How to Reverse Pre-Diabetes. Katie Did It Through a Plant Based Diet + Apple-sage Tofu Sausage


Although our whole food plant based meal plans are not designed to reverse or treat diabetes and pre-diabetes , they are packed with health promoting whole plant foods and they do not include meat, dairy or oil. I reached out to our meal plan subscribers and asked if anyone has been able to lower their Hemoglobin A1C since following our meal plans.

If you’re not sure what Hemoglobin A1C is, read this super informative post about how a plant based diet can help manage diabetes and then come back here.

I was not surprised when our inbox was flooded with responses from people who were pre-diabetic or type 2 diabetic and since going plant based and following our meal plans, have been able to reduce their medication, get off it completely, or they never had to start because of the marked improvement in their numbers in a relatively short amount of time.

Katie Holt is one such person. I loved chatting with her and I am stoked to share our talk.

Here’s a note from Katie before you watch the video.

I was diagnosed with gestational diabetes when I was pregnant with my second child, despite doing all the things one is supposed to do. I exercised daily, I didn’t eat fast food, and I ate what I thought was a super healthy diet. I was able to control it with diet and gave birth at 37 weeks to my little boy. Fast-forward three years when I went for a check-up and received a call from my doctor that my hemoglobin A1C was 6.2, which is on the high range of pre-diabetes.

I panicked.

My father developed type 2 diabetes in his 40s, and I was afraid of doing the same. I negotiated with my doctor who initially wanted to put me on metformin immediately. I requested that he give me 3 months to control my sugars on my own, and I asked to meet with a dietician. He agreed. I was able to get my HA1C down to 5.7 following a standard American “healthy” diet (lots of animal protein, some vegetables, some fruit, very few potatoes/pasta). I struggled to get my number down any lower.

I started graduate school in 2017 and noticed my sugars slowly creeping up. I did some research on Whole Food Plant Based eating at the suggestion of one of my mentors, and I started toying around with plant based recipes when I had time. The following semester, I started a gross anatomy lab. After I saw that a human cadaver dissection looked very similar to chicken, I switched to eating a Whole Food Plant Based diet immediately. I was able to get my Hemoglobin A1C down to 5.4 by eating plants, including potatoes and whole grain pasta.

I have not once regretted the change I made to my diet and am so grateful to Molly and the Dirty wizards for their amazing recipes, unconditional support, and enthusiasm. The meal plans have changed my life.

Huge thanks!

What an inspiration you are, Katie! Thank you for sharing your story and for letting people in your situation know that they aren’t doomed for a life of Metformin and no potatoes.

I am going to be sharing more chats like this in the future because I really want people to know that they are not powerless to type 2 diabetes or pre-diabetes.

Have you been able to reverse pre-diabetes or diabetes, reduce your diabetes meds or get off them completely by following a Whole Food Plant Based Diet? Bonus points if you follow our meal plans! I would love to know about it in the comments below.

Apple-Sage Tofu Sausage

Makes about 2 1/2 cups
Author: Molly Patrick


  • 1 package firm tofu, drained, rinsed and pressed (14 oz / 397 g) (instructions below)
  • 1 tablespoon tahini
  • 1 tablespoon vegan Worcestershire sauce
  • 1 tablespoon water
  • 2 teaspoons smoked paprika powder
  • ½ tablespoon 100% pure maple syrup
  • ½ teaspoon salt
  • ¾ teaspoon onion powder
  • ¾ teaspoon garlic powder
  • ¾ teaspoon dried rubbed sage
  • ½ teaspoon black pepper (about 20 turns)
  • 1 cup diced Granny Smith apple (150 g / about 1 medium / core removed / no need to peel)
  • ¼ cup diced red onion (35 g)
  • 2 tablespoons arrowroot powder (aka arrowroot starch)


  • Preheat oven to 375 °F (190 °C). Line a baking sheet with parchment paper or a silicone baking mat.
  • Remove the block of tofu from the package and rinse with water. Place the block of tofu on a plate and then set a cutting board on top of the tofu. Place something heavy on top of the cutting board, like a few cookbooks, and set aside for 10 – 15 minutes while the liquid is pressed out of the tofu.
  • In a large mixing bowl, whisk together the tahini, Worcestershire sauce, water, paprika, maple syrup, salt, onion powder, garlic powder, sage and pepper.
  • Crumble the pressed tofu into small pieces and place into the mixing bowl. Add the apple and onion and stir until everything is well coated with the marinade.
  • Add the arrowroot powder and stir again, continuing to break down the size of the tofu crumbles.
  • Evenly spread the mixture out onto your baking sheet. Bake for 45-50 minutes, until golden brown and chewy, stirring halfway through. Break up any large chunks of tofu as you stir.

