Most health problems announce themselves with something, whether that is a pain, a cough, or a change you can see in the mirror. The early stage of type 2 diabetes usually announces itself with nothing at all, and that silence is exactly why so many Canadians are living with it right now.
Prediabetes means your blood sugar is running higher than normal, though not yet high enough to count as type 2 diabetes. Diabetes Canada estimates that about 6 million Canadians have it, and because prediabetes symptoms are usually absent, most people only find out through a blood test. With November marking Diabetes Awareness Month in the country where insulin was discovered, this guide covers how you would know, what the numbers mean, and what you can still change.
Key takeaways
Diabetes Canada estimates that about 6 million Canadians have prediabetes, and close to 12 million live with diabetes or prediabetes.
More than a million Canadians are estimated to have type 2 diabetes without knowing it.
Prediabetes is usually found through a blood test, since it rarely causes anything you would notice.
Diabetes Canada recommends a blood sugar test every 3 years from age 40, and earlier or more often if you have risk factors.
Lifestyle changes can delay or prevent type 2 diabetes, and about half of people with prediabetes go on to develop it if nothing changes.
Why does high blood sugar feel like nothing at first?
The uncomfortable truth is that slightly high blood sugar usually feels like nothing at all. There is no pain, no obvious thirst, and no dramatic signal that sends you to a doctor, so your blood sugar can drift upward for years while you feel completely normal.
That silence helps explain why more than a million Canadians are living with type 2 diabetes they do not know about, according to Diabetes Canada. By the time the classic signs appear, such as constant thirst, frequent trips to the bathroom, blurry vision, or unexplained tiredness, the early window has often closed. That is why the in-between stage is found almost entirely one way, through a blood test that somebody thought to order.
What is insulin resistance doing inside your body?
Insulin is the hormone that moves sugar out of your blood and into your cells, where it becomes energy. Type 2 diabetes develops when the body stops responding to insulin properly, a problem called insulin resistance, and sugar starts to build up in the blood as a result.
In the early stage, your pancreas is still keeping up, though it is working overtime to do it. Picture a furnace running nonstop to hold a house at the right temperature while someone slowly opens the windows wider. For a while the house stays warm, and that is the stretch when a simple test can catch the strain before anything feels wrong.
Which risk factors can you actually change?
Some risk factors are out of your hands. Getting older, having a parent or sibling with type 2 diabetes, and being of Indigenous, Asian, Hispanic, or African descent all raise the odds. Age plays a bigger part than most people expect, as our guide to why your body handles sugar worse as you get older explains.
Other risk factors respond to everyday choices, including carrying extra weight around the middle, sitting for most of the day, and living with high blood pressure or high cholesterol. Those are the ones you can work on, and they matter because type 2 accounts for roughly 90 percent of diabetes in Canada, according to Diabetes Canada.
Can lifestyle changes still turn things around?
This is the part that gets lost when people first hear the word prediabetes. It is the one stage where you can still rewrite the story, and Diabetes Canada says that lifestyle changes can delay or even prevent type 2 diabetes. Without them, about half of people with prediabetes go on to develop it.
The changes that move the needle are rarely dramatic. Canadian guidelines recommend about 150 minutes of moderate activity a week, which works out to a brisk half-hour walk on five days, and losing even a modest amount of weight helps. Building meals around enough protein and fibre also steadies blood sugar, and our guide to whether you are eating enough protein is a practical place to start.
Some doctors also prescribe medication for people at higher risk. Either way, the early stage is less a verdict than a fork in the road, and most people never choose a direction because they never learn they are standing at it.
Prediabetes is common in Canada, and most of it goes unnoticed until someone orders a test.
Is the CANRISK quiz worth a few minutes?
The fastest first step is free and takes only a few minutes. The Public Health Agency of Canada's CANRISK questionnaire asks roughly a dozen questions about your age, family history, waist size, activity, and diet, then estimates your risk of prediabetes or type 2 diabetes. The agency built it for adults aged 40 to 74.
A high CANRISK score does not mean you have prediabetes. It is a reason to take the second step, which is a simple blood test, and to talk through your result with a doctor or nurse practitioner.
What does an A1C test actually tell you?
An A1C test measures your average blood sugar over roughly the past three months from a single blood sample, usually with no fasting needed. A fasting blood sugar test, taken after at least eight hours without food, is the common alternative.
