Stage 1: Insulin Resistance — Because the pancreas balances high blood sugar by releasing higher amounts of insulin, blood sugar levels seem normal. Stage 2: Blood Sugar Levels Rise (Pre-Diabetes) — The pancreas struggles to keep up with the demand for more insulin production to maintain normal blood sugar levels. Blood sugar levels begin to rise as the pancreas becomes fatigued from overworking and it puts out less insulin. Stage 3: High Blood Sugar Levels (Diabetes) — The pancreas begins to sustain damage as insulin output cannot cover the rise in blood sugar levels rise more quickly. Stage 4: Damage to the Pancreas (Diabetes) — Blood sugar levels are elevated as the result of years of the pancreas overworking. The pancreas overworks to lower blood sugar. Stage 5: Failed Pancreas (Diabetes) — The pancreas produces too little insulin or none at all. Insulin injections are needed to survive.