Ethnic and Gender Disparities in Risk Factors for Prediabetes—A Retrospective Exploratory Analysis in Southern Israel

Background/Objectives: Prediabetes significantly increases the risk of type 2 diabetes and related complications. Limited data exist for prediabetes among minority groups in Israel, particularly Bedouins. In the Negev region, Jewish and Bedouin populations differ markedly in culture and socioeconomic status. This study aimed to identify gender- and ethnicity-specific predictors of prediabetes. Methods: This retrospective, population-based observational exploratory study used data from 28,754 adults aged 20–65 years insured by Clalit Health Services in Southern Israel (2010–2020). Individuals with prediabetes were matched 1:1 with controls by age, gender, ethnicity, and year of diagnosis. Multivariate logistic regression models stratified by gender and ethnicity identified independent predictors. Results: Prediabetes was identified at significantly younger ages among Bedouins than Jews (6.8 years in men, 11.3 in women). The strongest predictor across all subgroups was metabolic syndrome (OR 2.0–4.0). Gestational diabetes was a major risk factor in women, particularly Jewish (OR 3.6). Cardiovascular disease and the use of statins or thiazide diuretics were independently associated with increased odds of prediabetes. Triglyceride-to-HDL cholesterol ratio was consistently elevated among prediabetes patients. Conclusions: Metabolic and medication-related factors contribute significantly to prediabetes-associated risk, with distinct gender and ethnic patterns. Culturally tailored early interventions and individualized risk profiling may enhance diabetes prevention in Southern Israel.