Could You Have Type 2 Diabetes and Not Know It? Find Out If You're at Risk
- t2diabetesnetwork
- Apr 23
- 4 min read
Written by Clare Koning, RN, PhD | April 2026 | 4 min read
Key Highlights
✅ In Canada, roughly 1 in 4 people with diabetes have not yet been diagnosed
✅ T2D can be present and causing damage for up to 10 years before symptoms appear
✅ Risk factors go well beyond weight and family history
✅ Certain ethnic backgrounds carry significantly higher risk at a younger age
✅ A simple blood test is all it takes to find out
You feel fine. You are not unusually thirsty, you are not losing weight without trying, nothing feels obviously wrong. And yet, right now, there is a real chance that your blood sugar has been quietly elevated for years.
Type 2 diabetes is, in many cases, a completely silent condition in its early stages. The body compensates for rising blood sugar remarkably well for a long time, producing no dramatic symptoms and sending no clear alarm. Meanwhile, that elevated glucose is doing slow, cumulative damage to blood vessels, nerves, and organs.
According to Diabetes Canada, roughly 10% of Canadians currently live with diagnosed diabetes. When undiagnosed cases are included, that figure climbs to approximately 15%. More than 600,000 Canadians are currently living with diabetes without knowing it.
Understanding your personal risk is not about anxiety. It is about information. And the earlier you have it, the more you can do with it.
The Risk Factors Most People Know
A few risk factors for T2D are widely recognized, and worth stating clearly.
Family history is one of the strongest individual predictors. If a parent, sibling, or child has type 2 diabetes, your lifetime risk increases by two to six times compared to someone with no family history. This is not a certainty, it is not a life sentence, but it is information that should translate into regular screening even in the absence of symptoms.
Excess weight around the abdomen is directly linked to insulin resistance. Fat stored around the waist and internal organs, as opposed to the hips and thighs, is metabolically active in ways that interfere with how cells respond to insulin. The CDC identifies overweight and physical inactivity as among the most significant modifiable risk factors for T2D.
Age is also a factor, with risk rising sharply after 40 in most populations. But this is not the full story, particularly in certain communities.
The Risk Factors That Are Less Talked About
Ethnicity and Earlier Onset
T2D does not affect all populations equally, and this is one of the most clinically important and under-communicated aspects of risk.
Diabetes Canada's guidelines and international evidence consistently show that people of South Asian, East Asian, African, Hispanic, Indigenous, and Middle Eastern descent face significantly elevated T2D risk at lower body weights and at younger ages than people of European descent. For these communities, the standard age-40 threshold for screening may be too late.
In Canada, early screening is recommended for people from these higher-risk ethnic backgrounds. If you fall into one of these groups and have not been screened, this is worth raising with your provider.
Gestational Diabetes
If you had gestational diabetes during pregnancy, your lifetime risk of developing type 2 diabetes is substantially elevated, even if your blood sugar normalized completely after delivery. Studies show that women with a history of gestational diabetes have a significantly higher likelihood of developing T2D within 10 years.
Postpartum screening at 6 to 12 weeks is recommended, but follow-up beyond that is inconsistent. If you had gestational diabetes and have not had metabolic screening in the past year or two, this is a gap worth closing.
Polycystic Ovary Syndrome (PCOS)
PCOS is closely linked to insulin resistance, which is both a feature of the condition and a driver of elevated T2D risk. Women with PCOS have a significantly higher lifetime risk of type 2 diabetes, independent of weight. This connection is frequently underdiscussed in PCOS management, with the focus remaining on reproductive symptoms.
If you have PCOS, regular metabolic screening including blood glucose and HbA1c should be part of your routine care.
High Blood Pressure and Abnormal Cholesterol
These are not simply comorbidities. They are part of a cluster of metabolic changes collectively known as metabolic syndrome, which increases T2D risk substantially. If you have been told your blood pressure is elevated, your HDL (good cholesterol) is low, or your triglycerides are high, these are signals that the same underlying metabolic processes that drive T2D may already be in motion.
Prediabetes
If you have been told you have prediabetes, an A1C between 5.7% and 6.4% or a fasting blood glucose between 6.1 and 6.9 mmol/L, you are in the window with the greatest opportunity to act. A European study cited by the Public Health Agency of Canada found that among adults aged 45 and older with prediabetes, the lifetime risk of progression to type 2 diabetes was 74%, underscoring just how seriously this intermediate state deserves to be taken.
It also underscores how much can be changed with early action. The evidence on lifestyle modification and prediabetes reversal is strong. That window matters.
So, What Are Your Actual Risk Factors?
Rather than running through a mental checklist, you can get a personalized picture in under five minutes using the CANRISK questionnaire, the Canadian Diabetes Risk Assessment tool developed specifically for the Canadian population. It asks about age, ethnicity, family history, gestational diabetes, blood pressure, physical activity, and waist circumference.
The result will tell you whether your risk is low, moderate, or high, and give you a concrete starting point for a conversation with your healthcare provider.
What Happens After a Diagnosis?
If a test confirms elevated blood sugar or a diabetes diagnosis, the most important thing to know is that this is manageable. Many people with T2D lead full, active lives with good glycemic control. And when caught early, the opportunities for lifestyle-based intervention are at their greatest.
The T2D Network exists to support people at every stage of this journey, from understanding risk and navigating diagnosis, to managing day-to-day life with T2D for the long term.
Take the CANRISK test today. Visit our Learn More page to understand your risk factors in more depth. Or if you have already received a high blood sugar result, our T2D resources have you covered.
