Eight in ten Americans don't realise they have a common condition which could turn deadly.
There are five subtle signs that could indicate you have the health issue, which impacts some 98 million people in the US.
The condition in question is prediabetes, also known as having insulin resistance.
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It's when the body makes insulin, a hormone that helps regulate the levels of sugar in your bloodstream, but doesn't use it correctly, causing blood sugar levels to be higher than normal.
Fortunately, prediabetes can be reversed, but it can take five years or less to turn into type two diabetes, which can be life-threatening.
Diabetes increases the risk of heart attacks, strokes, blindness and kidney failure. It can also lead to losing toes, feet or legs, according to Centers for Disease Control and Prevention.
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Most people don't have any signs of prediabetes, however there are a few symptoms which could indicate you unknowingly have the condition.
Feeling thirsty
As WedMD explains, the first is feeling thirstier than usual. This is because 'high levels of glucose can mean your kidneys need to produce more urine to help pass the glucose out of your body,' according to NHS Inform. So your body is attempting to make up the fluids it's lost.
More frequent toilet trips
In turn, you'll then find yourself peeing a lot more. Makes sense, if your water intake has increased.
Increased tiredness
Prediabetes can also make you way more tired than usual. This is because your body can't get enough glucose in to your cells for energy.
Blurry vision
Another symptom is experiencing blurry or distorted vision. John Hopkins Medicine explains that the macula — the center of the retina that provides sharp, straight vision — can swell due to leaky blood vessels caused by diabetes.
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Skin changes
One unusual symptom some experience is darkened areas of the skin, usually on the armpit or neck. Small skin growths, like skin tags, might also appear in these areas. Like blurry vision, this is caused by the impact of diabetes on the blood vessels.
There's no certain answer as to why people develop insulin resistance. Some contributing factors include genetics, excess body fat, long-term stress and a eating too many processed foods.
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Having an underactive thyroid and prolonged use of steroid medications can also be factors.
Doctors say eating a well-balanced diet, including fiber-rich foods, and taking up more physical activity can help manage prediabetes. In some cases, this is enough to reverse it.
If you're concerned about symptoms, make sure to visit your doctor.
Topics: Health
Ellie Kemp