Under Diabetes Canada's clinical practice guidelines, an A1C of 6.0 to 6.4 percent or a fasting result of 6.1 to 6.9 mmol/L points to prediabetes. An A1C of 6.5 percent or a fasting result of 7.0 mmol/L and above falls in the diabetes range, while results just below the prediabetes range are flagged as at risk and worth rechecking sooner.
Diabetes Canada recommends testing every 3 years from age 40, and earlier or more often if you have risk factors such as a family history or high blood pressure. Doctors usually confirm a result in the diabetes range with a second test on another day before making a diagnosis.
Diabetes Canada's guidelines sort results into four bands, and the two in the middle are where action helps most.
What should you do with a borderline result?
If a past borderline result ever came back a little high and no one followed up, treat this article as your follow-up. Ask your doctor for the actual number and when to test again, since the trend over time tells you more than any single reading.
Then pick changes you can keep up, instead of the ones that sound impressive. A daily walk you will actually take beats a gym plan you abandon by December, and swapping sugary drinks for water is one of the simplest food changes there is. Meals built around vegetables, protein, and fibre help blunt blood sugar spikes, and sleep and stress belong on the list too, since both push blood sugar around more than most people realize.
A registered dietitian can turn all of that into a plan built around what you actually eat, and many provinces offer diabetes prevention or education programs at no cost. These steps give you a simple order to work through.
Take the CANRISK quiz. Answer the questions online and note your score.
Book a blood test. Ask for an A1C or fasting blood sugar test if your score is moderate or high, or if you are 40 or older and have not been tested in 3 years.
Ask for your number. Find out the actual result and when to retest, instead of settling for normal or borderline.
Choose one change. Start with the habit you can keep, such as a daily walk or swapping sugary drinks for water.
Get support. Ask about a referral to a registered dietitian or a local diabetes prevention program.
Frequently asked questions
What are the warning signs of high blood sugar?
Most prediabetes symptoms are invisible, so many people feel completely well. As blood sugar climbs higher, signs can include constant thirst, frequent trips to the bathroom, blurry vision, tiredness, and cuts that heal slowly. Those usually point to diabetes that has already developed, which is why a blood test matters more than waiting for symptoms.
Can you feel it when your blood sugar is borderline?
Most people cannot feel anything at all, and that is the problem. Prediabetes symptoms are usually absent or easy to blame on a busy life, such as mild tiredness. The only reliable way to know is an A1C or fasting blood sugar test, which a doctor or nurse practitioner can order for you.
How often should you get your blood sugar tested?
Diabetes Canada recommends testing every 3 years from age 40. If you have risk factors, such as a family history of type 2 diabetes, high blood pressure, or a past borderline result, your doctor may test earlier and more often, sometimes every 6 to 12 months. Ask what schedule fits your situation.
Do you need to fast before an A1C test?
An A1C test usually needs no fasting, because it reflects your average blood sugar over about three months instead of a single moment. A fasting blood sugar test is different and typically requires at least eight hours without food or drinks other than water. Check the instructions on your requisition before you go.
Can borderline blood sugar go back to normal?
For many people, it can, especially when it is caught early. Diabetes Canada says lifestyle changes such as regular activity, healthier eating, and modest weight loss can delay or prevent type 2 diabetes. Retesting over time shows whether the changes are working, so ask your doctor when to check again.
Does eating sugar raise your risk?
Sugar alone is only part of the story. Type 2 diabetes develops when the body stops responding well to insulin, which is linked to age, family history, extra weight around the middle, and inactivity. Sugary drinks can add to the risk, so cutting them is one of the simplest changes you can make.
Who should take the CANRISK quiz?
The CANRISK questionnaire is designed for adults aged 40 to 74, though younger adults with risk factors such as a family history can still find it useful. It takes a few minutes and estimates your risk of prediabetes or type 2 diabetes. A high score is a reason to book a blood test, and it is never a diagnosis.
Your next step
Prediabetes only stays invisible if nobody looks for it. The Medimap Health Hub has more on blood sugar and everyday health, and you can find a family practice near you or book a walk-in clinic visit to ask for a blood test before November gets away from you.
Disclaimer: This article is for general information only and is not medical advice. It does not replace a conversation with a doctor or other qualified health professional who knows your history. If you think you are having a medical emergency, call 911 or go to the nearest emergency department.
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