An estimated 115.2 million American adults, more than 2 in 5 adults, are living with prediabetes, and about 8 in 10 have no idea, according to the CDC's 2026 National Diabetes Statistics Report. Blood sugar sits above the normal range but below the threshold for a type 2 diabetes diagnosis, and the condition often produces no obvious symptoms for years.
That silence is the point. The American Diabetes Association puts it plainly, noting that "there are no clear symptoms of prediabetes so you may have it and not know it." Still, as blood sugar climbs, a handful of small signals can show up. Most people miss them.
Eight quiet warning signs
1. Dark, velvety patches on the skin. The American Academy of Dermatology says a dark band of velvety skin on the neck, armpit, groin or elsewhere can be an early sign of prediabetes or type 2 diabetes. The condition is called acanthosis nigricans and is linked to high insulin levels.
2. Skin tags. These small, soft growths are harmless on their own. The dermatology group notes that having many of them may be a sign of type 2 diabetes.
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3. Increased thirst. As blood sugar rises, the body pulls water from tissues to help flush glucose, leaving you thirstier than usual. The National Institute of Diabetes and Digestive and Kidney Diseases lists "feeling very thirsty" among the core symptoms of diabetes.
4. Frequent urination. For the same reason, trips to the bathroom become more frequent, especially at night.
5. Ongoing fatigue. When cells respond poorly to insulin, glucose stays in the bloodstream instead of fueling muscles and organs. Persistent tiredness is a recognized diabetes symptom on the NIDDK list.
6. Blurred vision. Shifts in blood sugar can pull fluid into and out of the lens of the eye, temporarily changing its shape and blurring focus.
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7. Cuts and sores that heal slowly. High glucose interferes with circulation and immune response. The NIDDK includes "sores that do not heal" among the warning signs of diabetes.
8. Numbness or tingling in the hands or feet. Nerve damage can begin quietly. The NIDDK lists "pain, numbness, or tingling in the feet or hands" among the symptoms tied to type 2 diabetes.
These signs do not confirm prediabetes. Only a blood test can. But they are reasons to ask for one.
When to get screened
The American Diabetes Association's 2026 Standards of Care recommend routine screening for prediabetes and type 2 diabetes in all adults beginning at age 35. Testing should start earlier, at any age, in adults with overweight or obesity who have one or more risk factors, including a family history of diabetes, high blood pressure, physical inactivity or a history of gestational diabetes.
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If the first screen is normal, the guidelines say repeat testing is reasonable at least every three years, sooner if symptoms appear or weight climbs. Doctors can use a fasting glucose test, an oral glucose tolerance test or an A1C.
Prediabetes can be reversed
The diagnosis is not a life sentence. In the landmark Diabetes Prevention Program trial, adults at high risk who lost 5 to 7 percent of their body weight and got at least 150 minutes of moderate activity a week cut their risk of developing type 2 diabetes by 58 percent. For a 200-pound adult, that is roughly 10 to 14 pounds. Research suggests that for many adults, prediabetes may be reversible with sustained changes to diet and activity.
Anyone who notices these signs, or who has never been screened past age 35, can ask a primary care clinician for an A1C or fasting glucose test at their next visit.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.