What are the early signs and symptoms of prediabetes?

Around 1 in 3 American adults has prediabetes (~98 million people), but more than 80% do not know that they have it.¹ One factor that could play a role here is that most people with prediabetes don’t experience any symptoms.

In fact, many people only find out they have prediabetes after routine blood tests.²

In some cases, prediabetes can present with signs and symptoms related to how your body handles glucose and insulin. Recognizing these early signs can be the first step toward reversing the effects of prediabetes.

Prediabetes signs and symptoms

Most people with prediabetes don’t experience obvious signs or symptoms.²

However, in some cases, symptoms may appear that reflect how the body is managing blood glucose (blood sugar) and responding to insulin.

Signs and symptoms of prediabetes can include:^2,3,4

• Fatigue

• Increased hunger or appetite

• Blurry vision

• High blood pressure

• Elevated triglycerides (a type of fat in your blood)

• Difficulty losing weight

• Slower wound healing

• Frequent skin infections

• Skin tags

• Patches of darkened skin (acanthosis nigricans)

Some of these symptoms may be signs of insulin resistance—a condition where your body’s cells don’t respond effectively to insulin. In response, the pancreas works harder to produce more insulin to help keep your glucose levels within a normal range.

Over time, if the pancreas is unable to keep up with the increased demand for insulin, blood glucose levels begin to rise. This can lead to prediabetes—a state in which your glucose levels remain higher than normal, though not yet high enough to qualify as type 2 diabetes.⁵

How can prediabetes affect your skin?

When prediabetes comes with symptoms, some of these can be skin-related.

Patches of darkened skin known as acanthosis nigricans may develop. These patches can feel velvety to touch, have poorly defined borders, and are most likely to appear in skin folds, such as the armpit, groin, and back of your neck.⁶

Skin tags can also develop separately in these same areas, and these can sometimes be itchy or uncomfortable.⁴

Prediabetes can also make your skin more susceptible to infection as well as slow the healing process of any wounds you might have. This is because high glucose levels can reduce how well your immune system works.⁷

What to do if you think you have prediabetes

If you’re worried about prediabetes, it’s best to speak with your healthcare provider.

Healthcare providers can make a diagnosis of prediabetes after blood tests when any of the following are present:

• Fasting glucose is between 100-125 mg/dL (milligrams per deciliter).

• HbA1c is 5.7-6.4% (this is a measure of average blood glucose level over the past ~3 months).

• Glucose is between 140-199 mg/dL following an oral glucose tolerance test.

Your glucose levels change throughout the day, and lab tests can only give you snapshots of where they are. In contrast, continuous glucose monitors (CGMs) can show you how often your glucose rises above a healthy range over time.

Lingo is one such CGM that measures your glucose response to food, exercise, and other lifestyle factors. Where some sensors provide readings every 15 minutes, the Lingo biosensor streams real-time updates every minute, every day.

Research using CGMs has found that those who spend less time with their glucose above the healthy range (70-140 milligrams per deciliter) have a lower risk of type 2 diabetes over the next 5 years.⁸

Remember: a prediabetes diagnosis doesn’t mean you’ll eventually get type 2 diabetes. It’s an opportunity to make changes that will help get your blood sugar back to a healthier range.⁹

Preventing prediabetes from progressing to diabetes

Lifestyle interventions are the most effective ways to prevent or delay type 2 diabetes.^9,10

• Diet: Prioritizing protein, fiber, and healthy fats while cutting back on refined carbs and added sugars can help keep your glucose levels stable and support a healthy insulin response.

• Exercise: Regular exercise, particularly strength training, can make your body more responsive to insulin and help your body process glucose more efficiently.¹⁰

• Weight management: A modest amount of weight loss (i.e. 5-7% of body weight) can help with returning glucose levels to a healthier range.⁹

If lifestyle interventions aren't making a difference, or if you are at a higher risk of type 2 diabetes, your healthcare provider may also prescribe a drug called metformin alongside lifestyle changes.¹⁰

Learn more about how to reverse prediabetes.

A final note from Lingo

Prediabetes often comes with no signs or symptoms, with many people only discovering they have it after a routine blood test.

Some people may experience things like fatigue, hunger, and blurry vision, all of which are often associated with having high glucose levels and insulin resistance.

Due to its sometimes-invisible nature, prediabetes can be difficult to spot. This is likely why so many people with prediabetes do not realize they have it.

Tools like CGMs can help build awareness of how often someone’s glucose levels are outside a normal range, along with what factors might be associated with this. Lingo is a CGM that’s designed to help you build healthy habits that support your health goals.

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