Not just sugar: The long-term impacts of Type2 diabetes you cannot afford to ignore

Time of India

16-06-2025

In the blur of busy mornings, endless to-do lists, and late-night dinners, it is easy to brush off the little things—like feeling more tired than usual, needing a second glass of water more often, or barely noticing that a tiny wound is taking its time to heal. These moments slip by unnoticed, folded into the rhythm of everyday life. But sometimes, it is in these small shifts that the body starts to whisper—subtle signs that something deeper may be unfolding beneath the surface.
One of the most quietly persistent conditions that often begins this way is diabetes. Common, yes—but far from simple. It affects how the body manages blood sugar, often due to problems with insulin, the hormone that helps move glucose into our cells. When this process falters, sugar builds up in the blood, leading to long-term health issues if left unchecked.
There are three main types of diabetes:
Type 1
, which usually starts in childhood and needs insulin treatment for life
Gestational diabetes
, which happens during pregnancy and may go away after child birth
Type 2 diabetes
, the most common form which often develops in adults and is linked to lifestyle, diet and heredity. But it can also result from secondary causes such as chronic pancreatitis, Cushing's syndrome, or prolonged use of medications like steroids.
Prevalence of Type 2 diabetes is rising sharply in India due to shifting lifestyles, poor diets, physical inactivity, and rising obesity. According to the
Indian Council of Medical Research
(ICMR), over 101 million
1
people currently live with diabetes, and another 136 million
2
are pre-diabetic. The WHO estimates that around 77 million
3
Indian adults specifically have Type 2 diabetes, placing the country among those with the highest global burden. Yet despite these numbers, the condition often develops quietly, with subtle early signs that are easy to overlook. Recognising these signals early is crucial, as the real challenge lies not just in diagnosis, but in preventing the serious long-term risks Type 2 diabetes can bring.
To better understand the often-missed signs and why early screening is critical—especially for younger individuals with a family history—we spoke to Dr.
Ajay Agarwal
, Senior Director, Fortis Hospital, Noida. '
Some early signs include non-specific symptoms like increased thirst, frequent urination, and persistent hunger—even after meals. These form the classic triad of diabetes and should raise concern, particularly in those over 35,
' he said. '
Other indicators may be recurrent urinary infections, visual issues, slow-healing wounds, fatigue, and low energy.
' He stressed that early detection helps prevent serious complications such as kidney disease, retinopathy, and
neuropathy
, and also makes management simpler. '
While prediabetes can often be reversed with lifestyle changes, full-blown diabetes usually requires multiple medications, which can reduce compliance. Early diagnosis enables easier, more cost-effective treatment and significantly improves long-term outcomes.
'
Type 2 diabetes develops gradually and so do its complications. While these health risks may take years to surface, being aware of them early and managing blood sugar effectively, for example, by regularly monitoring at home with a good quality
glucometer machine
can greatly reduce their impact. Here are some common long-term health concerns linked to unmanaged Type 2 diabetes:
Cardiovascular health
: Diabetes can increase the risk of heart attacks, strokes, and peripheral artery disease by damaging blood vessels over time.
Kidney failure
: Chronic high blood sugar can silently lead to end-stage kidney disease, often requiring dialysis or transplant.
Nerve damage (Neuropathy)
: Starts with numbness or pain in feet and hands and may lead to digestive problems, sexual dysfunction, and even 'silent' heart attacks.
Vision loss
: Diabetic retinopathy is now one of the leading causes of blindness.
Amputations
: Poor circulation and nerve damage may cause ulcers and infections that go unnoticed—making diabetes the top cause of non-traumatic limb loss.
Other risks
: These include cognitive decline, increased risk of infections, and severe fatty liver disease.
On the long-term impact of unmanaged diabetes, Dr. Agarwal added, '
Chronic high blood sugar acts like a systemic poison, silently damaging blood vessels and nerves. The complications—from heart disease to kidney failure and diabetic foot—can be life-altering. Prevention of complications starts with early control of Diabetes.
'
The good news is that monitoring today doesn't need to be complicated or painful. With the availability of gentle lancing devices,
smart glucometer machines
, and user-friendly
digital tools
, people can track their sugar levels easily from home.
Highlighting the critical role of monitoring, Dr. Agarwal shared, '
Consistent glucose blood sugar monitoring using RBS (random blood sugar) charting and 3-monthly HbA1c testing is key. It keeps patients motivated and in control, while also giving doctors valuable insights into patients' glycemic profile.
' He further explained the evolving approach in clinical practice, '
We now recommend a 7-point blood sugar profile for many patients, which involves checking blood sugar levels before and after meals, as well as at bedtime. It's great information for the doctor and helps us tailor the treatment.
' Emphasising how monitoring directly informs risk assessment, Dr. Agarwal added, '
A newly diagnosed diabetic with an HbA1c of 10 worries me far more than someone with well-managed diabetes for 20 years and an HbA1c of 7. Regular and structured self-monitoring of blood glucose (SMBG) helps us catch before they escalate.
'
Because Type 2 diabetes develops slowly and its complications even more so, prevention and timely care are our most powerful allies. This is where lifestyle plays a crucial role. Eating balanced meals, staying active, maintaining a healthy weight, and blood sugar monitoring regularly—even when asymptomatic—can significantly delay or prevent diabetes. '
Lifestyle changes like losing 5–7% body weight, eating whole foods with fewer refined carbs, and exercising 150 minutes a week can dramatically reduce insulin resistance,
' says Dr. Agarwal. '
In people with a family history of diabetes, these habits, combined with regular monitoring with a
glucometer machine
at home, can delay or prevent diabetes altogether
', he added.
On the importance of early screening, especially for younger adults, Dr. Agarwal stresses, '
For adults in their 30s and 40s with a family history, screening is non-negotiable—even if they feel fine. A simple HbA1c test every 1–3 years can detect issues early. And regardless of results, adopting preventive habits is essential. I would also highlight women with gestational diabetes as a key group. Continuous glucose monitoring and Oral Glucose Tolerance Testing during pregnancy—once at the first consultation and again between 24–28 weeks—can help avoid dangerous complications
.'
Living with or working to prevent Type 2 diabetes is not about living in fear, but about understanding, care, and the quiet power of small, steady steps. It is a journey shaped not by perfection, but by progress. A journey that begins with staying curious about your health, asking questions, and making mindful choices each day. By approaching this path with patience and compassion, you not only support your own well-being but also create space for a healthier tomorrow for those around you.
References -
https://www.pib.gov.in/PressReleasePage.aspx?PRID=1944600
https://www.who.int/india/diabetes#:~:text=In India, there are estimated,developing diabetes in near future).
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-type-2
https://www.icmr.gov.in/icmrobject/custom_data/pdf/resource-guidelines/ICMR_GuidelinesType2diabetes2018_0.pdf
https://my.clevelandclinic.org/health/diseases/21501-type-2-diabetes