The Top 10 Signs and Symptoms of Pre-Diabetes: A Wake-up Call to Your Health

This video discusses the top 10 signs and symptoms of pre-diabetes, which is considered to be the greatest hidden health threat in the world today. Pre-diabetes, also known as insulin resistance, affects approximately 88 million people in the US alone. The video emphasizes that pre-diabetes is a gradient, not a binary condition, and provides information on the scale used to measure it. It highlights the importance of recognizing the early signs and symptoms of pre-diabetes and understanding that an optimal hemoglobin A1c level is around 5.3. The video also discusses the potential consequences of untreated pre-diabetes, such as type 2 diabetes, and its impact on various body systems like circulation, vision, and digestion. Lastly, it emphasizes the role of insulin resistance in weight gain and increased hunger.

Author Icon

Our Summaries are written by our own AI Infrastructure, to save you time on your Health Journey!

How does this happen?

Key Insights:

  • Pre-diabetes is a significant health threat affecting millions of people worldwide.
  • Insulin resistance is a gradient, and it is important to know where you are on the scale.
  • Hemoglobin A1c is a reliable measure of average blood glucose over a three to four month period.
  • A normal A1c level is around 5, while anything above 5.7 is considered pre-diabetic and above 6.5 is type 2 diabetic.
  • Approximately 75% of pre-diabetics eventually develop type 2 diabetes.
  • Much of the population falls within the range of 5.3 to 5.7 A1c, indicating a glucose handling problem.
  • Common signs and symptoms of pre-diabetes include elevated fasting insulin, fatigue, poor wound healing, numbness and tingling, kidney damage, blurred vision, frequent urination, digestive issues, joint pain and arthritis, weight gain, and increased hunger.
  • Insulin resistance causes inflammation, which can lead to joint pain and arthritis.
  • Weight gain and increased hunger are common despite having excess energy reserves in the form of fat.
  • Insulin resistance does not always result in weight gain, and individuals can become pre-diabetic or type 2 diabetic with a normal body weight.
  • Insulin resistance is a significant health problem but not the only health issue to consider.


Hello Health Champions. This video, the top 10 signs and symptoms of pre-diabetes, may be the most important video you will ever watch because pre-diabetes is the single greatest hidden health threat in the world today. Pre-diabetes, also known as insulin resistance, affects about 88 million people in the US today, and even though the US is sort of the worst in the world so far, the rest of the world is catching up rather quickly.

And the thing we have to understand about insulin resistance is that it’s not a condition that you either have it or you don’t, it’s a gradient, it’s a question of where you are on the scale. And the scale we’re going to use here is hemoglobin A1c. So what is that? It’s a really good measure of your average glucose because when you have blood sugar, which everyone does, some of that sugar gets stuck to the red blood cells, and the red blood cells live for about three to four months. Therefore, if we measure how much sugar gets stuck, it’s a really good indicator of your blood sugar over a three to four month period.

A normal A1c is going to be somewhere around five. So, on the official criteria, anything less than 5.7 is normal. Then, if you’re over 5.7 but below 6.5, then you’re considered pre-diabetic. And anybody over 6.5 is a type 2 diabetic. In the US today, as I said, we have 88 million people in the pre-diabetic range, we have 35 million people with full-blown type 2 diabetes. But here’s why they call it pre-diabetes, because around 75% of the pre-diabetics will get type 2 diabetes. Statistically, not everybody, but most people will get it, and they typically will develop this somewhere around a five-year period. So, that means the diabetic epidemic that we’ve seen is just the tip of the iceberg because 75% of these 88 million people, that’s 66 million more, so in just a matter of time, we’ll probably have a hundred million type two diabetics.

But if we don’t just wait until we are pre-diabetic, if we understand that there’s a problem a little bit sooner than that and we understand that an optimal A1c is up to about 5.3, then we realize that there’s probably somewhere around 75 million people, and this is my guesstimate, there are no real numbers that I’ve been able to find, but just based on what I’ve seen, based on a lot of blood tests, we probably have about 75 million optimal people who have a normal and good glucose tolerance and glucose handling. So, that means that there’s a lot of people between 5.3 and 5.7, and that would make up about 150 million people who are slipping and they’re part of this massive momentum of eating the standard American diet, of eating processed foods, lots of sugar, lots of white flour. And that means that they are also moving, they’re slipping. So unless they change, then these people are just younger and they haven’t abused their bodies long enough. And if only about 75 million people are normal or optimal, that means almost 300 million people in the U.S. have some degree of glucose handling problem, and that means almost everyone that you know is affected by this. That’s why it’s so important to understand these things.

