You just got the news. Your A1C is creeping up, maybe hitting 5.8% or 6.1%, and your doctor mentions the "P" word: prediabetes. It’s scary. Most people immediately think they have to swear off bread, pasta, and joy forever. But the truth about carbs per day for prediabetes is way more nuanced than just "stop eating sugar."
Honestly, the standard advice is often too vague. You might hear "eat less white stuff" or "watch your portions." That doesn't help when you're standing in the grocery aisle staring at a box of quinoa. What actually matters is how your specific body handles glucose.
The Numbers Game: How Many Carbs Do You Actually Need?
There isn't a single magic number that works for everyone. Seriously. The American Diabetes Association (ADA) used to suggest that about 45% of your calories should come from carbs, but they’ve shifted away from that one-size-fits-all approach. If you’re eating 2,000 calories, that’s roughly 225 grams of carbs. For many people with prediabetes, that is way too much.
On the flip side, some practitioners, like those at Virta Health, advocate for very low-carb or ketogenic diets—under 50 grams a day—to aggressively reverse insulin resistance.
Most experts today suggest a middle ground. Think 100 to 150 grams of total carbs per day.
Why that range? It’s enough to keep your brain fueled and your energy stable without sending your blood sugar on a roller coaster. But here is the kicker: 100 grams of lentils affects your body very differently than 100 grams of a bagel.
Understanding the "Net Carb" Trap
You've probably seen "net carbs" on keto bars. It’s the total carbs minus fiber and sugar alcohols. While fiber is your best friend because it slows down glucose absorption, don't get too caught up in the marketing. Some people find that certain sugar alcohols still spike their sugar.
Focus on the quality.
The Myth of "Good" and "Bad" Carbs
We love to label things. Sweet potatoes are "good," white potatoes are "bad." It’s not that simple.
✨ Don't miss: Why Sometimes You Just Need a Hug: The Real Science of Physical Touch
Glycemic Index (GI) and Glycemic Load (GL) are the tools you actually need. GI tells you how fast a food spikes your sugar. GL tells you how much a specific serving size will impact it. A watermelon has a high GI but a low GL because it’s mostly water. You’d have to eat a whole lot of it to cause a massive spike.
When figuring out your carbs per day for prediabetes, look at the cellular structure of the food. Intact grains—think farro, barley, or steel-cut oats—take longer to break down than "whole wheat" flour that has been pulverized into a fine powder. Your gut has to work harder to get the sugar out of the intact grain. That's what you want. Work.
Real-World Example: The Breakfast Test
Imagine two breakfasts. Both have 45 grams of carbs.
Breakfast A: Two slices of white toast with jam and a glass of orange juice.
Breakfast B: A bowl of Greek yogurt with half a cup of blackberries, a tablespoon of chia seeds, and a handful of walnuts.
Breakfast A is like a lightning bolt to your system. Your pancreas has to scream to keep up. Breakfast B? That’s a slow burn. The protein in the yogurt and the fats in the walnuts act like a brake for the carbs in the berries. Even though the carb count is similar, the metabolic impact is worlds apart.
Why Your Muscle Mass Matters More Than You Think
Here is something most people miss: your muscles are your primary "glucose sink."
When you eat carbs, they break down into glucose. Your body wants to store that glucose in your muscles. If your muscles are already "full" or if you aren't active, that sugar stays in your blood. This is why a 20-minute walk after dinner can drastically change how your body handles those carbs.
If you are lifting weights and building muscle, you can likely handle more carbs per day for prediabetes than someone who is sedentary. Muscle tissue is metabolically expensive. It wants that fuel.
🔗 Read more: Can I overdose on vitamin d? The reality of supplement toxicity
The "False Low" and Why You Feel Shaky
When you first start cutting back on carbs, you might feel like garbage. Shaky, irritable, "hangry."
This is often a "false low." Your body is used to running on blood sugar levels of, say, 140 mg/dL. When you eat better and your sugar drops to a healthy 90 mg/dL, your brain freaks out. It thinks you’re starving because the "new normal" is lower than the "old normal."
Stick with it. It usually takes about two weeks for your system to recalibrate.
Don't Forget the "Dawn Phenomenon"
You might wake up with high blood sugar even if you didn't eat anything before bed. This is the Dawn Phenomenon. Your liver dumps glucose into your system to give you energy to start the day.
It’s frustrating. You think, "I did everything right yesterday, why is my fasting number 105?"
It’s just biology. It doesn't mean your carb count for the day was wrong. Look at the trends over weeks, not the frustration of a single morning.
Practical Steps to Master Your Carb Intake
Don't try to change everything by Monday. You'll fail. It's too much.
Start by tracking what you eat for three days. Just three. Use an app like Cronometer or MyFitnessPal. Don't change anything yet—just see where you are. Most people are shocked to find they’re hitting 300+ grams of carbs without even trying.
💡 You might also like: What Does DM Mean in a Cough Syrup: The Truth About Dextromethorphan
Once you know your baseline, try these adjustments:
The Half-Plate Rule
Stop measuring every gram if it stresses you out. Instead, fill half your plate with non-starchy vegetables (broccoli, spinach, peppers). Fill a quarter with protein. The remaining quarter is for your carbs. This naturally keeps you in a safe zone for prediabetes.
Order of Operations
This is a game changer. Eat your vegetables first. Then your protein. Eat the carbs last. Studies show that having fiber and protein in your stomach before the glucose hits can reduce your post-meal blood sugar spike by up to 30%. Same food, different order, better results.
Test, Don't Guess
If you really want to be an expert on your own body, get a cheap glucose monitor. Test your sugar two hours after a meal. If it’s under 140 mg/dL, you handled those carbs well. If it’s 180, that meal had too many carbs for your current level of insulin sensitivity.
Watch the Liquid Carbs
Soda is an obvious no, but "healthy" smoothies can be just as bad. Blending fruit removes the mechanical structure of the fiber. You're basically pre-digesting the sugar for your body, leading to a faster spike. Eat the whole fruit instead.
Identify "Trigger Foods"
For some people, white rice is fine in small amounts. For others, a single sushi roll sends their sugar into the stratosphere. Everyone has "trigger foods" that cause a disproportionate spike. Identifying yours is more important than following a generic list from the internet.
Moving Forward
Managing carbs per day for prediabetes is about finding a sustainable rhythm. If you go too low, you might end up bingeing on bread on Friday night. If you stay too high, your A1C won't budge.
Focus on "coarse" carbs. Think beans, chickpeas, lentils, and berries. These are packed with fiber and micronutrients that actually help your insulin receptors work better.
Your Immediate Action Plan:
- Walk for 10 minutes after your largest meal today to help your muscles soak up excess glucose.
- Swap one refined carb (like white bread or white rice) for a whole-food version (like sprouted grain bread or cauliflower rice) at dinner.
- Prioritize sleep, as getting less than six hours a night can significantly increase insulin resistance the following day, regardless of what you eat.
- Increase your water intake; dehydration can cause blood sugar to appear more concentrated and higher than it actually is.