A new large-scale analysis from the American Red Cross is shedding light on a quiet but widespread public health issue: elevated blood sugar levels in people who may not know they are at risk.
The organization reviewed data from more than 920,000 blood donors across the US and found that one in five showed hemoglobin A1C levels consistent with prediabetes or diabetes.
Because blood donors are typically considered a generally healthy population, the findings suggest that early metabolic dysfunction may be far more common, and more hidden, than previously understood.
Among donors with elevated A1C levels, the vast majority, around 80%, fell into the prediabetes range, meaning their blood sugar levels are higher than normal but not yet in the diabetic range.
Prediabetes is often reversible with lifestyle changes such as diet modification, increased physical activity and weight management, but it frequently goes undetected without routine screening. The remaining portion of individuals had A1C levels consistent with diabetes, suggesting they may be living with the condition without a formal diagnosis.
Hemoglobin A1C is a standard clinical marker that reflects average blood glucose levels over the past two to three months. Elevated levels are associated with an increased risk of developing type 2 diabetes as well as complications such as cardiovascular disease, kidney damage and nerve problems.
Early identification of prediabetes can significantly reduce the risk of progression to type 2 diabetes, which affects millions of Americans and is a leading driver of long-term healthcare costs.
Because the study population consists of blood donors, individuals who must meet basic health criteria to donate, the results suggest that elevated blood sugar is not confined to traditionally high-risk groups. Instead, it may be affecting a much broader segment of the population than commonly assumed.
Public health experts have long warned that prediabetes is underdiagnosed, and the scale observed in the Red Cross study highlights just how easily early metabolic disease can go unnoticed.
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How to Check Your A1C Through the Red Cross
Through routine blood donation, the Red Cross provides an accessible way for donors to receive a snapshot of their A1C levels.
In promotional months like March and August, the Red Cross offers free A1C screening on all successful blood, platelet and plasma donations.
After a donation, donors can view their A1C results within one to two weeks via the Red Cross Blood Donor App or by logging into the donor portal at RedCrossBlood.org. Anyone with an elevated A1C is advised to follow up with a healthcare provider for further evaluation.
In addition to A1C, donors can also access other routine health indicators collected during the donation process, including blood pressure, hemoglobin, pulse and body temperature, which are measured as part of the mini-physical to confirm eligibility to donate.
As the largest blood supplier in the US, the Red Cross says it is increasingly positioned to help bridge preventive health gaps by providing donors with basic but important health data. Through its app and online portal, donors can regularly monitor these metrics and share results with their healthcare providers, supporting earlier awareness of potential health concerns.
“Each year, the Red Cross sees about 2.5 million blood and platelet donors, giving us a powerful opportunity to influence health outcomes at individual and national scale,” said Dr. Pampee Young, Red Cross Chief Medical Officer, in a press release. “Most importantly, we’re meeting donors where they already are — it’s not another stop in a busy day. By sharing personalized health insights, we’re empowering people who come in to save someone else’s life to also potentially save their own.”
The findings of the Red Cross study add momentum to ongoing efforts to expand routine screening for blood sugar levels, particularly in primary care settings.
They also reinforce the importance of earlier detection, broader awareness of metabolic health and preventive health strategies, including improved nutrition, physical activity and weight management at a population level, especially as rates of metabolic disease continue to rise globally.
The Red Cross data suggests that diabetes risk is not only common, but it may already be quietly present in millions of people who consider themselves healthy today.
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