Written by P. Deepika, Content Writer, Healthcare Industry.

Medically reviewed by: [Dr. N. Senthil M.D, Internal Medicine & Diabetology Specialist at Kanaga Hospitals]. Published: [28/10/2026]  |  Last medically reviewed: [28/10/2026]

“It was probably just stress.” “I thought it was my age.” Ask people who have just been diagnosed with diabetes when it began, and many will say something like this. Diabetes rarely arrives with a bang. It creeps in, and its early signs look so ordinary that most of us explain them away for months, sometimes years.

India is often called the diabetes capital of the world, and a large part of the problem is delayed diagnosis. Diabetes develops slowly over time, and its early signs, such as increased thirst and frequent urination, are so subtle that people ignore them for months or even years, until complications appear.

The numbers are hard to ignore. The ICMR-INDIAB study, published in The Lancet Diabetes & Endocrinology, estimated that about 101 million Indians were living with diabetes in 2021, and another 136 million had prediabetes. Tamil Nadu was among the southern states where more than 10 percent of adults had diabetes. Chances are that someone in your family is affected, or soon will be.

However, knowing what the early symptoms of diabetes are gives you the chance to take the steps needed to improve your health much sooner.

This guide, reviewed by a diabetes specialist at Kanaga Hospitals, walks you through the ten early signs, who is most at risk, how diabetes is diagnosed and what you can do today. Read it with your family in mind too: often it is someone else who notices the changes first.

What is diabetes?

Diabetes is not just ‘high sugar.’ It is a long – term health condition that affects how the body converts food into energy. The pancreas secretes a hormone called insulin. It helps glucose (sugar) from food and drink that is traveling in your bloodstream to reach the body’s cells to use for energy. When the pancreas is unable to produce insulin, or the body stops responding to insulin properly, it results in diabetes.

Diabetes is not just ‘high sugar.’ It is a long-term health condition that affects how the body converts food into energy. The pancreas secretes a hormone called insulin. It helps glucose (sugar) from food and drink that is traveling in your bloodstream to reach the body’s cells to use for energy. When the pancreas is unable to produce insulin, or the body stops responding to insulin properly, it results in diabetes.

A simple way to picture it: insulin is the key that opens the door of each cell so sugar can go in. In diabetes, there are either too few keys, or the locks have become stiff. The sugar stays outside, in your blood, and slowly causes damage.

Based on the cause, diabetes is divided into:

• Type 1 diabetes: An autoimmune condition where the immune system attacks and destroys the insulin-producing cells (beta cells) in the pancreas, resulting in a lack of insulin. It usually occurs during childhood or the teen years, but can appear at any age.
• Type 2 diabetes: The body still produces insulin, but the cells stop responding to insulin normally and sugar starts building up in your blood. It is the most common type of diabetes. While it mainly affects adults, it can occur in children as well.
• Type 3c diabetes: The pancreas has experienced structural or functional damage that isn’t autoimmune, which stops the production of insulin. It is usually the result of pancreatitis, pancreatic cancer, cystic fibrosis, hemochromatosis or pancreatic surgery.
• Gestational diabetes: This is high blood sugar that occurs for some women during pregnancy. This occurs due to the hormones from the placenta blocking insulin from working properly in the body.
• Neonatal diabetes: This is a rare form of diabetes, where diabetes develops within a baby’s first 6–12 months. For about 50% of the cases, the condition will resolve itself within the first few weeks or months, but may reappear in puberty. For the other half, they will have lifelong diabetes.

What about prediabetes? Prediabetes is not a type of diabetes. It is a warning stage, where blood sugar is higher than normal but not yet high enough to be called diabetes. Think of it as an amber traffic light. The encouraging part is that at this stage, healthy eating, regular activity and modest weight loss can bring blood sugar back to the normal range in many people.

Who is at risk?

Certain factors put a person at risk of developing diabetes during their life:

You cannot change some of these, such as age and family history. Others, such as weight, food, activity, stress and smoking, are within your control, and that is where the good news lies.

