In one 2024 screening, almost 4 in 10 people had prediabetes and most had no idea. Here's what the numbers mean, which tests to ask for, and why this stage is so hopeful.
If I could get one message across to every adult in Singapore, it would be this: Type 2 Diabetes rarely arrives out of nowhere. For most people there is a long, quiet stage beforehand, often lasting years, when blood sugar is creeping up but nothing feels wrong.
That stage is called prediabetes. It's incredibly common here, it's usually invisible, and it's also the point at which you have the most power to change the story.
Prediabetes means your blood glucose is higher than normal, but not high enough to be diagnosed as diabetes. Underneath, it usually reflects insulin resistance: your cells have become less responsive to insulin, so your pancreas has to work harder to keep blood sugar in check. For a while, it manages. Eventually, for many people, it can't keep up.
More common than most people think.
Prediabetes isn't a diagnosis to fear. It's an early warning, and early warnings are a gift.
Because it usually doesn't feel like anything. Some people notice subtle signs, but none of them are reliable on their own:
The only way to know is to test.
I was 38 when I was diagnosed with Type 2 Diabetes, at the same time as breast cancer. That experience is a big part of why I do this work today. I want more people to understand their numbers and catch rising blood sugar at the prediabetes stage, when change is easier.
These are the common tests, and the cut-offs used in Singapore's clinical guidance.2
| Test | What it shows | Prediabetes range |
|---|---|---|
| Fasting plasma glucose | Your blood sugar after an overnight fast | 6.1–6.9 mmol/L (impaired fasting glucose) |
| Oral glucose tolerance test (OGTT) | How well your body clears a standard sugar drink after 2 hours | 7.8–11.0 mmol/L (impaired glucose tolerance) |
| HbA1c | Your average blood sugar over roughly the past 2 to 3 months | Often included in health screening reports, but Singapore's guidance does not currently use it to diagnose prediabetes |
You may also see different thresholds online. For example, the American Diabetes Association considers an HbA1c of 5.7–6.4% to indicate prediabetes.4 If your HbA1c is in that range, it's worth a conversation with your doctor, even if your report doesn't flag it.
According to Singapore's clinical guidance, lifestyle intervention reduces the risk of developing Type 2 Diabetes by 31 to 37% over 2 to 6 years. The recommended targets are practical: at least 150 minutes a week of moderate activity such as brisk walking, and losing 5 to 10% of body weight (or reaching a BMI under 23) if you're carrying extra weight.2
Here's where I'd start:
Eat vegetables and protein before your rice or noodles. In one study, this simple change lowered post-meal glucose by up to 37%.5
Sweetened kopi, teh, juices and bubble tea add up quickly. Moving to siew dai and then kosong is one of the easiest wins.
A 10-minute walk after your biggest meal helps your muscles soak up glucose. Adding strength training twice a week gives that glucose more places to go.
Short sleep and chronic stress both push blood sugar up. They're not "soft" factors. They show up in your numbers.
A standard health screen gives you a snapshot. A CGM shows you the whole movie: which meals, habits and situations push your glucose up, so you can focus your effort where it matters most for you.
Rosalind had gained 7kg and couldn't understand why, even though she was eating clean and exercising, and her doctor couldn't find an issue. Wearing a CGM revealed hidden carbs that were quietly spiking her blood sugar. With a few simple changes, she lost all 7kg and more.
Prediabetes is common, silent and serious, but it is not a life sentence. If you haven't had your blood sugar checked recently, book a screening. If you've been told your numbers are "a bit high", take it as your invitation to act now, while the changes are smaller and the results come faster.
And if you have been diagnosed with diabetes already, please don't lose hope. I was told reversing mine was highly unlikely. No diagnosis is final.
I'm May, a breast cancer survivor who reversed my Type 2 Diabetes with the help of a CGM. I now coach people in Singapore to understand their blood sugar and build habits that last.
Work with meJoin a CGM workshopThis article is for education only and is not medical advice. Please speak with your doctor before making major changes to your diet, exercise or medication, especially if you have a pre-existing medical condition.
