Prediabetes and life insurance

What it means

Prediabetes describes blood glucose measurements that are above the normal range but below the threshold used to diagnose diabetes. Clinically it takes a few forms, including impaired fasting glucose, impaired glucose tolerance, and an A1C sitting in an intermediate band.

It is a risk marker rather than a disease. It indicates an increased likelihood of developing Type 2 diabetes, and it does not mean that has happened.

Insurers read it that way too, which is why the underwriting answer is usually undramatic.

The usual outcome

Standard rates, in a large proportion of cases.

An underwriter seeing prediabetes on an otherwise unremarkable file, with normal blood pressure, reasonable lipids, a build within guidelines and no other findings, generally notes it and moves on. Some insurers may hold back a preferred class, which is a category requiring unusually good measurements across the board, but standard rates are ordinary pricing rather than a penalty.

That is a genuinely different position from Type 2 diabetes, and it is why the two are separate pages rather than one.

When it starts to matter

Through the company it keeps.

Raised glucose seldom shows up alone. Where it appears alongside elevated blood pressure, an unfavourable lipid profile and a build above guidelines, an underwriter reads that combination as a cluster rather than as four unrelated items, and the assessment reflects the whole pattern.

In that situation the prediabetes is not the driver. It is one component of a picture where the components reinforce each other. The relevant pages are high blood pressure, high cholesterol and height, weight and life insurance.

The other factor that raises the significance is age. A borderline reading in someone in their late twenties invites more attention than the same reading at sixty, because the number of years ahead in which it could progress is far greater.

One reading or a pattern

Underwriters distinguish between these, and it works in most applicants’ favour.

A single value sitting slightly above the normal range, taken once, is weak evidence. Blood glucose moves for all sorts of ordinary reasons, and a lone result taken at a paramedical appointment is not a strong basis for anything.

A series of readings over a period tells a much clearer story, whichever direction it points. Where your own doctor has monitored this over time and the record shows a stable picture, that record is more useful to an underwriter than any single number, including one produced by the insurer’s own testing.

You still have to disclose it

This comes up often, and the answer is yes.

Applications ask whether you have been told you have a condition, whether you have had abnormal test results, and whether you have been advised to have monitoring or follow-up. Prediabetes normally engages at least one of those questions.

Beyond the obligation, it is impractical to omit. If the application involves a paramedical, the bloodwork will show it directly. A file where the application says nothing and the lab result says otherwise creates a discrepancy, and a discrepancy is a worse problem than the finding itself. See leaving something off the application.

If it has been picked up recently

Two things are worth doing, and only one of them is about insurance.

The insurance one: if the finding is very recent and your doctor has arranged follow-up bloodwork, it may be worth having that follow-up done before applying, so the underwriter sees a pattern rather than a single unexplained value. That is a timing question rather than anything else.

The other one is not our territory. A finding of prediabetes is information about your own health, and what to do about it is a conversation with your doctor. It has value entirely independent of any insurance application, and it should be had for that reason rather than this one.

The short version

For most applicants, prediabetes is a line in the file rather than a factor in the price. It is worth disclosing accurately, worth having a pattern rather than a single reading, and not worth deciding you are uninsurable over.