The most common way they diagnose pre-diabetes is when blood sugar is higher than normal but not as high as a diabetic. And that means that they measure the glucose and if the glucose is between 100 and 125 milligrams per deciliter, and if we measure the A1c we just talked about, it’s between 5.7 and 6.5. Even though they estimate 88 million people have this, they fall in this range, ninety percent of them don’t know it. And why is it that they don’t know it? It’s because we focus on blood sugar, we measure blood sugar, but blood sugar is something the body works very, very hard at keeping in a very narrow range because it’s super important for energy, for focus, for the brain, to keep it at a constant level.

So we have multiple systems in the body that are going to raise it when it’s low and lower it when it’s high. So if we measure something that is tightly controlled, we’re only going to see changes when the system has gone so far it completely failed. And that’s why when we measure blood sugar, we’ll see it be the same year after year after year. „No, you’re normal. No, you’re normal. Come back next year. No, you don’t have it yet. Come back next year.“ So 10 years, 15 years into it, we basically won’t see much difference. But the way the body keeps it down is with insulin. So if we measured insulin, we would see how hard the body is working at keeping it down. That’s a true measure of insulin resistance.

So, in the beginning, we might see a pretty balanced relationship between glucose and insulin. But a few years later, we might see two to three times as much insulin but the same glucose. The body is working twice as hard keeping it down. So if we only measure glucose, we miss it nine years later, 12 years later, 15 years later. And I’m not exaggerating these numbers, that a normal level of insulin is about three to four, maybe five, but by the time we get to diabetic, we’re at 25. And glucose changes very, very, very slowly. Like I said, only when the system fails are we going to see a change. Whereas if we watch the insulin instead, we will see almost a linear change. So we would know where we are on that scale. And if we look at the official criteria for insulin, we see that it’s a very wide range, it’s almost a tenfold difference. Normal is considered 2.6 all the way up to 25, whereas glucose has a very, very tight range. And if we measured it, then we would tell much, much earlier where we are.

So sign number two of insulin resistance, which really should be number one but it’s very rare that they measure it, is elevated fasting insulin. Sign and symptom number three is fatigue, and this is especially if you have fatigue after a meal. That’s a sign of insulin resistance. So when you eat food, then the purpose of that food is to be turned into energy, and this shouldn’t take a whole lot of effort for the body. It does require resources, and after a big meal, you often feel kind of relaxed, a little tired. But you shouldn’t have like a fatigue that interferes with what you’re doing. And if you do get severe fatigue, then it means that your carbohydrate machine is broken. You have a system to process carbohydrates, but if you have overwhelmed it over time, now it’s not really working anymore. So now you ate carbohydrates, but the cells are resisting because you’ve given them too much carbohydrate over too long a time, and they’re resisting. That’s insulin resistance. So now, instead of the food providing energy, you have to use energy to dispose of the carbs because they can’t stay in the bloodstream. That’s dangerous for the brain. We have to control this blood sugar, so the body has to use energy to convert the glucose into triglycerides. And this is why triglycerides or blood fats will get high when you eat glucose. So a lot of people on a low-fat diet will have very, very high blood fats because of this process.

Sign number four is poor wound healing. When you get a cut and it just kind of sticks around for weeks, and also number five, numbness and tingling, which is because of peripheral neuropathy. And I group these together because they are essentially the same cause, poor circulation. And why do you get poor circulation? Because the excess glucose, when you have a constant level of too much glucose, some of that leaks out into the surrounding tissues and it’s going to bind a little extra water, so we get swelling in the tissues. And this prevents the blood circulation from functioning optimally. And in the early stages, you might find that things just happen a little bit slower and you feel a little funny. And if this process continues uncontrolled, then eventually in type 2 diabetes, it could lead to amputation. Type 2 diabetes is the number one cause of amputations. And you’re not going to get amputations in pre-diabetes, but that’s why it’s so important to understand the process and change it early.

