Scenario

Ahmed is 56 years old and is visiting the community pharmacy to collect his prescription for ramipril 5mg daily for hypertension. He has been recently diagnosed with prediabetes (HbA1C result: 44mmol/mol), and was advised to change his diet. He asks for your advice about what he should eat.

Ahmed tells you he has a sedentary job in an office and a busy home life with four children. He eats a varied diet, which includes meat (excluding pork) and fish, with lots of rice, breads, pulses, especially lentils, and some vegetables. He tells you he has a ‘sweet tooth’ and regularly likes to snack on biscuits and boiled sweets in the office throughout the day. He adds three teaspoons of sugar to each cup of coffee.

Things to consider

Prediabetes can be managed with a dietary approach and lifestyle measures. A reduction in carbohydrate intake can lead to significant improvements in glycaemic control; it can be an effective option that has few side-effects. In some cases, following sustained dietary changes, people with type 2 diabetes have achieved remission, enabling them to reduce or stop taking diabetes medicines (with associated reductions in medicine costs).¹