Prediabetes: Risk Factors + Symptoms To Watch For

Prediabetes means your blood sugar is higher than normal, but not high enough to be diagnosed with type 2 diabetes (T2D). If you don’t make changes to your lifestyle, prediabetes can turn into T2D. Knowing what puts you at risk for prediabetes can help you  manage it and stop or slow down T2D.

Symptoms of prediabetes

Insulin resistance and prediabetes usually have no symptoms. People may have one or both conditions for several years without knowing it. Still, even without symptoms, healthcare providers can identify people who are at high risk based on several known factors.

Prediabetes risk factors

Like T2D, prediabetes doesn’t have just one cause. If you notice any of these risk factors, talk to your healthcare provider to get tested. Tests for prediabetes include an A1C test, an oral glucose tolerance test and a fasting blood sugar measurement.

Prediabetes risk factors include, but are not limited to:

• Being physically inactive
• Waist size and weight
• Smoking
• A cardiovascular disease (CVD) diagnosis
• History of polycystic ovary syndrome (PCOS)
• A family history of T2D (particularly a parent or a sibling)
• Giving birth to a baby weighing more or less than the baby’s target birth weight 
• History of gestational diabetes
• High blood pressure (130/80 mmHg or above) or being treated for high blood pressure
• HDL cholesterol level below 0.9 mmol/L (35 mg/dL) or a triglyceride level above 2.8  mmol/L (250 mg/dL)
• People in high-risks groups (for example, those living with HIV)
• People taking high-risk medicines including certain medications that are diuretics,, treat cancer, HIV or manage mental health, 
• People with periodontal (gum) disease
• People with a history of pancreatitis

People with very strong insulin resistance often develop dark patches or areas of skin, usually on the back of their neck.  These patches can also appear on elbows, knees, knuckles and armpits. This condition is known as acanthosis nigricans. Understanding this can help you recognize early signs and seek proper care.

Black/African-Americans, Alaska Natives, Native Americans, Asian-Americans, Hispanic/Latino and Pacific Islander-Americans are at a disproportionate risk of developing prediabetes.

Taking a prediabetes risk test can help you understand your predispositions. However, you should always consult your healthcare team for an official diagnosis and treatment.

The National Diabetes Prevention Program (NDPP) is helpful for those at risk

The CDC’s National Diabetes Prevention Program (NDPP) is designed to help people at risk for T2D make lifestyle changes, such as modifying diet and exercise, with support from an NDPP-trained lifestyle coach. 

According to the CDC, people with prediabetes who lose 5 to 7% of their body weight, establish a lower-calorie, healthy eating pattern  and get at least 150 minutes of exercise per week can significantly lower their risk of developing T2D, which is fantastic! With this program, at-risk individuals can reduce their risk of developing T2D by 58% over three years, and by 71% if they’re older than 60.

How often should you test for prediabetes?

Catching prediabetes early can give people time to make lifestyle changes and prevent diabetes and other adverse health outcomes. Healthcare providers may recommend more frequent testing based on initial results and risk status. 

When it comes to determining the right time for prediabetes screening, the American Diabetes Association (ADA) suggests the following helpful guidelines:

• Screenings should begin at age 35.
• Tests for prediabetes and T2D should be done in adults, regardless of age, who are living with overweight or obesity.
• Body Mass Index (BMI) equal to or more than 25 kg/m2 or equal to or more than 23 kg/m2 of people of Asian ancestry.
• Have one or more additional risk factors for diabetes.
• If the test results are normal, screenings should be done at least every three years.
• Children older than age ten or after the onset of puberty—whichever occurs earlier—who are living with overweight or obesity should be screened for prediabetes and diabetes.
• Children who have risk factors for diabetes and prediabetes should also be screened.
• Children whose mother had gestational diabetes or diabetes during pregnancy

In addition to weight, the location of extra adipose tissue (aka excess fat) on the body can be important. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance and increases a person’s risk for T2D. This is true even if a person’s body mass index (BMI) falls within the target range.

Why is screening for prediabetes important?

Remember, a prediabetes diagnosis is the opportunity to delay or prevent T2D. With your healthcare team, you can make the changes necessary to decrease your risks of developing T2D. Knowing the risk factors associated with prediabetes is an essential step towards that. 

Awareness is key to long-term health! The earlier you’re aware, the sooner you can start making the best changes for yourself. For many people, prevention is possible. Using resources on T2D from Beyond Type 1 is a good place to start. You may also find resources from the Association of Diabetes Care and Education Specialists helpful in your journey.

Living with T2D can carry a heavy burden of shame and stigma. Beyond Type 1 is changing what it means to live with T2D alongside a community of peers who truly understand. Join a community that’s been in your shoes. Explore our Community Apps.