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Blood tests for prediabetes What to check when your blood sugar is creeping up

More than 2 in 5 US adults have prediabetes, and 8 in 10 of them don’t know it.1 Finding it matters, because lifestyle change can cut the risk of diabetes by more than half.3 Here’s what to test, what the numbers mean and what to do next.

4 tests $19.00 Results in 2 to 3 days

The short answer

If your blood sugar is creeping up, four blood tests show whether you’re in the prediabetes range and give clues to whether insulin resistance is behind it. They also check the cholesterol changes that often come with it.2 HbA1c and fasting glucose, from a comprehensive metabolic panel, are the tests that diagnose prediabetes.2 A fasting insulin test adds a rough estimate of insulin resistance, and a lipid panel checks your cholesterol.

Before you go
Fast for 12 hours. Water is fine, but skip food, coffee and tea. If you take biotin, stop it 3 days before.
What the numbers mean
5.7% to 6.4% on HbA1c, or 100 to 125 mg/dL fasting glucose, is prediabetes.2 Above that is the diabetes range, which usually needs a second test to confirm.2
See a clinician soon
If you’re very thirsty, peeing much more than usual, losing weight without trying or your vision is blurry. Call 911 if you’re also vomiting, your breath smells fruity or you’re struggling to breathe.8 All the signs
What it costs
$19.00 for all four, from one blood draw. That’s the whole cost, and it’s HSA and FSA eligible.
The blood sugar tests
$19.00 · 4 tests, one draw
Order

What the four tests look for

Two measure your blood sugar and decide whether you have prediabetes. One adds a rough estimate of insulin resistance, and one checks the cholesterol changes that often come with it. All four come from one blood draw.

  1. 01

    Your average blood sugar

    HbA1c test

    Your average blood sugar over the past two to three months. Under 5.7% is normal, and 5.7% to 6.4% is prediabetes.2 You don’t need to fast for it, and it varies less from day to day than glucose does.2

    More likely to be raised if a parent, brother or sister has diabetes, or you had diabetes in a pregnancy.2

  2. 02

    Your fasting blood sugar

    Fasting glucose, in a metabolic panel

    Your blood sugar after a night without food: a snapshot of one morning, where HbA1c is an average. Under 100 mg/dL is normal, and 100 to 125 is prediabetes.2 The panel checks your kidneys and liver too.

    More likely to be raised if you carry extra weight around your middle or have high blood pressure.2

  3. 03

    Clues to insulin resistance

    Fasting insulin test

    When your body resists insulin, your pancreas makes extra to keep your blood sugar normal. Type 2 diabetes starts when it can’t keep up.2 Insulin is an extra next to HbA1c and glucose, not a diagnosis, and labs’ insulin tests give different numbers.2,9 With your fasting glucose, it gives a HOMA-IR score, a rough estimate with no agreed cutoff: studies put the line anywhere from about 1.6 to 3.8.4

    More likely to be high if you carry extra weight, or have PCOS or fatty liver.2

  4. 04

    The cholesterol changes that come with it

    Triglycerides and HDL, in a lipid panel

    Prediabetes often comes with high triglycerides and low HDL cholesterol.2 It raises your risk of heart disease as well as diabetes, so the American Diabetes Association advises checking your heart risk too.2

What else pushes blood sugar up?

Blood tests show where your blood sugar is, not what’s pushing it up, and that’s where the fixes are. In the Diabetes Prevention Program, losing weight and getting active cut the risk of diabetes by 58%.3

Weight around your middle

Extra weight causes some insulin resistance on its own, and prediabetes goes especially with weight around the waist.2

If you have weight to lose, aim for 7%, the trial’s goal: 14 pounds if you weigh 200.3

How active you are

Too little activity raises your risk, and moving more improves insulin resistance.2

Build up to 150 minutes a week of brisk walking. In the trial, people who got there cut their risk by 44%, even if they missed the weight goal.5

Sleep

Sleeping less than 6 hours a night, or more than 9, goes with up to 50% more risk of type 2 diabetes.5

Aim for about 7 hours, where the risk is lowest.5 If you snore or wake up unrefreshed, ask a clinician about a sleep test.

Medicines

Steroids such as prednisone, statins, thiazide water pills, some HIV medicines and some antipsychotics can raise blood sugar, often by causing insulin resistance.2

Don’t stop any of them. Ask whoever prescribed yours whether it could be playing a part.

