What blood sugar range is prediabetes?
Prediabetes is a fasting blood sugar of 100–125 mg/dL (5.6–6.9 mmol/L). It is also 140–199 mg/dL (7.8–11.0 mmol/L) on the 2-hour glucose test, or an HbA1c of 5.7–6.4%. These are the American Diabetes Association's 2026 lines, and India's ICMR uses the same. The WHO starts the fasting range higher, at 110 mg/dL.
What are the prediabetes ranges for each blood test?
The ADA's 2026 standards set prediabetes at 100–125 mg/dL fasting, 140–199 mg/dL two hours after a glucose drink, or HbA1c 5.7–6.4%.1
| Test | Below prediabetes | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting sugar | Under 100 mg/dL (5.6 mmol/L) | 100–125 mg/dL (5.6–6.9 mmol/L) | 126 mg/dL (7.0 mmol/L) or more |
| 2 hours after a glucose drink | Under 140 mg/dL (7.8 mmol/L) | 140–199 mg/dL (7.8–11.0 mmol/L) | 200 mg/dL (11.1 mmol/L) or more |
| HbA1c | Under 5.7% (39 mmol/mol) | 5.7–6.4% (39–47 mmol/mol) | 6.5% (48 mmol/mol) or more |
Source: ADA Standards of Care 2026, Tables 2.1 and 2.2; adults who are not pregnant.1 A prediabetes result on any one test counts.
Fasting means no calories for at least 8 hours.1 The 2-hour test (oral glucose tolerance test, OGTT) uses a drink with 75 g of glucose.1 Our post What does your HbA1c number mean? explains that test.
Indian lab reports often print a "PP" (post-meal) sugar. The 140–199 range is for 2 hours after the 75 g glucose drink, not an ordinary meal.1 RSSDI-ESI label it "2-h PPG during 75-g OGTT".5 Neither the ADA nor RSSDI-ESI sets a prediabetes range for a random reading.1,5 RSSDI-ESI say a random sugar of 100 to under 200 mg/dL (fingerprick: over 110) should lead to the full glucose test.5
Risk doesn't switch on at a line. The ADA says it "is continuous, extending below the lower limit of the range".1 Pregnancy uses different lines: India's ICMR workflow treats a first-trimester fasting sugar of 92–125 mg/dL as gestational diabetes.4
Why does the WHO start the fasting range at 110?
The WHO's 2006 report kept the fasting line at 110 mg/dL (6.1 mmol/L), a line the ADA had lowered to 100 in 2003.1,2
The ADA moved to 100 so that people flagged by fasting sugar would carry a diabetes risk similar to those flagged by the 2-hour test.1 The WHO worried that a lower line would sharply raise the number of people labelled. It found no evidence that labelling them would prevent diabetes.2
The WHO's 2-hour range matches the ADA's, 140 to 199 mg/dL.2 The WHO avoids the word "pre-diabetes" because "many people do not progress to diabetes". It says "intermediate hyperglycaemia" instead.2 It has set no HbA1c range below 6.5%, citing "insufficient evidence".3
What do Indian guidelines say about prediabetes?
India's ICMR treatment workflow (2022) uses the same numbers as the ADA: fasting 100–125 mg/dL, 2-hour 140–199 mg/dL, and HbA1c 5.7–6.4%.4
RSSDI and ESI, India's diabetes and endocrine societies, endorsed the ADA's prediabetes criteria for Indians in 2020.5 They add 2 cautions. HbA1c should not be the only test used to screen for diabetes or prediabetes.5 And for diagnosis in general, a fasting test alone "is less sensitive than 2-h OGTT in Indians".5
Both say people with prediabetes should be tested every year.4,5 Guide 1 sets these numbers beside the Indian BMI and waist cut-offs.
How many Indians have prediabetes?
About 15 in every 100 Indian adults (15.3%) had prediabetes among the 107,119 people tested in the ICMR-INDIAB survey (2008 to 2020).6
That 15.3% came from fingerprick (capillary) sugar tests, fasting and 2 hours after a glucose drink.6,7 It used the WHO's lines: fasting 110 to 125 mg/dL, or 160 to 219 mg/dL at 2 hours, the fingerprick equivalent.6 With the ADA's fasting line of 100, it rose to 32.8%. By HbA1c, in a subgroup of 18,090 people, it was 21.0%.6
Prediabetes was the only condition in the survey that was not more common in cities than in villages.6 Our post Prediabetes treatment in India: where do GLP‑1s fit? covers treatment. The type 2 diabetes path covers life after diagnosis.
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Related questions
Sources
- American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes 2026. Diabetes Care 2026;49(Suppl 1):S27–S49. Tables 2.1, 2.2 and 2.5; section "Diagnosis of Prediabetes". US guideline. doi:10.2337/dc26-S002 · PMC12690183
- World Health Organization and International Diabetes Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycaemia: report of a WHO/IDF consultation. Geneva: WHO, 2006. Recommendations 3, 4 and 7; summary table. iris.who.int
- World Health Organization. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus: abbreviated report of a WHO consultation. 2011 (WHO/NMH/CHP/CPM/11.1). iris.who.int (PDF)
- Indian Council of Medical Research and Department of Health Research, Ministry of Health and Family Welfare. Standard Treatment Workflow: Diabetes Mellitus Type 2 (ICD-10-E11), July 2022. icmr.gov.in (PDF)
- Chawla R, Madhu SV, Makkar BM, et al. RSSDI-ESI clinical practice recommendations for the management of type 2 diabetes mellitus 2020. Indian J Endocrinol Metab 2020;24(1):1–122. "Diagnosis of prediabetes" (Table 1), "Screening" (Step 2) and "Prediabetes" sections. doi:10.4103/ijem.IJEM_225_20 · PMC7328526
- Anjana RM, Unnikrishnan R, Deepa M, et al. Metabolic non-communicable disease health report of India: the ICMR-INDIAB national cross-sectional study (ICMR-INDIAB-17). Lancet Diabetes Endocrinol 2023;11(7):474–89. Methods and Results. doi:10.1016/S2213-8587(23)00119-5 · archived full text · PMID 37301218
- Anjana RM, Pradeepa R, Deepa M, et al. The Indian Council of Medical Research–India Diabetes (ICMR-INDIAB) study: methodological details. J Diabetes Sci Technol 2011;5(4):906–14. Section "Definitions". doi:10.1177/193229681100500413 · PMC3192597
Last checked 5 Oct 2026 · Next review due 5 Oct 2027 · Report an error
How this answer was made. Written by the GLP Guidebook team from the sources above. It's general information, not medical advice. Talk to a qualified doctor about your own test results. How we write