Pre-diabetes is a condition where blood sugar levels are higher than normal but not yet high enough to be diagnosed as type 2 diabetes. According to the Centers for Disease Control and Prevention (CDC), around 96 million American adults—over one-third of the population—have pre-diabetes, yet 80% of them are unaware of it. It is known that 20% of Malaysians are diabetic. Patients with pre-diabetes are 2 to 3 times at risk of developing cardiovascular diseases and diabetes too.

Pre-diabetes don’t come with severe symptoms, making it hard to detect without regular blood tests. The most common blood test used to diagnose pre-diabetes is the A1C test, which measures average blood glucose levels over the past three months

Many people with pre-diabetes show no symptoms, which is why it’s often called a “silent” condition. However, certain signs may indicate that your blood sugar is in a borderline range. Here are key symptoms and risk factors to be mindful of:

1. Near to diabetic range blood glucose level & HbA1c: Based on Malaysian guideline (MOH, 2016), HbA1c level of 5.6-6.2% indicates pre-diabetes.
2. Frequent Thirst and Urination: Higher-than-normal blood sugar levels can cause frequent thirst and urination as your body tries to flush out excess sugar. A study published by the American Diabetes Association reports that even slightly elevated blood glucose can lead to subtle signs of dehydration.

3. Increased Fatigue: If your blood sugar levels are high, it can affect how your body converts glucose into energy. Even in pre-diabetes, this impaired energy production can result in persistent fatigue. A survey found that up to 35% of people with pre-diabetes experience unusual tiredness.

4. Blurred Vision: Blood sugar fluctuations can affect the shape of the eye’s lens, leading to temporary blurred vision. According to a study by the National Institutes of Health, early vision changes may be one of the first noticeable signs for some people with high blood sugar.

5. Darkened Skin Patches (Acanthosis Nigricans): Dark, velvety patches often appear on the neck, armpits, or groin areas and are commonly associated with insulin resistance, which is a hallmark of pre-diabetes. Research indicates that acanthosis nigricans is present in about 25% of people with pre-diabetes.

6. Unexplained Weight Changes: Some people with pre-diabetes experience sudden weight gain or even weight loss without significant changes in their diet or activity level. Weight changes may be subtle but could signal that your body is struggling to regulate blood sugar properly.

7. Frequent Infections or Slow Healing: If you’re noticing frequent infections, especially urinary tract or yeast infections, or if cuts and bruises are taking longer to heal, it may be due to high blood sugar levels, which can impair immune function and slow down healing processes.