Type 1 diabetes:

1. Family history: If an immediate family member, like a parent or a sibling, has type 1 diabetes, it increases your risk of developing it as well. If the mother has type 1 diabetes, the risk is 1 in 25, if she has a child under 25. The chances are 1 in 100 if she has a child over 25. For fathers, the risk of their child having type 1 diabetes is 1in 17.
2. Age: While type 1 diabetes can develop at any age, it usually occurs during childhood and develops in children, teens, or young adults.

Type 2 diabetes:

1. Family history: Similar to type 1 diabetes, the presence of type 2 diabetes in immediate family members increases the likelihood of you developing it as well.
2. Age: Those who are 35 and above are generally at risk for diabetes, as age usually weakens the immune system.
3. Having prediabetes: This is a condition where your blood sugar is higher than normal, but not high enough to be considered type 2 diabetes. If left unmanaged, it can lead to developing type 2 diabetes.
4. Excess weight/Obesity: Adults with a BMI of 25 or more are more at risk at developing type 2 diabetes. This is because the excess fat stored in your abdomen region can lead to insulin resistance.
5. Sedentary lifestyle: Prolonged periods of inactivity lead to weight gain, insulin resistance, and poor blood sugar control. If left untreated, it can lead to further health complications.
6. Diet: Consuming high amounts of highly refined carbohydrates like processed foods, sugary drinks and refined grains for long periods of time contributes to obesity, which then contributes to insulin resistance.
7. Stress: It releases cortisol, which in turn raises blood sugar levels. Cortisol also tampers with appetite hormones, which leads to overeating and in turn, increases the risk of type 2 diabetes.
8. Alcohol consumption: Depending on the alcoholic beverage, it can either raise or lower blood sugar levels and contribute to weight gain as alcohol is high in calories. They also interfere with any medications you may be taking to manage type 2 diabetes.
9. Smoking: Nicotine and other chemicals in cigarettes can interfere with blood sugar regulation. Smoking also contributes to cardiovascular diseases and increases insulin resistance.

Risk in Children

India has a high population of children with type 1 diabetes, and the rate of children getting type 2 diabetes is rapidly increasing. While children display the same signs and symptoms of diabetes like adults, there are certain factors that leave some children more at risk of developing type 2 diabetes:

• Children whose mothers had gestational diabetes or diabetes during pregnancy
• Babies born with low birth weight
• Babies born prematurely or with a very high birth weight
• Teenage girls with polycystic ovary syndrome (PCOS)
• Children who have obesity
• Children with poor eating, sleep and exercise habits
• Children with a parent or sibling who has type 2 diabetes

Early symptoms of diabetes

Most people who experience any of the early signs and symptoms of diabetes usually misinterpret the cause, which can lead to delays in taking measures to manage blood sugar levels. These symptoms overlap for both type 1 and type 2 diabetes:

Type 1 symptoms tend to appear quickly, over a few weeks. Type 2 symptoms can be so mild that they go unnoticed for years, and some people with type 2 have no symptoms at all.

	Type 1 diabetes	Type 2 diabetes
Onset	Often fast (days to weeks)	Slow and gradual (months to years)
Weight loss	Often sudden and marked	Usually gradual, may be absent
Usually diagnosed in	Children, teens and young adults (can be any age)	Adults, but increasingly younger people
How it is often found	After a hospital visit with high sugar or ketoacidosis	On a routine blood test
Treatment	Insulin, always	Lifestyle changes, with or without tablets and insulin

1. Urinating frequently (Polyuria)

This sign is often mistaken for previously drinking too much fluids (e.g. water, coffee, tea, etc.) or having a weak bladder. Generally, people pass 1 – 2 liters of urine in a day. However, when your blood glucose levels are too high, the excess sugar overwhelms your kidneys.

To filter out the excess glucose, your kidneys pull fluids from your bloodstream and surrounding body tissues. This results in the person using the restroom several times or more, especially during the night.

2. Feeling more thirsty than usual (Polydipsia)

Frequent urination also leads to feeling constantly thirsty. This early sign is usually mistaken for simply needing more water, a response to hot weather or eating salty foods. In reality, since your body is rapidly using and losing fluids, due to your kidneys, you become dehydrated. This then results in your mouth feeling dry and feeling the need to constantly drink water, even after you already some.

