Signs of Type 2 Diabetes

Early signs of type 2 diabetes_Dr Suresh Agrawal

‘Ek Chammach Chini Kum’ every day to keep diabetes away writes Dr Suresh Agrawal

Diabetes Mellitus affects more than 15% of urban population and it is estimated that within next 10 years India will be World Capital of Diabetes. Although it is less prevalent in rural India as compared to urban, soon this difference in prevalence will get blurred due to rapid changing lifestyles and dietary habits.

Type 2 diabetes is a result of body becoming resilient to the normal effects of insulin. People suffering from type 2 diabetes struggle take longer to convert carbohydrates into energy. This leads to sugar build-up in their blood.

It is a silent disorder that develops over the years causing insulin resistance. This leads to an increase in blood glucose levels, triggering the pancreas to produce a lot of insulin wearing out insulin-producing cells over time. By the time type 2 diabetes is diagnosed, the person loses 50% to 70% od their insulin making cells.


Diagnosis of diabetes

Diabetes is diagnosed with fasting blood sugar tests or with HbA1C tests. A fasting blood sugar test is performed after overnight fasting for more than 8 hours. Normal fasting blood sugar is less than 100 mg/dl (5.6 mmol/l). For HbA1C blood test fasting is not needed, HbA1C indicates presence of glucose bound to Haemoglobin, and it gives overall picture of what our average blood sugar levels have been over a period of last 3 months.

Type 2 diabetes is diagnosed when one or more of these occur

  • Low production of insulin in the pancreas
  • Pancreas do not function effectively to produce insulin
  • Body cells stop effectively responding to insulin


Diagnostic criteria

Fasting blood sugar

Plasma glucose result (mg/dl)

99 and below – Normal

100 to 125 – Prediabetes

126 and above – Diabetes


2 hours after food

139 and below – Normal

140 to 199 – Prediabetes

200 and above – Diabetes



HbA1C below 6% (42 mmol/mol) – Non diabetic

HbA1C between 6-6.4% (42 – 47 mmol/mol) – Prediabetes

HbA1C 6.5% or above (48mmol/mol) – Diabetes


Risk factors of diabetes

Therisk factors for diabetics include high family aggregation, heart disease, organ and nerve damage, obesity, insulin resistance and sedentary lifestyles. Increased sugar levels may cause damaging nerves and blood vessels in the genitals causing some degree of impotence in men while women experience vaginal dryness.

In some case insulin resistance in the body increases production of insulin from the pancreas and overcomes the level of resistance. However, over time the pancreas gets fatigued and production of insulin declines leading to diabetes.


Many people may not be aware that they have diabetes especially in its early stages when symptoms are absent, and there is no definite way to know if you have diabetes without blood tests.

These can be the early signs of type to diabetes

  • Unexplained fatigue
  • Dry mouth
  • Weight loss
  • Excessive frequency of urination – especially during night
  • Dehydration
  • Frequent infections
  • Blurred vision
  • Obesity

Some symptoms are more serious and suggest that type 2 diabetes has likely already caused serious harm to your body. These include more frequent urinary tract infections or yeast infections, itchy skin in the crotch area, and cuts that are slow to heal.

Healthier ways to cut down on sugar

Most of the food we consume has sugar content in some form or the other. Hence being a little conscious about sugar while making food choices will help maintain your sugar levels effortlessly.

Here are six ways to cut down on sugar

1. Full fat products over Low fat – It may feel counter intuitive but low fat foods are high in sugar content and nasty additives. While full fat products contain less sugar and it will keep you fuller for longer.

 2. Water over cola – The daily sugar intake for adults is 30 grams that is seven teaspoons a day. A 330ml can of cola contains 35 grams of sugar that means if you enjoy that one can of cola you are consuming more than you should in the entire day. Instead you can have naturally flavoured water with cucumber or lime, they are super refreshing.

 3. Read labels – Start reading food packaging labels and look for hidden sugars. Sugar has 65 different names, which you will find within ingredients. Some of the common names are high-fructose corn syrup (HFCS), agave nectar, carob syrup, dextrin, maltose and dextrose.

 4. Cook from scratch – Instead of buy readymade mixes that may contain high amount of hidden sugar it will be wise to prepare your own food. This way you will have fun cooking as well as cut down on sugar.

 5. Be mindful about juices and alcohol – Fruit juices and alcohol have high sugar content that can cause your glucose levels to rise. Instead of fruit juices you can have the whole fruit. It is also essential to be aware of fruits that are high and low in sugar content to strike a balance.

6. Natural sugar over refined sugar – There is so much comfort in sweet dishes but it isn’t so comforting for your sugar levels. While preparing sweet dishes opt for ingredients that are naturally sweet. This way you can cut down on refine sugar which is more harmful that natural sugar.

 Type 2 diabetes is manageable with lifestyle changes – regular exercise, weight reduction, healthier eating habits and taking medication on time prescribed by the doctor. One can win diabetes and can lead normal healthy life. Remember to have ‘Ek Chammach Chini Kum’ every day to keep Diabetes away

About Dr Suresh Agrawal

Dr Suresh Agrawal, an alumnus of Seth G S Medical College and KEM Hospital, Mumbai, has been practicing in Colaba since 1981.

View all posts by Dr Suresh Agrawal

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