PCOS or diabetes in pregnancy

Type 2 diabetes is more common in women with PCOS and in women who had diabetes in a pregnancy.2

Tell whoever reads your results. After diabetes in pregnancy, the ADA advises testing every 1 to 3 years for life.10

Fatty liver

Fat building up in the liver goes with insulin resistance.2 With prediabetes, especially with extra weight, the ADA advises checking for liver scarring even if your liver enzymes are normal.6

Ask a clinician about a FIB-4 score. It uses your age, a platelet count from a blood count test and the ALT and AST from your metabolic panel.6 The full checkup includes the blood count.

See a clinician soon if you notice

  • Strong thirst that doesn’t let up
  • Peeing much more than usual
  • Weight loss you can’t explain
  • Blurry vision
  • Frequent urinary or yeast infections
  • Cuts or sores that are slow to heal
  • Numbness or tingling in your hands or feet
  • Dark patches of skin on your neck, armpits or groin
  • Feeling much hungrier or more tired than usual

These can be signs that your blood sugar is already high, so see a clinician rather than waiting to retest.2,7 Call 911 or go to the emergency room if you’re vomiting and can’t keep fluids down, your breath smells fruity or you’re breathing fast and deep or struggling to breathe. Go too if several signs come together, such as stomach pain, nausea and feeling very tired. These can be signs of diabetic ketoacidosis, which is sometimes the first sign of diabetes.8

How to get tested, and what it costs

Order the four tests on their own, or get them inside a full yearly checkup. Either way it’s one blood draw, and the checkup adds a urine sample.

The blood sugar tests
$19.00

The four tests on this page, from one blood draw. Fast for 12 hours first.

Best if your blood sugar is the thing you want answered.

Order the four tests
Base Core Annual
$213.25

The same checks, with an advanced cholesterol test that adds a second insulin resistance score, plus ApoB, Lp(a), thyroid, iron, vitamins and hormones: a full yearly checkup. 23 tests. Fast for 12 hours first.

Best if you also want your heart risk, thyroid and hormones checked, or it’s been a while since a checkup.

For women For men
  1. 01

    Order online

    Pick the four tests or the full checkup. The price is the whole cost, and you can pay with an HSA or FSA card.

  2. 02

    Blood draw

    Fast for 12 hours first; water is fine. If you take biotin, stop it 3 days before. Go to any Labcorp location for free, or have blood drawn at home for $75.

  3. 03

    Get your results

    In the Picardo app in 2 to 3 days, with an explanation of each one. Ask Picardo what they mean, and book a physician follow-up if you want one.

Already have results?

My HbA1c is 5.7% to 6.4%

That’s prediabetes, and the risk of diabetes climbs faster toward the top of that range.2 Weight loss and activity can bring it back to normal, and getting there even once goes with a lower risk of diabetes later.5 Retest at least once a year.5

Check your HbA1c number

My fasting glucose is 100 to 125

That’s prediabetes too, called impaired fasting glucose.2 Glucose varies a lot from one morning to the next, so look at your HbA1c as well before you draw conclusions.2

Check your fasting glucose number

My HbA1c and glucose don’t agree

They measure different things: HbA1c is a two-to-three-month average, and glucose is one morning. When only one is in the diabetes range, the ADA advises repeating that one.2 Anemia, low iron, recent blood loss or a transfusion, pregnancy, kidney failure and some hemoglobin variants can make HbA1c misleading, so glucose is used instead.2

My HbA1c is 6.5% or higher

That’s in the diabetes range. Unless you have clear symptoms and a very high glucose, it needs a second abnormal result to confirm it: HbA1c again, or a fasting glucose of 126 mg/dL or more, which can come from the same draw.2 See a clinician in the next week or two to plan what’s next, or sooner if you have any of the warning signs.

My blood sugar is normal but my insulin is high

That often goes with insulin resistance: your pancreas making extra insulin to keep your blood sugar normal.2 The ADA doesn’t use insulin to diagnose anything, labs’ insulin tests differ and published HOMA-IR cutoffs run from about 1.6 to 3.8, so treat it as a rough early warning, not a diagnosis.2,4,9 Losing extra weight and being more active improve it.2

Work out your HOMA-IR

Ask Picardo about your results. The app explains what each one means, and a physician can follow up if you want.

Questions people ask

What blood tests check for prediabetes?

