One in Five Americans Don't Know They Have Diabetes—Here's Why That Matters

More than 38 million Americans are living with diabetes, yet approximately one in five people with the condition don't know they have it. This gap in awareness creates a silent health crisis, leaving millions vulnerable to serious complications like heart disease, vision loss, and nerve damage without even realizing they're at risk. The good news: early detection through simple screening tools can help catch diabetes before it causes irreversible damage.

Why Are So Many People Unaware They Have Diabetes?

Type 2 diabetes, which accounts for about 90% of all diabetes cases, often develops quietly. Unlike Type 1 diabetes, which comes on suddenly with obvious symptoms, Type 2 diabetes can progress for years without noticeable warning signs. Many people don't realize their body is struggling to manage blood sugar (glucose) levels until they experience complications or get screened during a routine health visit.

The symptoms of Type 2 diabetes can be subtle and easy to dismiss. You might notice increased thirst and urination, persistent fatigue, slow-healing cuts and wounds, tingling or numbness in your hands and feet, or frequent infections—but these can feel like normal aging or stress-related issues. Because symptoms develop gradually, people often don't connect them to a metabolic problem.

Who Should Get Screened for Diabetes?

The Centers for Disease Control and Prevention (CDC) recommends that adults who are overweight should start getting tested for diabetes at age 35. However, screening shouldn't wait if you have other risk factors. Understanding your personal risk is the first step toward prevention and early management.

Several factors increase your likelihood of developing Type 2 diabetes. These include:

• Obesity and Physical Inactivity: Being overweight or obese, combined with a sedentary lifestyle, significantly increases insulin resistance and diabetes risk.
• Poor Diet: Consuming too much fat, sugar, and refined carbohydrates contributes to elevated blood sugar levels and metabolic dysfunction.
• Family History: Having a first-degree relative (parent or sibling) with Type 2 diabetes substantially increases your genetic predisposition.
• Age: Risk increases noticeably after age 45, though Type 2 diabetes is increasingly diagnosed in younger adults.
• Smoking: Tobacco use raises your chances of developing Type 2 diabetes independent of other risk factors.
• Certain Medical Conditions: High blood pressure, polycystic ovary syndrome (PCOS), and a history of gestational diabetes during pregnancy all elevate diabetes risk.

If any of these apply to you, discussing screening options with your healthcare provider is important. A simple blood test measuring your glucose levels or A1C (a measure of average blood sugar over three months) can reveal whether you're in the normal range, prediabetic, or diabetic.

The Prediabetes Warning You Shouldn't Ignore

Before diabetes develops, most people pass through a stage called prediabetes. This means your blood sugar is higher than normal but not yet in the diabetic range. Over 84 million adults in the United States have prediabetes, but many don't know it. Prediabetes is a critical warning sign—and importantly, it's often reversible with lifestyle changes.

The CDC views prediabetes as a serious public health concern because it frequently leads to Type 2 diabetes, heart disease, and stroke if left unaddressed. However, the encouraging reality is that catching prediabetes early and making changes to diet, physical activity, and weight can prevent or delay the onset of Type 2 diabetes. This makes screening not just important, but potentially life-changing.

How to Take Action Today

If you're concerned about your diabetes risk, a free online diabetes risk assessment quiz can be a practical first step. These screening tools help you understand your personal risk factors and determine whether you need medical evaluation. Many hospitals and health organizations, including Liv Hospital, offer patient-centered diagnostic support to help you understand your status and next steps.

The bottom line: knowing your diabetes status is foundational to preventing serious health complications. With over 38 million Americans already living with diabetes and one in five unaware of their condition, awareness and early screening have never been more important. Whether you're at high risk or simply want to understand your health better, taking a screening quiz or scheduling a simple blood test is a straightforward way to take control of your future.