Prediabetes means your blood glucose is higher than it should be, but not yet high enough to be called diabetes. It usually has no symptoms at all. It is also the single most modifiable stage in the whole metabolic disease pathway — the point where diet, movement and sleep still change the trajectory, and where most people never find out they are standing.
India has an estimated 136 million people with prediabetes and 101 million with diabetes — a weighted prevalence of 15.3% and 11.4% respectively (ICMR-INDIAB-17 national study, published in The Lancet Diabetes & Endocrinology, 2023). Abdominal obesity, the strongest single predictor, affects 39.5% of adults.
The number that matters is the first one. Prediabetes is a warning, not a diagnosis, and the population carrying it is larger than the population that has already crossed over.
South Asians develop insulin resistance at lower body weights than European populations, and carry more of their fat viscerally — around the organs rather than under the skin. Visceral fat is metabolically active and drives insulin resistance directly.
This is why Healthness+ scores BMI against the Indian consensus thresholds rather than the international ones. Overweight begins at a BMI of 23, not 25, and obesity at 25, not 30. A person told they are a “normal weight” under the WHO chart can be well inside the risk range under the Indian one.
Muscle, liver and fat cells stop responding properly to insulin. The pancreas compensates by producing more of it. For years — often a decade — blood glucose stays near normal because the extra insulin is doing the work, which is precisely why a single fasting glucose reading can look reassuring while the underlying problem is well advanced.
Prediabetes is the stage where that compensation starts to fail. Weight around the middle, energy crashes after meals, skin tags, darkened patches at the neck or armpits, and a family history of diabetes are all worth taking seriously together, even when each one on its own looks minor.
The interventions with the strongest evidence are unglamorous and behavioural rather than pharmacological:
The Healthness+ Health Risk Assessment scores metabolic signals alongside sleep, stress, gut and activity, because prediabetes rarely arrives on its own. A raised metabolic score sitting next to a poor sleep score is a different problem from the same score with good sleep, and it needs a different plan.