Maybe your doctor said it in passing at the end of an appointment. Maybe you saw it in your online lab results before anyone called you. "Prediabetes." Or "your blood sugar is a little high, let's keep an eye on it."
And then you went home with a word, no plan, and a quiet worry that sat with you for days.
If that's where you are right now, I want you to hear this first: prediabetes is not a sentence. It's a signal. It's your body telling you early, while there is still a real window to turn things around.
This week is World Diabetes Day (November 14), so let's talk about what that word actually means and what you can do with it.
What Prediabetes Actually Means
Prediabetes means your blood sugar is running higher than it should, but not high enough to be diagnosed as type 2 diabetes. In Canada, Diabetes Canada uses three main tests:
• A1C between 6.0% and 6.4%. This shows your average blood sugar over the last two to three months.
• Fasting blood glucose between 6.1 and 6.9 mmol/L. This is your blood sugar after eight hours without food.
• A two hour glucose tolerance test between 7.8 and 11.0 mmol/L. You drink a sugary drink and get tested two hours later.
Land in any of those ranges and you're in prediabetes territory. Go above them (an A1C of 6.5% or higher, for example) and the conversation becomes type 2 diabetes.
Here's the part most women are never told: those numbers are usually the last thing to change. Long before your fasting glucose creeps up, your body has often been working overtime, releasing more and more insulin to keep your blood sugar in a normal range. That's called insulin resistance, and it can go on quietly for years.
So if you've been told your labs are "fine" but you're dealing with afternoon crashes, sugar cravings at night and weight settling around your middle, your body may have been sending signals well before the lab report caught up.
Why This Shows Up in Your 40s
Perimenopause changes how your body handles sugar. As estrogen shifts, your cells can become less sensitive to insulin. Add in poorer sleep, more stress, less muscle than you had at 30, and a schedule that has you running on coffee until lunch, and your blood sugar has a much harder job than it used to.
That's why so many women tell me, "I'm eating the same way I always have and suddenly it isn't working." You're not doing anything wrong. Your body's rules changed and nobody handed you the new ones.
Diabetes Canada recommends that everyone 40 and older be screened for type 2 diabetes at least every three years, and more often if you have risk factors like a family history. If you can't remember the last time your A1C was checked, that's a fair question to bring to your next appointment.
The Window Is Real
This is the hopeful part, and it's backed by solid research. In the large Diabetes Prevention Program study, people with prediabetes who made lifestyle changes cut their risk of developing type 2 diabetes by more than half. Food, movement, sleep and stress management are not the "soft" option. For prediabetes, they are the main event.
You don't need a perfect diet. You need structure your blood sugar can count on.
Where I Would Start This Week
These are the same foundations I build every client plan on.
1. Protein first, at every meal
Start each meal with your protein: eggs, fish, chicken, Greek yogurt, lentils. Protein slows how quickly sugar reaches your bloodstream and keeps you full for hours. Eat a few bites of protein before the potatoes or the bread and you'll feel the difference by mid afternoon.
2. Three real meals, spaced about five hours apart
Constant grazing keeps insulin elevated all day. Giving your body around five hours between meals lets insulin come back down so your cells can become more responsive again. Skipping breakfast and grazing at 4 PM is the pattern that hurts most, so start with a real breakfast within an hour of waking.
3. Eat an apple a day
It sounds old fashioned, but an apple brings fibre and polyphenols that support a gentler blood sugar response. In Ottawa we have some of the best apples anywhere this time of year: Honeycrisp, Ambrosia, Spartan. Eat it with or after a meal, not on its own on an empty stomach.
4. Walk for 10 minutes after your biggest meal
Your muscles pull sugar out of your blood when they move. A short walk after dinner, even around the block in November, is one of the simplest blood sugar tools there is.
5. Protect your sleep
One short night can make you noticeably less sensitive to insulin the next day. Aim for a consistent bedtime and seven to nine hours. If you're waking at 3 AM, that's often a blood sugar signal too (more on that next week).
6. Get the right numbers
Ask for your A1C and fasting glucose, and ask what your fasting insulin is if your doctor is open to it. Keep copies. Watching your own numbers move is one of the most motivating things you can do.
Why This Is Personal for Me
I was diagnosed with hypoglycemia at 22. I thought it was just something I had to manage. It wasn't. Years later, my mother was diagnosed with type 2 diabetes, and I watched her try to make sense of it with nothing but conflicting advice. What she needed was someone to sit down with her and say, "Here's what's happening in your body, and here's exactly what to eat."
That's the conversation I wish she'd had. It's the one I have with every woman I work with.
A Soil to Plate Note
The foods that support blood sugar best are often the ones that grow well right here: kale, beans, onions, garlic, apples, berries and herbs. Next year I'm teaching people which of those foods to grow at home for blood sugar, whether you have a condo windowsill or a backyard. For now, start with what's on your plate this week.
If You've Just Heard the Word
You don't have to figure this out alone, and you don't have to wait until your next appointment to start. The Sugar Reset Method, powered by Metabolic Balance, starts with your blood work and builds a personalised nutrition plan around your body's numbers over 15 weeks. It isn't a diet and it isn't restriction. It's structure, built for your biology.
If you'd like to talk about where your numbers are and what's possible, book a free discovery call:
Not ready for a call? The Sugar Reset Starter Guide ($49.99) is a simple place to begin, and it counts toward the full program if you join within 60 days: Get the guide here
Keep Reading
• Insulin Resistance in Perimenopause: Early Signs Most Women Miss: https://www.nutritionalgardens.ca/blog/insulin-resistance-in-perimenopause-early-signs-most-women-miss
• Perimenopause and Blood Sugar: Blood Sugar Issues Don't Always Look Like Diabetes: https://www.nutritionalgardens.ca/blog/perimenopause-and-blood-sugar-blood-sugar-issues-dont-always-look-like-diabetes
• What 36 Blood Values Have to Do With Your Sugar Cravings, Belly Fat, and Exhaustion: https://www.nutritionalgardens.ca/blog/metabolic-balance-blood-values-personalized-meal-plan
About the author
Sarah Seguin, CNP is a Certified Nutrition Practitioner, Metabolic Balance® Coach and horticulturist with 15 years of experience growing food. She runs Nutritional Gardens in Ottawa, Ontario, where she helps women in perimenopause stabilise their blood sugar, end sugar cravings and rebalance their hormones through the Sugar Reset Method. Sarah was diagnosed with hypoglycemia at 22, and her soil-to-plate approach connects how food is grown with how it heals.
This article is for education only and isn't medical advice. If you have diabetes, take blood sugar medication or have a medical condition, talk with your healthcare provider before changing how you eat.