test measures how well your body can handle glucose. You’ll be asked to drink a glucose solution and your blood glucose will be measured after 2 hours. A reading of 140 to 199 mg/dL is indicative of Prediabetes.

Is There a Right Diet for Prediabetes?

While we cannot control our age and family history, we can definitely make good lifestyle choices that can help avoid and reverse Prediabetes. Speaking of diet, you need one that controls your blood sugar, keeping it within low normal levels.

What Is The Keto Diet?

The ketogenic or “keto” diet is a low-carbohydrate, moderate-protein, and high-fat diet. This diet puts your body in a normal metabolic state called ketosis.

This state is characterized by an increase in ketones — these are chemicals that your liver makes when your body doesn’t have enough sugar, so it taps into its stored fat.

(Important: Ketosis is different from ketoacidosis. Ketosis is normal while ketoacidosis is a dangerous condition seen primarily in Type I diabetics)

Interesting fact: Did you know that the keto diet was used in the 1920s as a treatment for epilepsy? The presence of ketone bodies and reduction in blood glucose levels had anticonvulsant effects on epileptic patients, according to a study.

Understanding low-carb

This part is extremely important for those with Prediabetes.

The keto diet, being low-carb in nature, limits your carb intake to only 20-50 grams of total carbs per daily. This reduction depletes your glycogen stores, forcing your body to tap into its fat. For those who want to lose excess body fat and overcome obesity, keto can be an excellent tool.

Since carbs have a direct impact on your blood glucose, eating fewer carbs will help you manage your glucose levels better. Fewer carbs = lower blood glucose.  

(How you should avoid hypoglycemia or abnormally low blood glucose is a topic for another day.)

Understanding moderate-protein

Protein, when consumed in excess, gets converted into glucose through a process called gluconeogenesis. Too much protein slows down your ability to enter ketosis.

What does a moderate protein intake look like on keto?

According to Virta Health, a company with a vision to “reverse” Type 2 Diabetes, a person should consume 1.2 g to 2.0 g of protein per kg body weight. This range accounts for sickness, aging, calorie restriction, and the minority that need more protein.

Note that this is higher than the standard recommendation which is 0.8 g per kg.

Understanding high-fat

A lot of people are concerned about “the high fat” part of the keto diet. Why do you need to eat more fat on keto?

You need fat to compensate for the decrease in dietary carbs. Based on a study, fats affect satiety and appear to regulate appetite. Also, dietary fat has a minimal effect on blood glucose and insulin levels.

It’s important to realize that not all fats are created alike!

There are beneficial fats that promote heart health, such as monounsaturated fats. On the other hand, some fats increase your risk of heart disease and weight gain, such as trans fats. For long-term health, make sure that you consume only healthy fats.

What Foods Should You Eat and Avoid On a Keto Diet?

Image credit: Pexels/Jenna Hamra

To induce ketosis, here are some healthy foods to add to your low-carb grocery list:

  • Beef
  • Pork
  • Chicken
  • Turkey
  • Lamb
  • Seafood
  • Eggs
  • Avocados
  • Blueberries
  • Broccoli
  • Cauliflower
  • Leafy greens
  • Nuts and seeds
  • Extra virgin olive oil
  • Butter
  • Ghee

For your baking needs, you’ll need to use low-carb flours such as almond flour and coconut flour. Also, use keto-friendly sweeteners like stevia and monk fruit. These sweeteners do not raise your blood sugar levels unlike white sugar, brown sugar, and honey. To get a complete list of keto-friendly foods, check out this comprehensive grocery list guide.

Here’s a list of foods to avoid:

  • Rice
  • White and wheat bread
  • Oatmeal
  • Corn
  • Potatoes
  • Most tropical fruits
  • Traditional chips and crackers
  • Baked goods
  • Fruit juices


More Benefits of the Keto Diet for Prediabetes

You already know that a low-carb ketogenic diet controls blood glucose which is high in those with Prediabetes. Aside from blood sugar management, the diet helps with the following:

1. Weight loss

Reducing your carb intake helps you lose weight.

At first, you lose water weight which explains why you see the number on the scale decrease during the first week of eating a keto diet. As your body burns through its stored fat and produces ketones, only then will you lose pure fat.

2. Clean eating

A well-formulated keto diet encourages the consumption of whole foods. Eating mostly whole foods ensures that you get the essential vitamins and minerals that your body needs to function optimally.

On the other hand, processed foods contain hidden sugars (like high-fructose corn syrup) and unhealthy fats.

3. Higher energy levels

You’re expected to experience a temporary dip in performance during the first few weeks of following a keto diet. This is expected because as your body tries to adjust to its new fuel source – ketones.

But as you become keto-adapted, you experience sustained energy. Say goodbye to the sluggishness and fatigue that come with blood sugar spikes!

4. Reversal of PCOS

The job of insulin is to lower your blood glucose. But as your pancreas produces more insulin, your cells become resistant to them. This increases your risk of Type 2 Diabetes. A reduced carb intake lowers the amount of insulin circulating in your body.

Final Thoughts

Low-carbohydrate diets have gained massive attention due to their ability to induce weight loss. The ketogenic diet, in particular, is especially beneficial for blood glucose control and overall health. If you have received a diagnosis of Prediabetes, you might want to consider following this diet under the guidance of your doctor or a qualified health professional.

Did you learn from this article? Share your thoughts in the comment section below.



Tiffany Joy Yamut is a registered nurse and health writer.  She is an advocate and ambassador for a healthy lifestyle, having found greater health after modifying her diet toward Keto.  Her articles include topics on anything low-carb, keto, and fitness. She is also a writer on Medium and author of her website ketogenic buddies. Your Health Forum warmly welcomes Tiffany on the platform.

Other articles written by Tiffany on Your Health Forum:

Good Carbs and Bad Carbs: How to Make the Right Choice for Your Health

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