What Is Prediabetes? Warning Signs and How to Catch It Early
Last updated: 21 Aug 2026
There is a good chance you have prediabetes and do not know it.
That is not meant to alarm you. It is a statistical reality. A 2024 study by the National University of Singapore found that nearly 40 per cent of respondents in Singapore had prediabetes. Of those, almost 70 per cent believed they did not have any form of blood sugar issue at all. They had no symptoms, no suspicions, and no diagnosis. Their blood sugar was elevated, quietly and consistently, and they had no idea.
This is what makes prediabetes so difficult to address. It is not a dramatic condition. It does not announce itself with pain, fatigue, or visible changes. It develops slowly, often over years, without producing any symptoms that would prompt someone to see a doctor. And by the time symptoms do appear, most people have already progressed to Type 2 diabetes.
The good news is that prediabetes is reversible. But only if you know you have it.
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What Prediabetes Actually Means
Prediabetes is a clinical term for blood sugar levels that are higher than normal but not yet high enough to be classified as Type 2 diabetes. It sits in the space between healthy blood sugar and diabetes, and it is the body's clearest warning that something needs to change.
In clinical terms, prediabetes is typically identified through one of two blood tests. A fasting blood glucose level between 6.1 and 6.9 mmol/L, or an HbA1c result between 5.7 and 6.4 percent, places you in the prediabetic range. Anything above those thresholds indicates diabetes. Anything below suggests your blood sugar regulation is functioning normally.
The important thing to understand is that prediabetes is not a mild or harmless version of diabetes. It is the stage at which your body is beginning to lose its ability to regulate blood sugar effectively. Your pancreas is still producing insulin, but your cells are becoming less responsive to it. This is called insulin resistance, and it is the engine that drives the progression from prediabetes to diabetes if nothing changes.
Why Prediabetes Has No Obvious Symptoms
Most people expect a health condition to feel like something. A cough. A pain. A visible change. Prediabetes rarely works that way.
The reason is that blood sugar in the prediabetic range is not high enough to cause the classic symptoms associated with diabetes. You are unlikely to experience excessive thirst, frequent urination, blurred vision, or slow-healing wounds at this stage. Those symptoms typically appear once blood sugar has crossed into the diabetic range and remained elevated for an extended period.
What some people with prediabetes do notice, though not always, is a collection of subtle changes that are easy to attribute to ageing, stress, or a busy lifestyle. These can include feeling more tired than usual after meals, gaining weight around the midsection despite no significant change in eating habits, feeling hungrier than normal (particularly craving carbohydrates and sugary foods), skin darkening in the creases of the neck, armpits, or groin (a condition called acanthosis nigricans), and difficulty losing weight even with regular exercise.
None of these on their own would typically prompt someone to ask their doctor about blood sugar. They are vague, common, and easily explained away. This is precisely why prediabetes is overwhelmingly detected through routine blood work rather than symptom-driven visits.
Who Is at Risk in Singapore
Singapore has one of the highest diabetes prevalence rates among developed nations. According to the Diabetes Singapore national data, approximately one in three Singaporeans is at risk of developing diabetes in their lifetime. The prevalence increases sharply with age, nearly doubling with each successive decade from 1.9 per cent among those aged 30 to 39, to 21.8 per cent among those aged 60 to 69.
Several factors increase your risk of prediabetes. Some you can influence. Others you cannot.
- Family history is one of the strongest predictors - If a parent or sibling has Type 2 diabetes, your own risk is significantly higher. Ethnicity also plays a role. Singaporeans of Malay and Indian descent have higher rates of diabetes compared to those of Chinese descent, though the condition affects all ethnic groups.
- Being overweight, particularly carrying excess weight around the abdomen, increases insulin resistance - A sedentary lifestyle compounds this. Physical inactivity reduces the body's ability to use insulin efficiently, even if your weight is within a normal range.
- Age matters too - While prediabetes can develop in younger adults, the risk increases meaningfully after 40. This is partly due to natural metabolic changes and partly because the cumulative effects of diet and lifestyle become more pronounced over time.
- A history of gestational diabetes (diabetes during pregnancy) also raises your future risk - Women who had gestational diabetes should be screened regularly even if their blood sugar returned to normal after delivery.
How to Catch It Early
There is only one reliable way to detect prediabetes: a blood test.
The two most commonly used tests are the diabetes fasting blood glucose test and the HbA1c test. Fasting blood glucose measures your blood sugar after an overnight fast and gives a snapshot of your current levels. HbA1c measures your average blood sugar over the past two to three months, providing a broader picture of how your body has been managing glucose over time.
