Pre-diabetes develops when blood sugar levels are higher than normal but not yet high enough for a type 2 diabetes diagnosis. According to Dr. Sadovskaya, this stage can last for years without obvious symptoms — but there are subtle physical and behavioral changes you can look out for. Catching them early can make a big difference in prevention. Read on to discover the six most ‘common’ signs.
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1. Excessive Stomach Fat
Carrying most of your weight around the belly — sometimes called “visceral fat” — isn’t just stubborn to lose; it’s also metabolically active and can interfere with the way insulin works in your body. This increases the risk of insulin resistance, which is the hallmark of pre-diabetes. Even people who appear slim can have excess visceral fat, so waist circumference can be an important measure to monitor.
2. Papillomas (Skin Tags)
Those tiny, soft, skin-colored growths that often pop up around the neck, eyelids, or underarms may be more than a cosmetic nuisance. In some cases, their appearance is linked to high insulin levels in the blood, which can trigger excess skin cell growth. While skin tags are common, an increase in their number — especially alongside other symptoms — should be discussed with a healthcare provider.
3. Dark Underarms
A condition known as acanthosis nigricans causes patches of skin to become darker, thicker, and sometimes velvety in texture. This change often appears in skin folds, such as under the arms, behind the neck, or in the groin area, and is a strong physical marker of insulin resistance. This happens because excess insulin stimulates skin cells and pigmentation, making it an important visual warning sign.
4. Increased Appetite & Sugar Cravings
If you find yourself reaching for sweet snacks more often — or feeling hungry soon after eating — your body may be struggling to keep blood sugar stable. When insulin function is impaired, glucose has a harder time entering cells for energy, prompting the body to signal for more food, especially quick sugar sources. This can create a cycle that pushes blood sugar levels even higher over time.
5. Sleepiness After Eating
That heavy, drowsy feeling after meals isn’t just from eating too much. In people with pre-diabetes, large swings in blood sugar can cause post-meal fatigue as the body works overtime to move excess glucose into cells. Over time, this sluggish response can signal worsening insulin resistance and may also contribute to weight gain.
6. Difficulties Concentrating
The brain relies heavily on a steady supply of glucose to function optimally. When blood sugar levels rise and fall rapidly, it can lead to “brain fog” — moments of forgetfulness, poor focus, or trouble processing information. Inconsistent glucose supply can impair cognitive performance over time, and in the long run, it’s linked to higher risks of dementia and other brain-related conditions.
Dr. Sadovskaya notes that recognizing these signs early gives you the best chance to reverse pre-diabetes through lifestyle changes like balanced eating, regular exercise, stress management, and routine blood sugar checks.
