Could You Have Prediabetes and Not Know It?

What if I told you that you could have a serious health condition for years without experiencing a single symptom?

No pain. No obvious warning signs. Nothing that would send you rushing to the doctor’s office.

And yet, that condition could be quietly increasing your risk of developing type 2 diabetes, heart disease, and stroke.

It’s called prediabetes, and according to the Centers for Disease Control and Prevention (CDC), more than 115 million American adults have it. Perhaps even more surprising? About 8 out of 10 don’t know they do.

But here’s the encouraging part. Prediabetes is also an opportunity to take action before more serious health problems develop.

What Exactly Is Prediabetes?

Your body needs glucose, a type of sugar, for energy. When you eat, your digestive system breaks down carbohydrates into glucose, which enters your bloodstream.

A hormone called insulin helps move that glucose from your blood into your cells, where it can be used for energy.

But sometimes, your body’s cells don’t respond to insulin as effectively as they should. This is called insulin resistance. Your pancreas may initially compensate by producing more insulin, but eventually your blood sugar can begin to rise.

When blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes, doctors call it prediabetes.

And here’s what makes it particularly tricky: Most people with prediabetes feel perfectly fine.

You can be active, go about your daily routine, and have no idea that your blood sugar is elevated.

That’s why testing is so important.

A Simple Blood Test Can Tell You a Lot

One of the most common ways doctors check for prediabetes is with an A1C blood test.

Unlike a regular blood sugar test that measures your glucose at a particular moment, the A1C test provides an estimate of your average blood sugar levels over the previous two to three months.

Here’s what the numbers generally mean:

A1C Result	What It Means
Below 5.7%	Normal range
5.7% to 6.4%	Prediabetes
6.5% or higher	Diabetes range

Doctors can also use fasting blood glucose or an oral glucose tolerance test. Your healthcare provider can help determine which test is appropriate and interpret the results.

The important thing is that you don’t have to wait until you feel sick to find out whether there’s a problem.

Who Is at Risk?

It’s easy to assume that prediabetes only affects people who eat too much sugar or don’t exercise enough.

But it’s not that simple.

Your risk can be influenced by several factors, including age, family history, excess body weight, physical activity, and certain medical conditions.

You’re more likely to develop prediabetes if you:

• Are 45 or older.
• Have a parent or sibling with type 2 diabetes.
• Are physically inactive.
• Have overweight or obesity, particularly excess abdominal fat.
• Have a history of gestational diabetes.
• Have conditions such as polycystic ovary syndrome (PCOS).

Genetics and other factors beyond your control can also play a role. And yes, people who appear healthy can develop prediabetes, too.

The American Diabetes Association recommends that most adults begin screening at age 35, with earlier testing for people who have certain risk factors.

If you’re unsure whether you should be tested, it’s worth discussing with your healthcare provider.

The Good News: Prediabetes Doesn’t Have to Become Diabetes

Now, here’s the part of this story I really want you to hear.

A prediabetes diagnosis doesn’t mean developing type 2 diabetes is inevitable.

In fact, one of the largest diabetes prevention studies found that people at high risk who participated in a structured lifestyle change program reduced their risk of developing type 2 diabetes by 58 percent.

For participants age 60 and older, the reduction was even greater: 71 percent.

And these weren’t people making extreme changes or following some miracle diet.

They focused on realistic improvements in their eating habits, regular physical activity, and modest weight loss when appropriate.

That’s encouraging news!

Small Changes Can Make a Big Difference

If you’ve been diagnosed with prediabetes, you don’t have to overhaul your entire life overnight.

Here are a few practical places to begin.

1. Get moving.

Aim for about 150 minutes of moderate physical activity each week, such as brisk walking. That’s just 30 minutes a day, five days a week.

And if you’re not active now, start where you are. Even a short walk after a meal can be a helpful first step.

2. Take a closer look at what you’re eating.

Focus on vegetables, whole grains, beans, nuts, and other fiber-rich foods. Choose water more often than sugary beverages, and pay attention to portion sizes.

You don’t have to eliminate every food you enjoy. The goal is to develop an eating pattern that supports healthier blood sugar levels over time.

3. Make manageable changes to your weight, if needed.

For people with overweight, research shows that losing just 5 to 7 percent of body weight can significantly reduce diabetes risk when combined with regular physical activity.

For someone weighing 200 pounds, that’s approximately 10 to 14 pounds.

Of course, not everyone with prediabetes needs to lose weight. Your healthcare provider can help you identify the changes most appropriate for your health.

4. Don’t try to do it alone.

Making lasting lifestyle changes is easier when you have support. Consider walking with a friend, preparing healthier meals with your family, or joining a structured diabetes prevention program.

The CDC’s National Diabetes Prevention Program offers evidence-based lifestyle coaching and support for people at risk of developing type 2 diabetes.

Don’t Wait for a Warning Sign

Here’s something I’ve learned about taking care of our health: We often wait until something feels wrong before we pay attention.

But some of the most important things happening inside our bodies don’t announce themselves.

Prediabetes is one of them.

The good news is that a simple conversation with your doctor and an appropriate blood test can help you understand your risk. And if your blood sugar is higher than it should be, there are meaningful steps you can take.

You may not be able to control every factor that affects your health, but you can make choices that improve your chances of staying well.

And that’s worth knowing before a problem becomes something more serious.

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Sources and Further Reading

• Centers for Disease Control and Prevention: Prediabetes, Your Chance to Prevent Type 2 Diabetes
• American Diabetes Association: Standards of Care in Diabetes, 2026, Prevention or Delay of Diabetes

This article is for educational purposes and is not a substitute for individualized medical advice. Speak with your healthcare provider about screening, diagnosis, and treatment.