April 17, 2026

The silent warning: understanding prediabetes

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The silent warning: understanding prediabetes

About 115 million American adults have prediabetes and the vast majority do not know it.

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My sibling was recently diagnosed with prediabetes, and now I am wondering if I could be at risk too. Is this condition genetic, and what does it mean to have it?

Having a close family member with diabetes can increase your chances of developing it yourself, but such history is just one factor. Other factors like age, weight, lifestyle, blood pressure, cholesterol and ethnic background also affect the risk. Here is a clearer look at prediabetes and what you should know.

What Is Prediabetes? Prediabetes occurs when blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. It is far more common than most people realize, particularly because it often has no symptoms.

The Centers for Disease Control and Prevention estimates that about 115 million American adults have prediabetes and the vast majority do not know it. Without intervention, many may develop type 2 diabetes within 10 years.

Even before then, elevated blood sugar can quietly damage blood vessels and raise the risk of heart disease, stroke, kidney disease, nerve damage and vision problems. Once diabetes develops, daily blood sugar monitoring, medications, or insulin and lifestyle adjustments may become necessary, which can affect one’s overall quality of life.

The good news is that prediabetes does not make diabetes inevitable. In many cases, blood sugar can return to healthier ranges. Modest weight loss, regular physical activity and healthier eating habits can significantly reduce, or sometimes eliminate, the risk of progression. In some situations, medications may also be prescribed to help control blood sugar.

Who Should Get Tested? Prediabetes does not usually cause any noticeable symptoms, so testing is the only reliable way to know if you have it. Adults 35 and older should be screened, particularly if they are overweight. Younger adults should also consider testing if they are overweight and have other risk factors such as high blood pressure, high cholesterol, a sedentary lifestyle or a family history of diabetes. Certain ethnic groups, including Latino, Black, Asian and Native American adults, are at a higher risk and may benefit from earlier screening. To quickly assess your risk, take the free online screening test at doihaveprediabetes.org.

Diagnostic Procedures If you are at risk, your doctor can order one of three tests. The fasting plasma glucose (FPG) test requires an eight-hour fast. The oral glucose tolerance test (OGTT) measures how your body processes sugar. The hemoglobin A1C test reflects your average blood sugar over two to three months and can be done at any time, regardless of when you last ate.

Most Medicare and private insurance plans generally cover diabetes screening tests at little or no cost if you meet risk criteria such as being overweight, having high blood pressure or having a family history of diabetes. It is important to note that home glucose meters are not intended to diagnose prediabetes.

Take Action If you are diagnosed with prediabetes, do not panic. Many people restore healthy blood sugar with lifestyle changes alone. Studies have shown that reducing at least 7% of your body weight, getting at least 150 minutes of moderate exercise per week and reducing refined carbohydrates can make a meaningful difference.

For additional support, the Centers for Disease Control and Prevention sponsors the National Diabetes Prevention Program, which offers structured lifestyle-change classes in person and online across the United States (cdc.gov/diabetes-prevention). Check with local hospitals, clinics and community centers, as they may also offer similar programs.

The most important step is awareness. A simple screening test can provide peace of mind or give you the opportunity to take action now and prevent diabetes in the future.

“Savvy Living” is written by Jim Miller, a regular contributor to NBC’s “Today Show.” The column, and others like it, is available to read via The American Legion’s Fund Development program, a way of establishing your legacy of support for the organization while providing for your current financial needs. Consider naming The American Legion in your will or trust as a part of your personal legacy. Learn more about the process, and the variety of charitable programs you can benefit, at legion.org/plannedgiving. Clicking on “Learn more” will bring up an “E-newsletter” button, where you can sign up for regular information.

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