More than 85 million Americans over 18 have prediabetes, according to the ADA. If you have already been diagnosed with prediabetes, you are at risk of joining the 1.5 million Americans newly diagnosed with diabetes every year. If you have a fasting glucose level between 100 and 125 mg/dL, and/or a hemoglobin A1c level between 5.7 and 6.4, you are considered prediabetic. Without some form of intervention, you are likely to progress to full Type 2 diabetes over time.

Genetics and heredity can play a role in developing Type 2 diabetes. You are at increased risk if any of the following family members have the disease:

• Parents
• Grandparents
• Aunts/Uncles
• Siblings

If you are overweight or obese, you are at greater risk of having or developing Type 2 diabetes. A particular risk factor is excess belly fat, which gets in the way of your body’s ability to manufacture insulin and handle glucose.

The risk of Type 2 diabetes starts increasing after the age of 45. After age 65, your risk increases significantly. Official guidelines recommend you get a Type 2 diabetes screening every 3 years after the age of 45.

You face a higher risk of developing Type 2 diabetes if you are a member of one of the following racial or ethnic groups:

• African-Americans
• Native Americans
• Latinos
• Asians
• Pacific Islanders

Cigarette smoking increases your risk of developing Type 2 diabetes. The number of cigarettes smoked also correlates to your risk, and smoking more than 25 cigarettes per day significantly increases your risk of Type 2 diabetes.

If you aren’t getting much physical activity, you are at greater risk of Type 2 diabetes. You don’t need to be a fitness fanatic, but regular physical activity and exercise improves sensitivity to insulin, processing of glucose, and lowers your Type 2 diabetes risk.

Other medical risk factors for Type 2 diabetes include:

• High blood pressure, with readings above 140/ 90 mmHg
• High triglyceride levels above 250 mg/dL
• Low HDL (“good” cholesterol) below 35 mg/dL
• Hypothyroidism (Note: Hypothyroidism is a risk even if diagnosed and treated.)
• Sleep apnea: breathing issues while sleeping, often associated with snoring

What you eat – or don’t eat – affects your risk of Type 2 diabetes. The following nutritional issues increase your Type 2 diabetes risk:

• Your diet is high in red meat and poultry
• Your diet is low in fiber
• You eat a high-glycemic (high in processed carbohydrates and sugar) diet
• Your diet is low in antioxidant-rich fruits and vegetables

Woman have several gender-specific risk factors for type 2 diabetes.

• Gestational diabetes puts you at a 3-7 times higher risk of developing Type 2 diabetes in the 5-10 years after pregnancy.
• Research shows that more than half of all women diagnosed with polycystic ovary syndrome (PCOS) develop prediabetes or Type 2 diabetes.
• A Dutch study found that early menopause before 40 is a risk factor
• Having breast cancer – especially the BRCA1 and BRCA2 genes – is a risk
• Taking a statin drug

If you are prediabetic or have undiagnosed and untreated Type 2 diabetes, you may have some of the following symptoms:

• Increased thirst
• Frequent urination
• Increased hunger
• Unexpected weight loss
• Fatigue
• Irritability
• Blurry vision
• Numb/tingling hands or feet
• Dark, velvety skin patches in folds of skin (armpits and neck) called acanthosis nigricans

Currently, guidelines recommend diabetes screening every three years only if you are over the age of 45 and overweight. It's estimated that this screening misses more than half of people at high-risk of developing (or having) Type 2 diabetes.

Experts now recommend screening if you have at least one of the following risk factors:

• Over age 45
• Overweight
• Family history of diabetes
• History of gestational diabetes
• Polycystic ovarian syndrome (PCOS)
• Non-white race or ethnicity

Prediabetes and Type 2 diabetes are diagnosed by blood tests, or in some cases, the oral glucose tolerance test. Here are the criteria for diagnosis:

Prediabetes

• An A1C level of 5.7 to 6.4 percent
• Fasting glucose level of 100 mg/dL or higher, and/or
• A 2-hour glucose tolerance level of 140 mg/dL or higher

Type 2 diabetes

• An A1C level of 6.5 percent or higher
• Fasting glucose level of 126 mg/dL or higher on at least 2 occasions, and/or
• A 2-hour glucose tolerance level of 200 mg/dL or higher