Five Risk Factors for Prediabetes, and What to Do if You Have It

Imagine living with a silent condition that is nudging you toward type 2 diabetes without your knowledge. This is the reality for millions of people with prediabetes, where blood sugar levels are elevated but not yet at the diabetes level. Unfortunately, many of them are unaware that they have prediabetes because they haven’t been diagnosed and don’t have any symptoms.

Could you have prediabetes or be at increased risk for it? Read on to learn five common risk factors for prediabetes – and what you can do if you have it.

1. Excess belly fat

Carrying excess weight, particularly around the waist, is a major risk factor for prediabetes.(1) Having too much fat surrounding the organs in your abdominal cavity – known as visceral fat – can cause insulin resistance.(2) When the cells in your body are resistant to insulin, they can’t use insulin effectively, which leads to higher blood glucose levels.

2. Physical Inactivity

A sedentary lifestyle can contribute to developing prediabetes.(3) What’s more, a lack of exercise may increase heart disease risk in those with prediabetes.(4) Engaging in physical activity has been shown to improve insulin sensitivity.(5)

3. Family History or Ethnic Background

If you have a family history of type 2 diabetes, your risk for prediabetes is greater – especially if you are not obese.(6) The same is true if you are of African, Indian, Hispanic, Native American, or Pacific Islander heritage.(7)

4. Age

The likelihood of developing prediabetes increases with age.(8) This is partly due to changes in muscle function that contribute to insulin resistance.(9) The US Preventive Services Task Force recommends that adults aged 35 to 70 who are overweight (BMI >25) or obese (BMI >30) undergo screening for prediabetes and type 2 diabetes.(10) However, since not everyone with prediabetes is overweight or obese, it is a good idea to begin getting screened for prediabetes at age 35, regardless of your BMI.

5. Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects women of reproductive age and is closely linked to insulin resistance and prediabetes.(11) Women with PCOS often experience weight gain, particularly around the abdomen.(12) But normal-weight women with PCOS are also at increased risk for developing prediabetes and diabetes.(13)

How You Can Begin to Reverse Prediabetes

If you have prediabetes or suspect you may have it, speak with your doctor. If you do have prediabetes, the upside is that you can take proactive steps to prevent its progression. One of the most effective ways to reverse prediabetes and improve your metabolic health is by switching to a ketogenic diet.

To discover how a ketogenic lifestyle can help, read our article, Conquer Prediabetes with a Ketogenic Diet, and take the first step toward a healthier future.

REFERENCES

1. Measurement of visceral fat for early prediction of prediabetes—Cross-sectional study from Southern India, Journal of Taibah University Medical Sciences, 2022
2. Association Between Visceral Adiposity Index and Insulin Resistance: A Cross-Sectional Study Based on US Adults, Frontiers in Endocrinology, 2022
3. Physical Activity and Abnormal Blood Glucose Among Healthy Weight Adults, American Journal of Preventive Medicine, 2017
4. Objectively Measured Physical Activity and Sedentary Time Are Associated with Cardiometabolic Risk Factors in Adults with Prediabetes: The PREVIEW Study, Diabetes Care, 2018
5. Update on the effects of physical activity on insulin sensitivity in humans, BMJ Journals, 2016
6. Family history of diabetes is associated with higher risk for prediabetes: a multicentre analysis from the German Center for Diabetes Research, Diabetologia, 2017
7. Racial/Ethnic Disparities in the Prevalence of Diabetes and Prediabetes by BMI: Patient Outcomes Research To Advance Learning (PORTAL) Multisite Cohort of Adults in the U.S, Diabetes Care, 2019
8. The Interaction Between Age and Risk Factors for Diabetes and Prediabetes: A Community-Based Cross-Sectional Study, Diabetes, Metabolic Syndrome, and Obesity, 2023
9. Mechanism of increased risk of insulin resistance in aging skeletal muscle, Diabetology & Metabolic Syndrome, 2020
10. Screening for Prediabetes and Type 2 Diabetes: US Preventive Services Task Force Recommendation Statement, JAMA Network, 2021
11. Incidence of prediabetes and risk of developing cardiovascular disease in women with polycystic ovary syndrome, Biomolecules and Biomedicine, 2016
12. Obesity and polycystic ovary syndrome, Clinical Endocrinology, 2021
13. Prospective Risk of Type 2 Diabetes in Normal Weight Women with Polycystic Ovary Syndrome, Biomedicines, 2022