nutrition plan for adults For Prediabetes and

Type 2 Diabetes
Management and
Prevention
Type 2 diabetes continues to rise, affecting nearly 36 million Americans, and
is one of the leading causes of death in the United States. The CDC
estimates 97.6 million U.S. adults have prediabetes, and many of them do
not know they have it. This is a nutritional plan for adults with prediabetes
focused on preventing a type 2 diabetes diagnosis and reversing their
health condition.
ADULTS WITH PREDIABETES 2

NUTRITION PLAN FOR ADULTS WITH PREDIABETES

According to the Centers for Disease Control and Prevention [CDC], chronic diseases

such as heart disease, type 2 diabetes, stroke, and Alzheimer’s disease are among the leading

causes of death in the United States, causing 1.6 million deaths in 2021 (2024). The National

Center for Chronic Disease Prevention and Health Promotion [NCCDPHP] estimates six in ten

adults in the US have one chronic disease, and four in ten have two or more chronic diseases

(2022). Chronic diseases account for 90% of the $4.1 trillion annual healthcare spending in the

United States, with diabetes costing an estimated $412.9 billion (CDC, 2024; National Institute

of Diabetes and Digestive and Kidney Diseases [NIDDK], 2023). Type 2 diabetes has

increasingly affected more individuals throughout the United States over the past several

decades, lowering life expectancy by an estimated 15 years (Eilender, 2016). This nutrition plan

covers the nutritional needs of adults, 18 years and older, with a preexisting prediabetic health

condition.

The CDC estimates more than one in three, about 98 million, adults are living with

prediabetes, and of those individuals 8 in 10 do not even know they have the condition (CDC,

2023). Type 2 diabetes is a chronic disease associated with high blood sugar levels due to the

body’s inability to use insulin. Insulin is a hormone the pancreas produces to help cells use the

glucose they need for cellular energy. If the cell cannot take in glucose it begins to oversaturate

the body and over time severely affects organs such as the kidneys, eyes, and cardiovascular

system (NCCDPHP, 2022). According to the CDC (2023), risk factors for type 2 diabetes include

obesity, poor diet, a sedentary lifestyle, tobacco use, and excessive alcohol use.

The Client
ADULTS WITH PREDIABETES 3

The client, aged 35, presents with nutritional planning needs after being diagnosed with

prediabetes. She reports her activity level is sedentary and has a history of obesity, heart disease,

and a family history of type 2 diabetes. She is Caucasian with two children, living in a rural area

about 45 minutes from a major city. She reports her community has two grocery stores that meet

her nutritional needs. She listed several processed foods in her regular diet including hotdogs,

canned baked beans, Oreos, Diet Coke, and pizza. She stated she does not regularly eat fresh

fruits or vegetables. The client presents with a body mass index [BMI] of 32 kg/m^2 and a waist

circumference of 92 cm. Blood test results: A1C 5.7%-6.4%; fasting glucose: 100-125mg/dL; or

2-hour oral glucose: 140-199 mg/dL (National Institute of Diabetes and Digestive and Kidney

Diseases [NIDDK], 2024). The following tests are average blood tests used to identify

prediabetes and diabetes and additional tests to monitor:

Test Normal Prediabetes Diabetes

A1C <5.7% 5.7% to 6.4% >6.5%
Fasting Blood Sugar <99 mg/dL 100-125 mg/dL >126 mg/dL
2-Hr Glucose Tolerance <140 mg/dL 140-199 mg/dL >200 mg/dL
Normal Inadequate Deficiency
Microalbumin 3.5 to 5.5 g/dL
Vitamin D >20 ng/mL 12 to <20 ng/mL <12 ng/mL
Lipid Profile:
Total Cholesterol <200 mg/dL
LDL <100 mg/dL
HDL >40 mg/dL
Triglycerides <150 mg/dL
Blood Pressure <120/80 mm Hg <130/80 mm Hg
*Blood pressure level for diabetics is a target level to stay under.
(Centers for Disease Control and Prevention [CDC] (2023)

Nutritional Needs of Adults

Nutritional needs for adults, ages 19 through 59, are highly dependent upon several

factors such as height, current weight, gender, age, activity level, and health status (Eilender,
ADULTS WITH PREDIABETES 4

2016; NIH, 2023). Nutritional choices are solely dependent upon the individual adult if they are

independent and do not rely on others for their daily nutritional choices. Several factors influence

an individual’s daily nutritional choices, including marketing from processed food companies,

friends and family, convenience, access, and personal preferences. To maintain a healthy weight

and prevent and manage chronic diseases adults should consume the recommended daily

calories, avoid overindulging, and use portion control in conjunction with daily physical activity.

It is also important for adults to be mindful of the quality of foods and calories they are

consuming. For example, consuming sports drinks or juice, which are high in sugars and

calories, will often lead to consuming too many calories as they do not contain any fiber or

proteins which help you feel fuller longer.