HbA1c and fasting glucose, the two tests usually used to screen for it.2 An HbA1c of 5.7% to 6.4%, or a fasting glucose of 100 to 125 mg/dL, is prediabetes.2 Insulin and a lipid panel add clues to insulin resistance and the cholesterol changes that often come with it.

Do I need to fast for these tests?

Yes, for 12 hours, because the glucose and insulin tests need a fasting sample. HbA1c doesn’t, since a recent meal won’t change it.2 Water is fine, but skip food, coffee and tea. A morning appointment makes it easier. If you take biotin, stop it 3 days before: it can throw off the insulin result.

Can prediabetes be reversed?

It can be. In the Diabetes Prevention Program, aiming to lose 7% of body weight and to be active 150 minutes a week cut the risk of diabetes by 58% over about three years.3 Getting back to normal blood sugar, even once, went with a lower risk of diabetes later.5

Is there a blood test for insulin resistance?

Not one with an agreed cutoff. Fasting insulin and glucose from the same draw give a HOMA-IR score, but studies put the line for insulin resistance anywhere from about 1.6 to 3.8,4 and insulin tests differ between labs.9 The ADA doesn’t use insulin to diagnose anything, so treat it as a clue rather than a diagnosis.2

How often should I get my blood sugar checked?

Every three years from age 35 if it’s normal, and every year if you have prediabetes.2 Start younger if you carry extra weight and have another risk factor, such as diabetes in a parent, brother or sister, high blood pressure or PCOS.2

Can I get these tests without seeing a doctor first?

Yes. Order them online, get a blood draw at a Labcorp location or at home, and your results arrive in the Picardo app in 2 to 3 days. You can book a physician follow-up if you want to talk them through.

What happens if a result is off?

The app explains what it means and what usually comes next. For prediabetes, that’s usually weight loss and more activity,5 and a result in the diabetes range needs a second test and a clinician.2 A physician can follow up if you want one.

Do I need medicine for prediabetes?

Usually not at first. In the Diabetes Prevention Program, lifestyle change cut the risk of diabetes by 58%, against 31% for metformin.3 The ADA suggests considering metformin at especially high risk: for example, if you’re 25 to 59, have a BMI of 35 or more, a fasting glucose of 110 mg/dL or more or an HbA1c of 6.0% or more, or had diabetes in pregnancy.5 In people with obesity, weight-loss drugs such as semaglutide and tirzepatide also lower the risk, though none is approved just to prevent diabetes.5

Sources

  1. 1 Centers for Disease Control and Prevention. A U.S. report card. Updated March 16, 2026. Accessed October 28, 2026. www.cdc.gov/diabetes/communication-resources/diabetes-statistics.html
  2. 2 American Diabetes Association Professional Practice Committee for Diabetes. 2. Diagnosis and classification of diabetes: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S27–S49. doi.org/10.2337/dc26-S002
  3. 3 Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393–403. doi.org/10.1056/NEJMoa012512
  4. 4 Gayoso-Diz P, Otero-González A, Rodriguez-Alvarez MX, et al. Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study. BMC Endocr Disord. 2013;13:47. doi.org/10.1186/1472-6823-13-47
  5. 5 American Diabetes Association Professional Practice Committee for Diabetes. 3. Prevention or delay of diabetes and associated comorbidities: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S50–S60. doi.org/10.2337/dc26-S003
  6. 6 American Diabetes Association Professional Practice Committee for Diabetes. 4. Comprehensive medical evaluation and assessment of comorbidities: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S61–S88. doi.org/10.2337/dc26-S004
  7. 7 Centers for Disease Control and Prevention. Symptoms of diabetes. Updated May 15, 2024. Accessed October 28, 2026. www.cdc.gov/diabetes/signs-symptoms/index.html
  8. 8 Centers for Disease Control and Prevention. Diabetic ketoacidosis. Updated May 15, 2024. Accessed October 28, 2026. www.cdc.gov/diabetes/about/diabetic-ketoacidosis.html
  9. 9 Rohlfing C, Petroski G, Hatten-Beck M, et al. The current status of serum insulin measurements and the need for standardization. Clin Chem Lab Med. 2025;63(12):2442–2446. doi.org/10.1515/cclm-2025-0552
  10. 10 American Diabetes Association Professional Practice Committee for Diabetes. 15. Management of diabetes in pregnancy: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S321–S338. doi.org/10.2337/dc26-S015

Updated 4 Nov 2026.

This is general health information, not medical advice: talk to your clinician about your results and before changing any treatment.