Prediabetes: India’s 13.6-Crore Warning Sign You Can Still Act On
There is a stage before diabetes with almost no symptoms, and for many people it is still reversible. What prediabetes means on a lab report, why it is easy to miss, and the habits that turn it around.
There's a stage before diabetes that most people walk straight through without noticing. It has no real symptoms. You feel fine. And it is, for a great many people, still reversible. In India, roughly 13.6 crore adults are living in exactly this window right now.
It's called prediabetes, and it deserves far more attention than it gets, not as a cause for panic, but as an early warning that still leaves room to act.
What "prediabetes" means on a lab report
Prediabetes is a state where blood glucose is higher than normal but not yet high enough to be called diabetes. Clinicians usually spot it through one of a few tests:
- HbA1c (a three-month average of blood sugar) between roughly 5.7% and 6.4%.
- Fasting glucose in the impaired range, above normal but below the diabetes threshold.
- An oral glucose tolerance test showing impaired handling of a sugar load.
Your doctor decides which test and which cut-off applies to you. The point for the rest of us is simpler: these numbers can be measured cheaply, and knowing them changes what you can do about them.
Why it's so easy to miss
Prediabetes rarely announces itself. There's no dramatic thirst, no obvious warning. That's precisely why it's dangerous, and why South Asians deserve extra vigilance, since research shows people of Indian origin tend to develop insulin resistance at a lower body weight than many other populations. Being slim is reassuring, but it isn't a guarantee.
The hopeful part: this stage can often be turned around
Unlike a lot of health news, this one comes with genuine agency. Large studies of lifestyle change have shown that modest, sustained habits can significantly lower the chance of prediabetes progressing to type 2 diabetes. The levers are unglamorous and effective:
- Movement most days. Regular activity, even brisk walking, improves how sensitively your body responds to insulin.
- A modest, steady drop in excess weight, where relevant, has an outsized effect on blood sugar.
- Fewer refined carbohydrates and sugary drinks, more fibre from vegetables, whole pulses and whole grains.
- Sleep and stress, the quiet variables that nudge blood sugar in the wrong direction when they're chronically off.
The one action that matters most
You cannot manage a number you've never measured. If you're an adult, especially with a family history of diabetes, a larger waistline, or high blood pressure, a simple fasting glucose and HbA1c test is inexpensive and widely available. Ask your doctor whether you're due for one.
Prediabetes isn't a diagnosis to fear. It's a door that's still open. The people who do best are simply the ones who noticed it in time.
References & further reading
- Anjana RM et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study. The Lancet Diabetes & Endocrinology, 2023. thelancet.com
- Indian Council of Medical Research. ICMR-INDIAB study executive summary. icmr.gov.in (PDF)
- ICMR-National Institute of Nutrition. Dietary Guidelines for Indians, 2024. icmr.nic.in (PDF)
This article is for educational purposes only and does not constitute medical advice. Please consult a qualified doctor or dietitian before making changes to your diet, exercise, or medication. Data cited is the most recent available at the time of writing.
