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Concerning diet therapy for adults with diabetes and prediabetes, the Diabetes Care article has only this to say specifically about the paleo diet:
Research studies focused on a paleo eating pattern in adults with type 2 diabetes are small and few, ranging from 13–29 participants, lasting no longer than 3 months, and finding mixed effects on A1C, weight, and lipids.
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A variety of eating patterns (combinations of different foods or food groups) are acceptable for the management of diabetes.
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Until the evidence surrounding comparative benefits of different eating patterns in specific individuals strengthens, health care providers should focus on the key factors that are common among the patterns:
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○ Emphasize nonstarchy vegetables.
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○ Minimize added sugars and refined grains.
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○ Choose whole foods over highly processed foods to the extent possible.
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Reducing overall carbohydrate intake for individuals with diabetes has demonstrated the most evidence for improving glycemia and may be applied in a variety of eating patterns that meet individual needs and preferences.
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For select adults with type 2 diabetes not meeting glycemic targets or where reducing antiglycemic medications is a priority, reducing overall carbohydrate intake with low- or very low-carbohydrate eating plans is a viable approach.
Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care
Paleo Diabetic 