For this client recommended caloric intake is 1,800 calories/per day

Macronutrients Daily Serving Percentage of Daily Calories
Protein 170 g 15 to 35% of calories
Carbohydrates* 130 g 45 to 65% of calories
Fat 25 to 35% of total calories
Saturated Fats <10% of total calories

Fiber 25-27 g
Sucrose <10% of total calories
Sodium <2,300 mg
Water 11 cups
*Carbohydrate levels will change according to physician recommendations, and current
blood sugar levels. The recommended serving is based on average recommendations.

Micronutrients Daily Serving Alternative Units

Calcium 1,000 mg
Iron 18 mg
Vitamin A 900 mcg RAE- retinol activity equivalents
Vitamin B-Folate 400 mcg DFE-dietary folate equivalents
Vitamin B-12 2.4 mcg
Vitamin C 90 mg
Vitamin D 15 mcg 600 IU – international units
Iodine 220 mcg upper limit recommendation
Zinc 8 mg
(Eilender, 2016; National Institutes of Health [NIH], 2023)
ADULTS WITH PREDIABETES 5

Prediabetes Nutritional Needs

The management of prediabetes should be focused on maintaining a healthy weight and

reducing blood sugars to the average range, A1C below 5.7 percent. While nutrition is a

significant aspect of preventing a type 2 diabetes diagnosis, physical activity should be an

element of every nutritional and healthy lifestyle plan. Carbohydrates are crucial in diabetes

management, but restrictive diets must be closely monitored and can lead to improper nutrition,

eating disorders, and dyslipidemia. Although carbohydrates are causing blood sugar issues for an

individual with prediabetes and diabetes, it is typically due to too many carbohydrates, unhealthy

carbs, and/or the body’s inability to use the carbohydrates available. Because carbohydrates are

necessary for a healthy diet, in moderation, choosing low-glycemic carbohydrates, meaning they

have a lower potential for raising blood sugar, will help prevent raising blood sugar levels (NIH,

2023; Yau et al., 2020).

Nutritional Plan

Establishing appropriate serving sizes and maintaining the recommended daily calories is

an important aspect of improving nutritional health and developing healthy habits. Obesity and

weight gain are often associated with a sedentary lifestyle, but overconsumption and portion

control are contributing factors (Eilender, 2016; Tuso, 2014). Consideration should be made

when choosing foods, as some foods are more calorically dense than others, for example, highly

processed foods are often high in calories and do not sustain hunger. Additionally, when using

condiments be sure to measure the amount consumed, as they are often high in calories and

overconsumed. The following serving sizes are recommended for a females, aged 31 to 50:
ADULTS WITH PREDIABETES 6

Foods Daily Serving 1 Serving Size Equivalents

Protein 5 to 6 ounces 1 oz of lean meat, poultry, or
seafood; 1 tbsp of peanut butter; ¼
cup cooked beans; ½ oz nuts or
seeds
Fruits 1.5 to 2 cups 1 cup of raw or cooked; ½ cup dried
fruit; 1 cup 100% juice
Vegetables 2 to 3 cups 1 cup raw or cooked; 2 cups of leafy
greens; 1 cup of 100% juice
Grains 5 to 6 ounces 1 oz serving is 1 slice of bread; ½
cup of cooked rice, pasta, or cereal
Dairy 3 cups 1 cup of milk, yogurt, or alternative
dairy product; 1.5 oz of natural
cheese
(Eilender, 2016; NIH, 2023)
A prediabetes diet should include six key aspects: protein, carbohydrates, fruits and

vegetables, fiber, water, and portion control. Protein, and healthy fats, are crucial aspects of any

diet, but especially for prediabetes, as they do not require insulin, and very small amounts are

stored as glucose. Protein also helps you feel fuller longer, which helps decrease overeating and

assists in portion control (NCCDPHP, 2023; NIH, 2023). One aspect of a healthy lifestyle that is

often forgotten is water consumption. We often think about calories and exercise, but water is

another crucial aspect of improving overall health and reducing weight. Water not only helps

keep you hydrated, but it also helps prevent overeating as it keeps your stomach full and reduces

overall caloric intake (NCCDPHP, 2023). Carbohydrates should be on the low-glycemic index,

whole grains, and fresh fruits and vegetables, when possible. Examples of low-glycemic

carbohydrates include vegetables such as peppers, onions, celery, broccoli, green beans,

cucumbers, and lettuce; few fruits such as pears, apples, cherries, oranges, berries, and avocados;

whole-grains such as sourdough, wheat, bran, and barley; and dairy products including plain

yogurt, cheese, and cottage cheese (NIDDK, 2023). See Appendix B for a recommended weekly

meal plan. Avoiding processed foods can be incredibly difficult for busy individuals, who have
ADULTS WITH PREDIABETES 7

issues accessing healthy foods and/or have financial issues, but there are strategies you can

follow to help stick to a healthier diet and avoid processed foods.

Strategies to Maintain Dietary Recommendations

One strategy to follow to ensure you are consuming healthy, whole foods is shopping the

outer perimeter of the grocery store, avoiding fast food restaurants, and being selective when

eating out. Additionally, understanding what you are consuming by reading the nutrition label.

