Prediabetes is a condition where blood glucose levels are higher than normal but not yet high enough for a diabetes diagnosis. Without intervention, it significantly increases the risk of developing type 2 diabetes, cardiovascular disease, and other chronic complications.¹

In Australia, screening is generally recommended from age 45, or earlier for those with risk factors such as obesity, sedentary lifestyle, or family history.²

Ageing brings physiological changes that affect how the body processes nutrients, including reduced metabolic rate, altered appetite, and changes in nutrient absorption.³

For older adults, this means diet quality becomes more important than total calorie intake. Poor dietary patterns can accelerate progression to diabetes, while higher-quality diets can slow or prevent disease development.⁴

The evidence is clear: lifestyle intervention is highly effective in older populations.⁵

Key strategies include:

• Losing 5-7% of body weight
• Engaging in at least 150 minutes of moderate physical activity per week
• Improving overall diet quality
  

These interventions have been shown to reduce diabetes risk by up to 71% in adults over 60.³

Focusing solely on calorie reduction overlooks a crucial factor, nutritional quality.

A high-quality diet supports:

• Stable blood glucose levels
• Cardiovascular health
• Muscle maintenance and function
  
• Reduced inflammation and chronic disease risk
  

Improved diet quality has been consistently associated with a lower incidence of type 2 diabetes in long-term studies.³

Older Australians should focus on foods that provide essential nutrients without excess energy intake:

• Vegetables and fruits
• Whole grains such as oats and brown rice
• Lean proteins including fish, legumes, and eggs
  
• Healthy fats such as olive oil, nuts, and avocado
  

These foods help regulate blood glucose while supporting overall health.

Carbohydrates remain an important part of a healthy diet, but quality matters.

• Prefer whole grains, legumes, and high-fibre foods
  
• Limit refined carbohydrates, added sugars, and ultra-processed foods

High-fibre carbohydrates are slower to digest, leading to improved glycaemic control.¹

Pairing carbohydrates with protein or healthy fats can reduce blood glucose spikes.

Examples include:

• Wholegrain toast with avocado
• Fresh fruit with nuts
• Brown rice with fish or legumes

This approach improves post-meal glucose response and satiety.

Limiting discretionary foods is essential for metabolic and cardiovascular health.

Older Australians should reduce intake of:

• Sugary beverages and desserts
  
• Processed and fried foods
  
• High-sodium packaged foods
  

Irregular eating can contribute to blood glucose variability. Regular, balanced meals help maintain stable glucose levels, particularly for older adults with reduced appetite or irregular intake.

Diet alone is not enough. Physical activity plays a key role in improving insulin sensitivity.

Recommended activities include:

• Walking or group exercise programs
  
• Swimming or aqua aerobics
  
• Resistance training to maintain muscle mass
  

Combined lifestyle interventions remain the most effective strategy for preventing progression to diabetes.^6,7

• Follow the Australian Dietary Guidelines as a foundation.²
• Choose fresh, seasonal, and minimally processed foods
• Use community or meal delivery services if needed
• Seek guidance from a GP or Accredited Practising Dietitian

Early detection enables timely intervention. Regular screening allows individuals to make lifestyle changes before complications develop, improving long-term outcomes.²

Diabetes-Specific Nutritional Formulas (DSNF), like Glucerna*, are formulated specifically for people with diabetes or impaired glucose tolerance, with a low GI slow-release carbohydrate blend aiding slower glucose absorption.

Prediabetes is not an inevitable pathway to type 2 diabetes. For older Australians, focusing on diet quality, staying active, and engaging in early screening can significantly improve health outcomes.

Small, sustainable changes, such as choosing whole foods, balancing meals, and maintaining physical activity, can make a meaningful difference over time.

*Glucerna is a Food for Special Medical Purposes. Please use only under the medical supervision.