Risk factors

The same factors that increase the odds of getting type 2 diabetes also increase the risk of prediabetes. These factors include:

• Weight. Being overweight is a primary risk factor for prediabetes. The more fatty tissue you have — especially inside and between the muscle and skin around your abdomen — the more resistant your cells become to insulin.
• Waist size. A large waist size can indicate insulin resistance. The risk of insulin resistance goes up for men with waists larger than 40 inches and for women with waists larger than 35 inches.
• Diet. Eating red meat and processed meat, and drinking sugar-sweetened beverages, is associated with a higher risk of prediabetes. A diet high in fruits, vegetables, nuts, whole grains and olive oil is associated with a lower risk of prediabetes.
• Inactivity. The less active you are, the greater your risk of prediabetes. Physical activity helps you control your weight, uses up sugar for energy and makes the body use insulin more effectively.
• Age. Although diabetes can develop at any age, the risk of prediabetes increases after age 45.
• Family history. Your risk of prediabetes increases if you have a parent or sibling with type 2 diabetes.
• Race or ethnicity. Although it's unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are more likely to develop prediabetes.
• Gestational diabetes. If you had diabetes while pregnant (gestational diabetes), you and your child are at higher risk of developing prediabetes. If you've had gestational diabetes, your doctor will likely check your blood sugar levels at least once every three years.
• Polycystic ovary syndrome. Women with this common condition — characterized by irregular menstrual periods, excess hair growth and obesity — have a higher risk of prediabetes.
• Sleep. People with obstructive sleep apnea — a condition that disrupts sleep repeatedly — have an increased risk of insulin resistance.
• Tobacco smoke. Smoking may increase insulin resistance. Smokers also seem to carry more weight around the middle.

Other conditions associated with prediabetes include:

• High blood pressure
• Low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol
• High levels of triglycerides — a type of fat in your blood

When these conditions occur with obesity, they are associated with insulin resistance.

The combination of three or more of these conditions is often called metabolic syndrome.