Diabetes that hides in plain sight: Doctor explains how some people have high blood sugar without classic symptoms, who are at risk

High blood sugar may persist for months or years without obvious symptoms. A doctor explains what can raise the risk, precautions to take, and more.

The burden of diabetes is high and increasing globally. The 2019 estimates showed that 77 million individuals had diabetes in India, a figure expected to rise to over 134 million by 2045, according to a study published in the Indian Journal of Ophthalmology. While there are some common warning symptoms for diabetes, including insatiable thirst, frequent urination, unplanned weight loss or fatigue, it is a disease that is not always as obvious.

Dr Vineeta Singh Tandon, senior consultant – internal medicine, ISIC Multispeciality Hospital, stressed that for many people, high blood sugar can persist for months or years without noticeable symptoms and can lead to type 2 diabetes.

This is why it is easy to overlook diabetes, she stressed, adding, “Someone can be feeling well and not realise that their blood sugar is elevated until they have a routine health exam. At that time, this disease may have been running for a long period without being noticed.” In an interview with HT Lifestyle, she listed the warning signs you shouldn't ignore, why diabetes is often detected too late, and more.

How does diabetes hide in plain sight?

Being healthy does not necessarily mean having healthy blood sugar.

According to her, sometimes people notice minor changes in their lives but don't associate them with diabetes. Tiredness can be attributed to work-related stress, and poor eyesight can be attributed to excessive screen time. Here are some warning signs that you shouldn't overlook:

• Excessive thirst or urination
• Unexplained loss of weight, fatigue and blurring of vision
• Wounds that don't heal quickly or numbness and tingling in hands or feet

The key point is that even if you don't have any symptoms, it doesn't necessarily mean your blood sugar is normal.

People who are more at risk

Dr Vineeta stressed that individuals with certain risk factors should be more mindful of their blood glucose levels, even if they feel completely fine. “If you have a family history of diabetes, are overweight, don't exercise much, have high blood pressure, or have received a diagnosis of prediabetes in the past, you may be more likely to get it,” she added.

Pregnant women with diabetes should also talk with their doctor about regular blood sugar check-ups, she cautioned, adding that if any of the following occurs, talk to your doctor about testing for blood sugar:

• Diabetes runs in your family
• You are overweight, are sedentary or have hypertension (high blood pressure)
• You've already had prediabetes or diabetes while you were pregnant.

Even if there are no symptoms, do not refrain from testing if risk factors are present.

Your blood sugar is measured by a fasting blood sugar test, and the average blood sugar over the last 2-3 months is measured by an HbA1c.

A simple blood test can reveal what symptoms don't

Dr Vineeta emphasised the importance of blood tests, stressing that they are the simplest and most convenient way to detect hidden diabetes. “Your blood sugar is measured from a fasting blood sugar test, and the average blood sugar over the last 2-3 months is measured from an HbA1c,” she explained. Here are a few key things to remember when getting yourself checked:

• HbA1C levels of < 5.7% are typically considered normal.
• A glucose level of 5.7-6.4% is considered prediabetes.
• A glucose level of 6.5% or higher is considered diabetes.
• Fasting blood sugar greater than or equal to 126 mg/dl is also considered diabetic.

But it is always best to have it diagnosed or confirmed by a health care professional. Lastly, Dr Vineeta said, “The bottom line is to not wait until there is dramatic symptomology before considering diabetes. Being healthy does not necessarily mean having healthy blood sugar. Early diagnosis can mean a person is diagnosed with diabetes or prediabetes earlier and can make lifestyle changes and receive the care and treatment they need before complications set in.”

Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.