Objective: The study aimed to evaluate diabetic hand complications and hand function in prediabetic individuals and explore factors influencing hand dysfunction and its early musculoskeletal effects in prediabetes. Design: Controlled, observational study. Setting: The study was conducted at a tertiary care hospital between January and July 2019. Participants: One hundred prediabetic patients and 50 normoglycemic controls aged 18-65 years were included. Participants were selected using a convenience sampling method, with eligibility based on American Diabetes Association prediabetes criteria. Participants with conditions affecting hand function were excluded. Interventions: Not applicable. Main Outcome Measures: Hand function was assessed using the Duruöz Hand Index (DHI). Grip strength measurements were obtained bilaterally using a calibrated digital dynamometer. The presence of hand complications such as carpal tunnel syndrome (CTS), limited joint mobility (LJM), trigger finger (TF), sclerodactyly, and Dupuytren's contracture was evaluated using standardized clinical criteria. Results: Prediabetic individuals had significantly higher DHI scores, indicating impaired hand function compared to controls (P=.025). Hand complications, particularly LJM (P=.024), were more prevalent in the prediabetic group. Regression analyses revealed that CTS (P=.002), TF (P=.007), and lower nondominant hand grip strength (P=.003) were each statistically associated with impaired hand function. No significant relationship was found between DHI scores and hemoglobin A1c (HbA1c), fasting glucose, or 2-hour post-oral glucose tolerance test glucose levels. Conclusions: Prediabetes is associated with impaired hand function and an increased prevalence of complications, particularly LJM. CTS and TF appear to have a strong statistical association with hand dysfunction in people with prediabetes, whereas HbA1c levels were not directly linked.