Could I Have Prediabetes and Not Know It?

You track your cholesterol, your blood pressure, maybe even your daily steps. But blood sugar? That one might sneak past you. Which begs a serious question: Could you have prediabetes without knowing it?

An expert explains.

Think of prediabetes as a “check engine” light

You may already be familiar with type 2 diabetes — what most of us think of us as simply “diabetes.” It’s when your average blood sugar is consistently too high (6.5% or higher), which over time can damage your heart, nerves and other organs.

Prediabetes, as the name suggests, comes before this point. Your blood sugar is higher than normal (between 5.7%-6.4%), but not yet high enough to cause damage.

“Think of prediabetes as a warning light on your dashboard,” says Monaa Zafar, MD, at Soundview Medical Associates. “It’s a clue that type 2 diabetes could be on the horizon, if your blood sugar isn’t managed.”

The good news? Catching prediabetes early gives you a chance to turn things around. The bad news? In day-to-day life, it doesn’t come with any actual warning lights.

> Related: Can These 4 Steps Reverse Your Prediabetes?

Yes, you could have prediabetes without knowing it

Prediabetes affects more than 98 million American adults, yet more than 8 in 10 don’t know they have it.

“Most people with prediabetes feel completely fine — no tiredness, no thirst, no warning signs,” says Dr. Zafar.

How do you find out? Blood tests are the only way to know for sure. These tests are usually part of standard bloodwork at your annual wellness check — so if you haven’t been keeping up with your primary care team, now’s the time to schedule an appointment.

“Bottom line: Even if you feel healthy, getting checked is key,” says Dr. Zafar.

Who’s at the highest risk?

Prediabetes does tend to show up in certain people more than others.

If you have any of the following risk factors, it’s especially important to talk to your healthcare provider:

• Carrying extra weight, especially around the abdomen
• Family history of type 2 diabetes
• Age 45 or older
• Physical inactivity
• Poor sleep habits
• Certain health conditions, like high blood pressure, high cholesterol or a history of gestational diabetes

Certain groups may also face higher risk based on ethnicity. For example, adults who are African American, Hispanic/Latino, Native American, Asian American, or Pacific Islander tend to develop prediabetes at higher rates.

“Your risk isn’t just about weight or age — so many factors, from family history to ethnicity and even stress, can all play a role,” says Dr. Zafar. “That’s why awareness is everything.”

> Related: 7 Early Signs of Prediabetes You Don’t Want to Ignore

If you have prediabetes, here’s what you can do about it

Take 10 people with prediabetes. Studies suggest that, without intervention, about one will develop type 2 diabetes within the year. As many as seven will eventually develop diabetes during their lifetimes.

Fortunately, if you’re diagnosed with prediabetes, you have a real say in the outcome.

“Think of prediabetes as a chance to hit pause and course-correct,” Dr. Zafar says. “If you’re consistent, even small lifestyle changes can really move the needle on blood sugar.”

For example:

• Moving more: Aim for 150 minutes of moderate activity per week, like brisk walking or cycling.
• Eating smart: Prioritize whole grains, non-starchy vegetables, lean proteins, legumes and fruits. Limit sugary drinks, sweets and refined carbs.
• Prioritizing sleep: Aim for 7–9 hours of quality sleep per night.
• Monitoring your health: Check your blood sugar as recommended by your provider.

With attention and effort, research shows that prediabetes can often be managed successfully — or reversed entirely.

“Prediabetes doesn’t have to turn into diabetes,” says Dr. Zafar. “With the right guidance and simple changes, you can take control of your health.”

You may have prediabetes without knowing it, but once you do, you can take real steps to turn things around.