Wishing you a happy week. May it be filled with finding a better way.


Get a weekly dose of inspiration to eat more plants and celebrate imperfection

Our Sweary Saturday Love Letters are written by our ex-boozer, ex-smoker, plant-loving co-founder, Molly Patrick.


  1. Cindy on January 19, 2020 at 6:33 am

    I would love to make this but I truly detest sage. What would be a replacement?
    Thank you!

    • Team Clean Food Dirty Girl on January 20, 2020 at 7:44 am

      Hi Cindy, The Herbs & Spices section of our Substitution guide suggests poultry seasoning / savory / marjoram / rosemary as substitutions for sage. However, this recipe will also work just fine if you leave out the sage altogether. Our free Trial meal plan that gives a test drive of the new classroom with our scaling features has an alternate version of the tofu sausage with an Italian flavor profile – you are welcome to sign up for the Trial over here if you’d like to try that version, too. ~Karen

  2. Jill on January 20, 2020 at 12:58 pm

    Just made this. Ideas on what to do with it would be appreciated. Thanks so much. Keeping diabetes at bay which both parents ate their way into.

    • Molly Patrick on January 20, 2020 at 2:14 pm

      You could add it to a burrito, serve it with rice, have it on the side with some roasted potatoes and fruit.
      Our meal plans are perfect for giving you directions for how to put everything together.
      You can read more about them here.

      • Lesley Nicol on January 25, 2020 at 2:17 pm

        Could you please tell me if this dish is something that could be kept in the fridge and added to dishes like a salad topping or is it best eaten hot once cooked.. Also how long would it last in the fridge please.

        • Team Clean Food Dirty Girl on January 25, 2020 at 4:28 pm

          Hi Lesley, Yes, this recipe is originally from our #TisTheSeason meal plan. In that meal plan the batch is used on Monday, Wednesday and Friday recipes so it will last in the fridge at least the five days. You can choose to re-heat it or add it to a salad cold – up to you! ~Karen

  3. Lesley Nicol on January 20, 2020 at 1:10 pm

    Never made tofu but this recipe looks like something I could try so thank you.
    I’m going to show my age here and the fact I’m not from the USA. This is an observation and not a personal attack btw. I watched the whole interview and I was sometimes nearly driven to distraction by the number of likes in nearly every sentence, especially by Molly. I think “like” must have taken over from “um”.

  4. Karen on January 22, 2020 at 11:03 am

    I enjoyed Katie’s interview – women who have gestational diabetes are more likely to go on to develop type 2 diabetes and hearing that you were able to reverse the trend for yourself is really huge. I think women will relate to Katie’s struggle with eating lean “healthy” meats and then justifying having sweets – and still keeping their numbers low but ultimately realizing that it’s not sustainable. Thank you for sharing, Katie!

  5. G.J. on January 25, 2020 at 5:16 am

    I am no cook. I do not have most,if not all of the spices and seasonings you use in the recipes you provide. Is there a standard list of such available? What are you recommendations?

    • Team Clean Food Dirty Girl on January 25, 2020 at 8:29 am

      Hi G.J. – Yes! We do have a staple pantry list you can download over here. The list comprises items that are commonly used in our meal plans. Even if you aren’t following our plans, it’s a solid list for a whole food plant based kitchen. The initial monetary outlay to transition over to a plant based pantry is something you might need to plan for so you aren’t feeling strapped cash-wise to purchase everything all at once. Figuring out what you’ve got on hand will help you know where you’ll need to spend money to get your pantry stocked. ~Karen

  6. Kristin on February 17, 2020 at 12:49 pm

    Will this work with tofu that has been frozen?

    • Team Clean Food Dirty Girl - Steph on February 17, 2020 at 3:04 pm

      Hi Kristin! We haven’t tested the recipe with previously frozen tofu, but we think it should work fine. Enjoy!

  7. Rebecca Rose on April 11, 2020 at 6:19 am

    5 stars
    Just made it and it is delicious! My omni husband liked it. Thank you once again for providing a wonderful vegan option for mealtimes.

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