How to Know If You're Pre-Diabetic: Risk Factors and Testing

Barbara felt fine. No unusual thirst, no fatigue, no blurry vision. At her annual wellness visit, her doctor ordered routine bloodwork. Her A1C came back at 6.0% — pre-diabetic. She was stunned. Pre-diabetes almost never causes noticeable symptoms. That's what makes it dangerous: more than 2 in 5 American adults have it, but 8 in 10 don't know, according to the CDC. Three blood tests can detect it. An A1C between 5.7% and 6.4% means pre-diabetes — it measures your average blood sugar over 3 months. A fasting blood glucose between 100 and 125 mg/dL is another indicator. And an oral glucose tolerance test reading between 140 and 199 mg/dL after 2 hours confirms it. Your risk goes up if you are over 45, carry extra weight (especially around the middle), have a parent or sibling with diabetes, are physically active fewer than 3 times a week, or have had gestational diabetes. For people over 65, here is important context: a Harvard Health study found that fewer than 12% of adults over 71 with pre-diabetes progressed to Type 2 diabetes over 6.5 years. The condition progresses more slowly in older adults — but lifestyle changes still matter for heart health and overall well-being. Medicare covers diabetes screening tests at no cost as part of your preventive benefits. You can get tested twice a year if your doctor says you are at risk. Don't wait for symptoms that may never come. Ask for your A1C at your next visit.