Fast Five Quiz: Prediabetes

Anne L. Peters, MD


October 03, 2019

The Mediterranean (emphasizing whole grains, vegetables, fruits, beans, fish, and healthy fats), vegetarian or vegan, low-fat, and low-carbohydrate eating plans have been the focus of the greatest number of studies and report benefits across multiple health domains.

  • Mediterranean: reduces risk for diabetes, reduces A1c level, lowers triglyceride levels, and reduces the risk for major cardiovascular events

  • Vegetarian or vegan: reduces risk for diabetes, reduces A1c level, helps with weight loss, and lowers total and low-density lipoprotein cholesterol

  • Low-fat: reduces risk for diabetes and helps with weight loss

  • Low-carbohydrate: reduces A1c level, helps with weight loss, lowers blood pressure, and increases high-density lipoprotein cholesterol and lowers triglyceride levels

It is no longer recommended that protein intake be reduced in patients with chronic kidney disease; these patients do not need any protein restriction compared with what is recommended for the general population. However, patients with macroalbuminuria may benefit from switching to soy-based protein to reduce their risk for cardiovascular disease.

The Ornish or Pritikin (very low in fat), low- or very low-carbohydrate, and DASH (emphasizing foods lower in sodium) eating plans are all acceptable as long as the patients are getting the right distribution of macronutrients and micronutrients to achieve their target goals. Patients should work with a registered dietitian to create an appropriate and individualized eating plan. Any eating plan should be revisited periodically for adjustments because the way patients eat and their lifestyles may change over time.

Overall, vitamin supplementation is not recommended unless it is proven that a patient has a deficiency. That said, vitamin B12 status should be assessed annually in patients who take metformin.

Learn more about medical nutritional therapy for type 2 diabetes prevention.

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