India is home to an estimated 101 million people with diabetes and 136 million with prediabetes, according to the ICMR-INDIAB study published in The Lancet Diabetes & Endocrinology. Doctors warn that the real danger of this metabolic disorder lies not just in high blood sugar but in how silently it damages the body over time.
Understanding Type 2 Diabetes
Type 2 diabetes is a long-term metabolic disorder that occurs when the body cannot use insulin properly or gradually stops producing enough insulin. Insulin is the hormone that allows glucose from food to enter cells and be converted into energy. When this system breaks down, glucose remains in the blood, leading to persistently high blood sugar levels.
The scale of the problem is enormous. The Government of India has highlighted that nearly 57% of people with diabetes are projected to be undiagnosed, meaning millions are unaware of their condition and the ongoing damage to their bodies.
Silent Onset and Common Symptoms
The disease often begins insidiously. Common symptoms include excessive thirst, frequent urination, unusual fatigue, increased hunger, blurred vision, slow wound healing, recurrent infections, numbness or tingling in the feet, and unexplained weight change. Many people dismiss these signs as stress, ageing, heat, or general weakness, allowing the disease to progress unchecked.
The main causes are insulin resistance and decreased pancreatic function. Risk factors include abdominal obesity, physical inactivity, high intake of refined carbohydrates and sugary drinks, poor sleep, chronic stress, family history, hypertension, smoking, and PCOS. Indians are particularly susceptible because South Asians tend to develop insulin resistance and diabetes at lower body weights compared to many Western populations.
Prevention is Powerful
Research shows that lifestyle intervention can dramatically reduce the risk of developing Type 2 diabetes. The landmark U.S. Diabetes Prevention Program found that intensive lifestyle change reduced the risk by 58%, while the drug metformin reduced it by 31% in high-risk adults.
The long-term Da Qing Diabetes Prevention Study in China demonstrated that lifestyle intervention in persons with impaired glucose tolerance delayed the onset of diabetes by nearly 4 years. Over 30 years, it also reduced cardiovascular events, microvascular complications, cardiovascular deaths, and all-cause deaths.
Importance of Good Sugar Control
After diagnosis, maintaining good control of blood sugar is critical. The UKPDS (United Kingdom Prospective Diabetes Study) showed that intensive glucose control reduces microvascular complications, and metformin improved diabetes-related outcomes in overweight patients.
Systemic Nature of Diabetes
Type 2 diabetes is not just about high sugar; it is a systemic disease affecting the heart, kidneys, eyes, nerves, liver, and blood vessels. The best defence remains early screening, weight management, regular exercise, a high-fibre diet, adequate sleep, and timely treatment.
Dr. Nishant Raizada, HOD of Endocrinology and Diabetes at Amrita Hospital, Faridabad, emphasizes that awareness and proactive measures are key to combating this silent epidemic.
