Type 2 Diabetes: Symptoms, Causes, Diagnosis and Treatment
Type 2 diabetes affects tens of millions of Indians. Learn the early symptoms, what causes it, the tests that confirm it, and how diet, activity and medicines keep it in control.
Medically reviewed by Doctoright Medical Review Panel · Written by Doctoright Editorial Team
Updated on · 4 min read
Key takeaways
- Type 2 diabetes happens when the body doesn't respond well to insulin and the pancreas can't keep up, so blood sugar stays high.
- Early symptoms (thirst, frequent urination, tiredness, slow healing wounds) are easy to miss, so screening from age 30 matters in India.
- It is diagnosed with a fasting glucose of 126 mg/dL or more, an HbA1c of 6.5% or more, or a 2 hour glucose test of 200 mg/dL or more.
- Weight loss, regular activity and a balanced Indian diet can put early type 2 diabetes into remission for some people; medicines protect the rest.
Insulin is the hormone that moves sugar (glucose) from your blood into your cells, where it's used for energy. In type 2 diabetes, the body's cells stop responding well to insulin (called insulin resistance) and over time the pancreas can't make enough extra insulin to compensate. Glucose builds up in the blood, and years of high blood sugar can damage the heart, kidneys, eyes, nerves and feet.
India has one of the largest numbers of people with diabetes in the world. The national ICMR INDIAB study estimated that around 1 in 10 Indian adults has diabetes and a further 15% have prediabetes, and many don't know it.
Symptoms
Type 2 diabetes often develops slowly, and many people have no symptoms for years. When symptoms do appear, they may include:
- feeling very thirsty
- passing urine more often, especially at night
- tiredness and low energy
- blurred vision
- cuts and wounds that heal slowly
- frequent infections, such as urinary tract, skin or genital yeast infections
- tingling, numbness or burning in the hands or feet
- unexplained weight loss
Because the early signs are so subtle, India's national programme for noncommunicable diseases offers diabetes screening to everyone aged 30 and above. You can check your numbers in our guide to normal blood sugar levels.
Causes and risk factors
Type 2 diabetes results from a mix of genes and lifestyle. Your risk is higher if you:
- have a parent or sibling with diabetes
- carry extra weight, particularly around the waist
- are physically inactive
- are over 30 (South Asians often develop diabetes about a decade earlier than Europeans)
- had diabetes during pregnancy (gestational diabetes) or a baby weighing more than 4 kg
- have high blood pressure, high triglycerides or low HDL cholesterol
- have polycystic ovary syndrome (PCOS)
Why waist size matters: Indians tend to store fat around the abdomen and liver, even at a "normal" body weight. A waist above 90 cm (men) or 80 cm (women) is a useful warning sign. You can check your BMI with Indian cutoffs using our BMI calculator.
Diagnosis
Your doctor can diagnose diabetes with one of these blood tests, usually repeated to confirm:
| Test | Normal | Prediabetes | Diabetes |
|---|---|---|---|
| Fasting plasma glucose | Below 100 mg/dL | 100 to 125 mg/dL | 126 mg/dL or higher |
| HbA1c | Below 5.7% | 5.7 to 6.4% | 6.5% or higher |
| 2 hour oral glucose tolerance test | Below 140 mg/dL | 140 to 199 mg/dL | 200 mg/dL or higher |
A random glucose of 200 mg/dL or more along with classic symptoms is also enough for a diagnosis.
Treatment
The goal is to keep blood sugar, blood pressure and cholesterol in a healthy range to prevent complications.
Lifestyle changes
- Lose weight if you need to. Losing 5 to 10% of body weight improves blood sugar significantly. In a landmark UK trial, nearly half of people who lost 10 kg or more achieved remission.
- Build a balanced plate. Fill half your plate with vegetables, a quarter with protein (dal, paneer, eggs, fish, chicken) and a quarter with whole grains. Swap white rice and maida for millets, brown rice or whole wheat.
- Move every day. Aim for at least 150 minutes of brisk activity a week: see our guide to walking for weight loss.
- Sleep and stress. Poor sleep and chronic stress both raise blood sugar.
- Stop smoking, which multiplies the risk of heart disease in people with diabetes.
Medicines
Metformin is usually the first medicine prescribed. Others include sulfonylureas, DPP4 inhibitors (gliptins), SGLT2 inhibitors (gliflozins), GLP1 receptor agonists and insulin. Your doctor chooses based on your sugar levels, weight, kidney function and heart health. Never stop or change a diabetes medicine without medical advice.
Complications
Uncontrolled diabetes can lead to heart attack, stroke, kidney disease, vision loss (diabetic retinopathy), nerve damage and foot ulcers. Yearly eye, kidney (urine albumin and creatinine) and foot checks catch problems early.
When to see a doctor
See a doctor if you notice the symptoms above or if you're over 30 and haven't been screened. Get urgent care for very high sugar readings with vomiting, confusion, drowsiness or rapid breathing: these can signal a diabetic emergency.
The bottom line
Type 2 diabetes is common in India but very manageable. Early testing, a sustainable change in eating and activity, and the right medicines let most people live long, active lives without complications.
How we reviewed this article: 5 sources
Doctoright has strict sourcing guidelines and relies on peer reviewed studies, academic research institutions and medical associations. Learn more.
- World Health Organization. Diabetes fact sheet.
- American Diabetes Association. Understanding diabetes diagnosis.
- NHS. Type 2 diabetes.
- Anjana RM, et al. Metabolic noncommunicable disease health report of India: the ICMR INDIAB national cross sectional study. Lancet Diabetes Endocrinol. 2023.
- Lean MEJ, et al. Primary care led weight management for remission of type 2 diabetes (DiRECT). Lancet. 2018.
Last medically reviewed on 8 October 2026. Originally published 2 July 2026.