Risk of developing diabetes

The scale of the problem: a silent epidemic

Type 2 diabetes has become one of the most widespread diseases of the century — and one of the most inconspicuous. According to the IDF Diabetes Atlas 2025, in 2024 about 589 million adults aged 20–79 had diabetes (11.1% of everyone in that age range), and by 2050 that number will grow to 852.5 million.

The most alarming part is the hidden side of the iceberg: roughly one in five adults with diabetes (251.7 million people, 48.8%) has never been diagnosed. People live for years with high blood sugar without knowing it. The reasons are limited access to testing, a shortage of healthcare resources and low awareness. And the longer diabetes goes unrecognized, the higher the risk of complications: cardiovascular disease, kidney failure, nerve damage and premature death. That's why early screening on simple indicators matters so much.

Prediabetes and type 2 diabetes: what's the difference

Prediabetes is a disturbance of carbohydrate metabolism where blood sugar is already above normal but not yet high enough to meet the criteria for diabetes. It's the “yellow zone”: at this stage the process is often reversible. Type 2 diabetes develops when a relative insulin shortage is added to insulin resistance, and glucose persistently exceeds the threshold values.

Why high blood sugar is dangerous

High blood sugar itself usually doesn't hurt — that's the catch. But over years, excess glucose damages the body from within, and complications often become the first noticeable sign of the disease.

• Vessels and heart. High blood sugar accelerates atherosclerosis and raises the risk of heart attack and stroke — the leading cause of death in diabetes.
• Kidneys. Damage to the small vessels of the kidneys can lead to chronic kidney failure.
• Nerves. Diabetic neuropathy causes numbness, tingling and pain, most often in the feet.
• Eyes. Damage to the retinal vessels (retinopathy) is one of the causes of vision loss in adults.

The good news: at the prediabetes and early-diabetes stage these processes can still be slowed or reversed — which is why it's so important to catch high blood sugar early.

Who is at risk

The risk of type 2 diabetes is made up of many factors. Some cannot be changed — but they hint at how closely you should watch your blood sugar. Others depend on lifestyle, and those are exactly the ones worth working on.

• Age. Below 35 the baseline risk is low; in the late 30s to early 40s it starts to rise; 45–54 is the decade when prediabetes most often first appears; after 55 the lifetime risk is noticeably higher.
• Sex. At the same weight and activity, men's risk of type 2 diabetes is often a bit higher than women's.
• Ancestry (ethnicity). People of South Asian, Hispanic, African, Pacific Islander and Native American descent develop diabetes more often and at a lower weight than people of European descent.
• Family history. Diabetes in distant relatives slightly raises the risk, and in first-degree relatives (parents, a brother or sister) — considerably.
• A history of gestational diabetes. Diabetes during pregnancy or delivering a large baby (> 4 kg) raises a woman's long-term risk of T2D.
• High blood sugar in the past. Even a single borderline result — and all the more so repeated high glucose or HbA1c values — is a strong signal of future risk.

How to read your lab results

The two indicators give different snapshots: fasting glucose is “here and now,” while HbA1c is the average blood sugar over the last 2–3 months. A diagnosis is made from their combination, but even a single elevated result is a reason to check the other.

How to measure correctly

The accuracy of the screening depends on how the measurements are taken. Take them under the same conditions each time — that way the result can be fairly compared over time.

• Height. No shoes, standing straight against a wall. Measure under the same conditions.
• Weight. Ideally in the morning, on an empty stomach, on the same scale, in minimal clothing.
• Waist circumference. Per the WHO protocol — at the midpoint between the lower edge of the last palpable rib and the top of the hip bone. The tape runs parallel to the floor without compressing the skin; measure on a relaxed exhale.
• Glucose and HbA1c. From a blood chemistry panel: glucose is measured strictly fasting (8+ hours without food), while HbA1c can be taken any time — it doesn't depend on meals.

What the two indices mean

The tool deliberately computes risk from two angles — that gives a fuller picture than a single number.

• Prediabetes index (0–10). Estimates risk from lifestyle and history — without lab results. This is handy when you don't have a recent panel on hand: it shows how predisposed you are to prediabetes. Zones: 1–3 low, 4–6 moderate, 7–10 high.
• T2D index (0–100). Adds your lab values, weight and waist to the factors, so it more accurately reflects your current risk of type 2 diabetes specifically. Zones: <25 low, 25–50 moderate, ≥50 high.
• The overall level is taken from the highest of the indicators (including the lab classification): risk is always assessed “on the worse side” so as not to miss a problem.

How to lower your risk

You can't change your age or heredity, but you can influence weight, activity, diet and blood pressure. Introduce one or two changes at a time and repeat your lab tests every 6–12 months.

Frequently asked questions