Number six is kidney damage, and there’s something called microvessel disease which is related to the circulatory issues we just talked about. And the kidney has an incredibly large number of tiny, tiny blood vessels. And if we get swelling, then we also get some leaking and some destruction of those blood vessels. And if we recognize the early signs, we can reverse it, but if it goes unchecked, then we will probably, at some point, see kidney failure. And type 2 diabetes is the number one cause of kidney failure, leading to dialysis.

Sign number seven is blurred vision, and this happens because of retinopathy, disease of the retina, which is the sensitive light-detecting area in the back of the eye. Now, I saw a video with millions of views, it was one of those animated things with a computerized voice, that said that retinopathy is swelling of the lens, which, of course, is incorrect because the lens is up in the front of the eye and the retina is in the back. So just like in the kidney, it’s a case of microvessel disease. You have tiny, tiny blood vessels, and when these blood vessels swell, then we have damage to the retina. And if this goes far enough, it can result in vision loss. You start with blurred vision, then eventually you could have vision loss. And again, type 2 diabetes is the number one cause of blindness. So you want to stop it long before that.

Another thing we hear about very often is frequent urination, and that is not a problem typically with pre-diabetes because pre-diabetes is when your blood sugar is 100-125, and there’s something called a kidney or renal threshold. If the blood sugar gets above 180, now there’s too much sugar in the blood for the kidneys to reabsorb that, so you filter it out with the water and then the kidneys reabsorb it. But it has to get pretty high, the diabetes has to be completely out of control before we start spilling sugar in the urine and losing water and getting very thirsty. So that’s a sign of a full-blown, really poorly controlled type 2 diabetes.

Another thing we often see claimed related to pre-diabetes is digestive issues. And while you can have that, it’s not a causal factor, it’s an association. The insulin resistance is not causing the digestive issues, it is probably because you have dysbiosis, you are screwing up your bacterial flora by feeding them the wrong foods. When you have an unbalanced flora and now you keep feeding them carbs, now you get bloating and digestive issues. So yes, you can have it, but it’s not the cause of the pre-diabetes.

Number eight is joint pain and arthritis. And while this does happen, it’s not for the reasons we think. Typically, what I hear people say is, „I’ve had hundreds of people come into the office and they say, ‚I know my knees are hurting, my back is hurting because of my weight. If I just lost some weight, I know I wouldn’t have that pain.'“ And that is not how it works. +We’ve heard it so many times that we think that the weight causes the pain, that there’s a direct relationship there, but that’s not true. Instead, insulin resistance causes inflammation, and this inflammation causes the joint pain and the arthritis because whether it’s osteoarthritis or rheumatoid arthritis, it’s an inflammatory condition. The osteoarthritis is a much milder form of inflammation, but it’s still inflammation. And then, of course, insulin resistance also causes weight gain.

So that’s number nine, weight gain. We know this because that’s the purpose of insulin. Insulin lowers blood glucose. It guides that glucose into the cell where a tiny bit can be stored as carbohydrate, and most of it gets stored as fat. That’s the purpose. And we can watch this relationship, this causal relationship, by giving people extra insulin and watching them gain weight. And this is what happens in the treatment of type 2 diabetes. They’re not treating the diabetes, they’re treating the blood glucose, making the diabetes worse and making the weight worse.

And sign and symptom number 10 is hunger. So even though you’re gaining weight, even though you’re having more and more energy reserves on your body in the form of fat, you’re getting hungrier and hungrier because when you’re insulin resistant, your body has a tendency to store rather than retrieve. So even though you have all that energy, you can’t get to it. Your body is in storage mode. You’re gaining weight, but you’re getting hungrier. So you’re gaining weight, but you’re getting hungrier, and on and on. And this is the real problem. This is why we can’t control our behavior. That’s why it’s not about calories, it’s about insulin and insulin resistance.

But there are two more things that we have to realize. One, you don’t necessarily gain weight when you become insulin resistant because a lot of it has to do with the liver. And a lot of people, even thin people, they might have a tiny little bit of a potbelly, usually. But you can become pre-diabetic and type 2 diabetic with a normal body weight. And the other thing to understand is that this is the biggest health problem that we have, but it’s not the only problem.

So if you’re watching this, don’t automatically think that all of what’s going on with you is insulin resistance. It is 80% or so of the problem for most people, but it’s not the only problem. If you enjoyed this video, you’re going to love that one, and if you truly want to master health by understanding how the body works, make sure you subscribe, hit that bell, and turn on all the notifications so you never miss a life-saving video.