By looking at the nutrition label you are visualizing the food’s ingredients, calories, macro- and

micronutrients, and vitamins and minerals. The Food and Drug Administration [FDA] (2024),

has several resources to utilize when trying to understand how to read the label and

understanding how to interpret it. See Appendix A for a breakdown of a nutrition label. When

grocery shopping buying foods that are in season, as they are often more cost effective, buy

small quantities, and buy foods you and your family enjoy.

Decrease Processed Foods Consumption SMART Goal

Reduce the amount of processed foods to one item per day over the next four weeks. To

accomplish this goal utilize a weekly meal plan and structured grocery list, only

purchasing what is on your list.

1. To accomplish reaching the daily recommended servings use the weekly meal
plan and grocery list.
2. Track daily meals with the meal tracker included in the nutrition plan.
3. Attend free nutrition webinars and utilize the National Center for Chronic
Disease Prevention and Health Promotion resources and the National Institute
of Diabetes and Digestive and Kidney Diseases websites to learn more about
healthier diet choices.
ADULTS WITH PREDIABETES 8

4. Enroll in food assistance programs available in the community, which will

help alleviate issues with access to healthier food options and reduce costs.

Rationale and Accountability

This nutrition plan utilizes current evidence-based nutrition practices for reversing

prediabetes and preventing a type 2 diabetes diagnosis. The client presented with a prediabetes

condition and requested assistance improving her diet choices and overall health, as type 2

diabetes was looming if she did not improve her lifestyle. By making better food choices and

reducing her daily calories she will not only improve her weight and BMI, she will begin to shift

her overall health status. Several key aspects include consuming the daily recommended protein

servings, daily monitoring of blood sugars, and reducing daily calories the client will help

reverse her prediabetes and create a healthy lifestyle for not only herself but her children as well.

Another important aspect of this nutrition plan is accountability, as it is not easy to change habits

and it is easy to get off track. The client has agreed to weekly check-ins, in person, to go over

weekly diet habits and grocery lists. After three and six months we will redraw bloodwork and

analyze how effect her diet and activity levels have had on her overall health.

As ultra-processed foods and convenience foods continue to wreak havoc on our society

it is more important than ever to fully understand what the foods we are consuming are doing to

our bodies and overall health, as chronic disease continues to severely affect the health of our

nation and our healthcare system. Type 2 diabetes affects 38 million Americans, and an

additional 98 million Americans are facing a T2D diagnosis if they do not improve their lifestyle

choices (CDC, 2023). This evidence-based nutrition plan, in conjunction with an exercise plan,

aims to help individuals avoid a T2D diagnosis and reverse their prediabetes condition by

improving dietary choices.

ADULTS WITH PREDIABETES 9

References
Centers for Disease Control and Prevention [CDC]. (2024, January 17). Leading causes of death.

U.S. Department of Health and Human Services [HHS]. https://www.cdc.gov/nchs/fastats

/leading-causes-of-death.htm

Centers for Disease Control and Prevention [CDC]. (2023, September 5). What is diabetes? U.S.

Department of Health and Human Services [HHS]. https://www.cdc.gov/diabetes/basics/

diabetes.html

Eilender, E. (2016). Nutrition throughout the lifecycle. Momentum Press.

Food and Drug Administration [FDA]. (2024, March 5). What’s on the nutrition facts label?

Retrieved April 20, 2024, from https://www.fda.gov/food/nutrition-facts-label/whats-

nutrition-facts-label

National Center for Chronic Disease Prevention and Health Promotion [NCCDPHP]. (2022, July

21). About chronic diseases. Centers for Disease Control and Prevention [CDC].

https://www.cdc.gov/chronicdisease/about/index.htm

National Institute of Diabetes and Digestive and Kidney Diseases [NIDDK]. (2024, January).

Diabetes statistics. U.S. Department of Health and Human Services. https://www.niddk.

nih.gov/health-information/health-statistics/diabetes-statistics

National Institute of Health [NIH] Office of Dietary Supplements. (2023). Dietary supplement

fact sheets. U.S. Department of Health & Human Services [HHS]. https://ods.od.nih.gov/

factsheets/list-all/#I

Tuso, P. (2014). Prediabetes and lifestyle modification: Time to prevent a preventable disease.

The Permanente Journal, 18(3), 88-93. https://doi.org/10.7812/TPP/14-002

U.S. Department of Agriculture [USDA]. (2020, December). Dietary guidelines for Americans,
ADULTS WITH PREDIABETES 10

2020-2025 (9th ed.). U.S. Department of Health and Human Services. https://www.dietary

guidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-

2025.pdf

Yau, J.W., Thor, S.M., & Ramadas, A. (2020). Nutritional strategies in prediabetes: A scoping

review of recent evidence. Nutrients, 12(10), 1-24. https://doi.org/10.3390/nu12102990

ADULTS WITH PREDIABETES 11

Appendix A
Nutrition Label Education
The Food and Drug Administration [FDA] (2024) created the educational resource below:
ADULTS WITH PREDIABETES 12

Appendix B
Weekly Meal Plan for Adults with Prediabetes
ADULTS WITH PREDIABETES 13

Appendix C
Weekly Nutrition and Habits Tracker
ADULTS WITH PREDIABETES 14

Appendix D
Healthy Eating Tips