At Regis Medical, we recommend both tests as part of routine health screening, particularly for adults aged 40 and above. For those with risk factors such as family history, excess weight, or a sedentary lifestyle, screening should begin earlier.
The Ministry of Health includes diabetes screening as part of Singapore's recommended preventive health guidelines. If you are enrolled in Healthier SG, your enrolled clinic can incorporate regular blood sugar checks into your care plan.
If your results fall in the prediabetic range, our Doctors will discuss what that means in the context of your overall health, lifestyle, and risk profile. This is not a moment for panic. It is a moment for clarity and action.
Beyond the Blood Test: Continuous Glucose Monitoring
Blood tests like fasting glucose and HbA1c are essential for diagnosing prediabetes. But they only tell you what your blood sugar is doing at a single point in time, or as an average over several months. They do not show you what happens after you eat a bowl of rice, skip a meal, sleep poorly, or go for a walk.
This is where continuous glucose monitoring (CGM) offers something genuinely different. A CGM is a small wearable sensor placed just under the skin, typically on your upper arm, that tracks your glucose levels throughout the day and night. Instead of a single reading, you get a continuous stream of data sent to your smartphone, showing exactly how your body responds to different foods, activities, and habits in real time.
For people with prediabetes, this kind of visibility can be transformative. You might discover that your blood sugar spikes sharply after white rice but stays stable after brown rice. Or that a 20-minute walk after dinner brings your post-meal glucose down significantly. Or that poor sleep on certain nights leads to higher fasting glucose the next morning. These are patterns that no single blood test can reveal.
CGM is not a replacement for clinical blood tests. It does not diagnose prediabetes on its own. But as a behavioural tool, it turns abstract numbers into something you can see, understand, and act on. At Regis Medical, we offer CGM solutions from Dexcom and Abbott, and our Doctors can guide you on whether a short period of CGM monitoring would add value to your prediabetes management plan.
What Happens If You Catch It
This is where the story changes, and for the better.
Unlike Type 2 diabetes, which requires long-term management and often medication, prediabetes can frequently be reversed through lifestyle changes alone. The evidence for this is strong. Research consistently shows that modest weight loss (5 to 7 per cent of body weight), regular physical activity (150 minutes per week of moderate exercise), and dietary adjustments can reduce the risk of progressing to diabetes by more than 50 per cent.
These are not extreme changes. They do not require a dramatic overhaul of your life. For most people, they involve walking more consistently, reducing refined carbohydrate and sugar intake, eating more vegetables and whole grains, managing portion sizes, and improving sleep quality. Small, sustained adjustments rather than radical short-term diets.
At Regis Medical, we approach prediabetes as an opportunity rather than a crisis. Our Doctors work with you to develop a realistic management plan based on your current habits, preferences, and health goals. This may include follow-up blood tests every three to six months to track your progress, dietary guidance tailored to your lifestyle, and referrals where appropriate.
The key is that these interventions only work if you know you have prediabetes in the first place. Without a blood test, there is nothing to act on.
What Happens If You Don't
Left unaddressed, prediabetes progresses to Type 2 diabetes in a significant proportion of cases. Once that threshold is crossed, the condition becomes chronic. It requires ongoing management, typically involving medication, regular monitoring, and the lifelong risk of complications including cardiovascular disease, kidney damage, nerve damage, and vision loss.
The financial burden is also considerable. The projected economic cost of diabetes in Singapore is expected to rise from over $940 million in 2014 to $1.8 billion by 2050, reflecting both direct medical costs and lost productivity.
None of this is inevitable. Prediabetes is the body's way of giving you advance notice. It is telling you that your blood sugar regulation is under strain, but it has not failed yet. Acting at this stage is the difference between a condition you reverse and a condition you manage for the rest of your life.
Start With a Simple Blood Test
If you are over 40, if you have a family history of diabetes, if you carry excess weight around your midsection, or if you simply have not had your blood sugar checked in the past year, a diabetes screening test is the most practical step you can take.
It is quick, it is affordable, and it gives you information that could genuinely change the course of your health. If everything is normal, you have peace of mind. If your results show prediabetes, you have caught it at the only stage where it can still be reversed.
Our Doctors at Regis Medical can include diabetes screening as part of health screening or as a standalone blood test. Either way, it starts with a conversation.
Find out if you have pre-diabetes
Patient-first, Holistic, Dedicated Healthcare
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