Researchers are not sure of the exact cause for the insulin regulation process to become impaired. A few contributing factors include:

•  Being overweight and having excess fat around the abdomen increases the risk for prediabetes because the extra fat tissue can make the body more insulin resistant. A large waist size of more than 40 inches in men and 35 inches in women is linked to insulin resistance.
• Lack of physical activity increases the risk of prediabetes. Being active helps manage weight, improves glucose control, and helps in utilizing insulin more effectively.
• The risk of prediabetes increases if there is a history of type 2 diabetes in the family (parent or sibling).
• Though diabetes can occur at any age, the risk of developing prediabetes increase after 45 years of age.
• Gestational diabetes (diabetes during pregnancy) increases the risk of developing prediabetes for the mother. It also increases the child’s future diabetes risk.
• People with polycystic ovary syndrome, a condition characterized by obesity, irregular menstruation cycles, and excessive hair growth in women, have a higher risk of prediabetes.
• Sleep disorders such as obstructive sleep apnea increase the risk of prediabetes.
• Smoking can be a factor that causes prediabetes, as nicotine is linked to increased insulin resistance.

Additionally, when health problems like high blood pressure, low HDL (good) cholesterol, and high triglycerides (a type of fat) occur along with obesity, they are associated with insulin resistance, which can trigger prediabetes.