ICD-10 · E11
Type 2 Diabetes
Type 2 diabetes is a long-term condition where the body becomes resistant to insulin and blood glucose stays high. India has over 100 million people living with diabetes, and it often develops a decade earlier here than in Western populations, frequently at a lower body weight.
Symptoms
Increased thirst and urination, unexplained weight loss, tiredness, blurred vision, slow-healing wounds, recurring skin or urinary infections, and tingling or numbness in the feet. Many people have no symptoms at all for years.
Causes & risk factors
Insulin resistance driven by excess abdominal fat, physical inactivity, a refined-carbohydrate diet, family history, gestational diabetes, and South Asian genetic predisposition to central obesity.
Diagnosis
Fasting plasma glucose of 126 mg/dL or higher, a 2-hour post-glucose value of 200 mg/dL or higher, or HbA1c of 6.5% or higher, confirmed on two occasions. Annual checks should include kidney function, lipids, eye examination and foot assessment.
Treatment options
Metformin is the standard first medicine, usually 500 mg once or twice daily after meals, titrated up. Other options include sulfonylureas such as glimepiride, DPP-4 inhibitors such as sitagliptin, SGLT2 inhibitors such as dapagliflozin, and insulin when oral drugs are insufficient. Diet, 150 minutes of weekly activity and 5–10% weight loss can substantially reduce HbA1c.
When to see a doctor
Blood sugar readings persistently above 250 mg/dL, symptoms of very low sugar (sweating, confusion, palpitations), a foot ulcer or non-healing wound, sudden vision change, or repeated infections.