About 115 million American adults have prediabetes, according to the CDC. That’s more than 2 in 5 adults, making it one of the most common metabolic conditions in the United States. Most people with prediabetes don’t know they have it, which is part of what makes the condition so consequential: without changes, roughly 5 to 10 percent of people with prediabetes progress to type 2 diabetes each year.
What the Numbers Look Like Across the U.S.
Prediabetes affects every major demographic group at similar rates. CDC data from 2021 to 2023 shows the condition is remarkably consistent across racial and ethnic lines: about 41.6 percent of white adults, 41.6 percent of Asian adults, 38.9 percent of Black adults, and 47.7 percent of Hispanic adults meet the criteria. Education level doesn’t create meaningful differences either. This is not a condition concentrated in one group. It’s spread across the adult population.
Age, however, makes a significant difference. A Johns Hopkins analysis of adults aged 71 to 90 found that 59 percent had prediabetes when measured by fasting blood sugar, and 44 percent qualified based on a different blood test. The older you get, the more likely your blood sugar regulation has shifted into the prediabetic range, sometimes without any obvious symptoms.
How Prediabetes Is Defined
Prediabetes sits in a specific zone between normal blood sugar and type 2 diabetes. Doctors use three possible tests to identify it, and you only need one abnormal result to qualify:
- A1C test: 5.7 to 6.4 percent. This measures your average blood sugar over the past two to three months.
- Fasting blood sugar: 100 to 125 mg/dL. This is a single blood draw after you haven’t eaten overnight.
- Oral glucose tolerance test: 140 to 199 mg/dL two hours after drinking a sugary solution. This checks how well your body processes a sugar load.
Any result at or above the upper end of these ranges crosses into type 2 diabetes territory. Any result below the lower end is considered normal. The prediabetic range means your body is already struggling to manage blood sugar efficiently, but hasn’t yet lost enough function to be classified as diabetic.
Why So Many People Don’t Know
Prediabetes rarely causes noticeable symptoms. There’s no pain, no dramatic change in energy, no obvious warning sign that something is off. Your blood sugar is elevated enough to cause gradual damage to blood vessels and organs, but not enough to make you feel sick. This is why the awareness gap is so large. Most people with the condition find out only when a routine blood test happens to catch it, or when they’ve already progressed to type 2 diabetes.
The lack of symptoms also means that many people who technically qualify for a prediabetes diagnosis have never been tested. The 115 million figure is an estimate based on population-level surveys and lab data, not a count of people who have actually received a diagnosis from their doctor.
What Happens Without Intervention
Each year, between 5 and 10 percent of people with prediabetes develop type 2 diabetes. Over a decade, that cumulative risk becomes substantial. But progression is not inevitable. The same research that established these rates also shows that a meaningful percentage of people with prediabetes return to normal blood sugar levels, particularly with lifestyle changes.
The interventions that work are straightforward in concept, if not always easy in practice. Losing 5 to 7 percent of your body weight (about 10 to 14 pounds for someone who weighs 200) and getting 150 minutes of moderate physical activity per week can cut the risk of progressing to diabetes by more than half. These numbers come from the Diabetes Prevention Program, one of the largest and most influential clinical trials on the topic, and the results have held up across follow-up studies spanning more than a decade.
The Economic Scale
Prediabetes costs the U.S. economy an estimated $43 billion annually. On an individual level, a person with prediabetes incurs roughly $500 more per year in medical expenses than they otherwise would. That may sound modest compared to the cost of managing full-blown diabetes, which can run into thousands of dollars annually for medications, monitoring supplies, and complications. But multiply $500 by 115 million people, and the financial footprint is enormous, especially for a condition that is largely preventable from progressing further.
Who Should Get Tested
Standard screening recommendations suggest testing for prediabetes if you’re 35 or older, particularly if you’re overweight. Other factors that increase your likelihood include having a parent or sibling with type 2 diabetes, a history of gestational diabetes, or belonging to a racial or ethnic group with higher diabetes rates. If you’ve had a normal result, retesting every three years is typical. If your results land in the prediabetic range, more frequent monitoring helps track whether you’re stable, improving, or moving toward diabetes.
Given that more than 40 percent of American adults already meet the criteria, the question for most people isn’t whether prediabetes is relevant to them. It’s whether they’ve been checked recently enough to know where they stand.