Dr Pavithra Thamizharasan, Senior consultant & Diabetologist, Iswarya Hospital. OMR. Chennai
This World Diabetes Day, let us move beyond treating high blood sugar and focus on preventing diabetes, identifying it early and protecting people from lifelong complications. Diabetes is no longer a disease that affects only the elderly. Today, it is increasingly diagnosed among young adults, working professionals and even individuals in their twenties and thirties. In India, where changing lifestyles, urbanisation, dietary habits, physical inactivity and genetic predisposition intersect, diabetes has become one of our most significant public health challenges.
What makes diabetes particularly concerning is not just its increasing prevalence, but the fact that it often progresses silently. Many individuals continue with their daily lives, unaware that their blood glucose levels have been elevated for months or even years. By the time they seek medical attention, some may already have developed complications involving the eyes, kidneys, nerves or cardiovascular system.
This is why the message for World Diabetes Day 2026, ‘Early Action on Diabetes,’ is particularly relevant. We need to shift our approach from treating diabetes after it develops complications to identifying risk early, diagnosing it promptly and intervening before irreversible damage occurs.
The danger of ignoring the early warning signs One of the biggest misconceptions about diabetes is that it always produces obvious symptoms. Increased thirst, frequent urination, unexplained weight loss, excessive hunger, fatigue, recurrent infections and blurred vision are some of the common warning signs.
However, Type 2 diabetes can remain asymptomatic for a prolonged period. A person may feel perfectly healthy while persistently elevated blood glucose levels gradually damage blood vessels and vital organs.
I frequently encounter patients who come for a routine health check-up or evaluation for an unrelated complaint and are surprised to discover that they have diabetes. Some are diagnosed only after developing complications.
The important message is simple: Do not wait for symptoms to get your blood sugar checked.
Individuals with a family history of diabetes, abdominal obesity, sedentary lifestyles, hypertension, abnormal cholesterol, previous gestational diabetes or polycystic ovary syndrome should be particularly proactive about screening. Women with a history of gestational diabetes must also continue glucose surveillance after pregnancy, as their future risk of Type 2 diabetes is increased.
What about people in Prediabetes ??
First of all what is Prediabetes- it is a stage in which blood glucose levels are higher than normal but do not yet meet the diagnostic criteria for diabetes. Unfortunately, many people dismiss this finding because they believe it is not a disease. In reality, prediabetes is an important window of opportunity. With appropriate lifestyle modifications, weight management, regular physical activity and dietary changes, progression to Type 2 diabetes can often be delayed or prevented. For individuals at particularly high risk, medical intervention may also be appropriate. The earlier we identify this stage, the greater the opportunity to change the course of the disease.
Prevention begins with everyday choices
Diabetes prevention does not necessarily require expensive diets, complicated exercise programmes or drastic lifestyle changes. Sustainable, realistic modifications can make a significant difference. A balanced Indian diet with appropriate portions of rice, millets, whole grains, vegetables, pulses and adequate protein is a practical starting point. The goal is not to eliminate carbohydrates completely but to make informed food choices and maintain portion control. Regular physical activity is equally important. At least 150 minutes of moderate-intensity physical activity per week, combined with resistance exercises, can improve insulin sensitivity and metabolic health.
Adequate sleep, stress management, avoidance of tobacco and maintaining a healthy waist circumference are also important components of diabetes prevention. Most importantly, lifestyle changes should be sustainable. Extreme diets and short-term fitness challenges rarely provide lasting benefits. Consistency is far more valuable than perfection. Diabetes management is more than controlling blood sugar For someone already diagnosed with diabetes, treatment should never be limited to achieving a good HbA1c value. Diabetes is a complex metabolic condition that increases the risk of heart disease, stroke, chronic kidney disease, diabetic retinopathy and neuropathy. Therefore, comprehensive diabetes care must include regular assessment of blood pressure, cholesterol, kidney function, urinary albumin, retinal health and foot health.
The treatment plan should be individualised, taking into consideration the patient’s age, duration of diabetes, associated medical conditions, cardiovascular and renal risk, lifestyle and personal preferences. Modern diabetes management has evolved considerably. We now have medications that not only improve glucose control but can also offer important cardiovascular and kidney protection in appropriately selected patients. Continuous glucose monitoring and other technological advances have further improved our ability to personalise treatment.
However, medication alone is not enough. Patient education, regular follow-up, treatment adherence and active participation in decision-making remain fundamental to successful diabetes care.
What about the various stigma surrounding diabetes??
Another important aspect that deserves attention is the stigma associated with diabetes. Patients often feel guilty about their diagnosis, believing that they have developed the disease solely because of poor lifestyle choices. Some even hesitate to disclose their condition to family members or colleagues. We must understand that diabetes is multifactorial. Genetics, age, environmental influences, hormonal factors, lifestyle and metabolic predisposition all contribute to its development. Blaming or judging patients does not improve outcomes. What they need is understanding, encouragement and access to appropriate medical care. Diabetes should be managed without fear, guilt or discrimination.
The way forward: Act early, live better
The fight against diabetes cannot be the responsibility of doctors alone. Families, workplaces, educational institutions, communities and policymakers all have a role to play. We need greater awareness about early screening, accessible preventive health check-ups, healthier food environments and opportunities for physical activity. Schools should encourage healthy habits from childhood, while workplaces should support employees in maintaining healthy routines and accessing healthcare. As physicians, our responsibility extends beyond prescribing medicines. We must educate, motivate and empower individuals to take charge of their health.
This World Diabetes Day, let us remember that the goal is not simply to bring down a blood sugar reading. It is to prevent complications, preserve quality of life and help people live longer, healthier and more fulfilling lives. Diabetes may be a lifelong condition, but its complications are not inevitable. Early recognition, timely intervention and consistent care can change the future. Let us not wait for diabetes to announce itself through a complication. Let us act early, because when it comes to diabetes, the right action at the right time can make all the difference.
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