3. Feeling hungry even after having a meal (Polyphagia)

For people with diabetes, low insulin levels or insulin resistance prevents their body from converting glucose into energy. Since your cells don’t have energy, you still feel hungry even after a full meal, or have cravings, especially for high and refined carbohydrates like sugary drinks and processed food. This often leads to overeating, which only increases already high blood glucose levels.

4. Blurry vision

When the eye problems happen, people usually attribute it to eye strain from using screens or to age, when it could be an early warning of diabetes. High glucose levels cause the lenses of your eyes to swell and change shape. This temporarily affects clarity of your vision and your ability to focus (clearer some days, blurrier on other days). The fluctuation in your vision depends on how your blood glucose levels shift throughout the day.

5. Sudden weight loss

When your cells don’t receive glucose, your body starts burning through fat and muscle for energy. This leads to weight loss even if the person has not changed their diet or doing any consistent physical activity. For type 1 diabetes, the weight loss is usually extremely sudden, whereas for type 2 diabetes, it is more gradual.

6. Constant tiredness

When your cells don’t absorb glucose properly, you feel sluggish and drained, even if you had a full night’s sleep. This sign of diabetes is often mistaken as the result of depression, stress, poor lifestyle choices, poor sleep habits, etc.

7. Slow healing wounds

Small cuts, bruises and wounds that usually heal within a few days are still lingering. High blood sugar reduces blood flow to the affected tissue, weakens immunity, and compromises the ability of white blood cells to fight bacteria. 

8. Recurring infections

High blood sugar puts stress on your body, and makes your white blood cells work hard. Since your immune system has been weakened. This means that you frequently become sick with recurring infections in the skin, gums or urinary tract. These include fungal and yeast infections, urinary tract infection (UTI), and swollen, bleeding or infected gums.

9. Tingling and numbness in hands & feet

Diabetic neuropathy, or nerve damage caused by high blood sugar, usually shows as mild tingling, burning or numbness in the toes or fingertips.

10. Darkened skin patches (Acanthosis Nigricans)

Acanthosis Nigricans is a skin condition where areas like the back of the neck, armpits, groin and elbows have dark, thick and velvety patches. This is caused by insulin resistance, and the most visible sign of the onset of diabetes

For gestational diabetes, it typically does not show any symptoms. It develops around the 24th week of pregnancy, so patients need to be tested between 24 and 28 weeks of pregnancy.

It can include signs like unusual thirst, frequent urination, fatigue even after resting, etc. However, none of these are a reliable confirmation since these are also standard pregnancy experiences. A glucose challenge test and oral glucose tolerance test (OGTT) are usually the most reliable way to determine if a mother has gestational diabetes.

Early signs of diabetes in men and women

Diabetes does not discriminate, but a few signs show up differently.

• In women: repeated vaginal yeast infections or UTIs, irregular periods with acne or excess facial hair (which can point to PCOS and insulin resistance), and vaginal dryness.
• In men: difficulty getting or keeping an erection, recurring infections of the genital skin, and reduced stamina or muscle strength.

Complications

If you delay taking action when you experience the early symptoms of diabetes, various complications can develop. When you have high blood sugar levels for a prolonged period of time, it damages the structure and function of your blood vessels. This affects your body’s ability to transport blood to different parts of your body, leading to various complications. The complications for diabetes are divided into acute (sudden and severe) and long – term.

Acute complications:

• Hyperosmolar Hyperglycemic State (HHS): When your blood sugar levels are very high (over 600 milligrams per deciliter or mg/dL) for a long period of time, it leads to severe dehydration and confusion. It mainly affects people with type 2 diabetes and requires immediate medical treatment
• Diabetes-related ketoacidosis (DKA): When insulin is absent, the body cannot break down glucose and instead breaks down fat. This process releases substances called ketones, which turn your blood acidic. Its symptoms are labored breathing, vomiting and loss of consciousness. DKA mainly affects people with type 1 diabetes and requires immediate medical treatment.
• Hypoglecemia – This is when your blood sugar level drops below a healthy range. It mainly affects people with diabetes who use insulin. The symptoms include blurred or double vision, clumsiness, disorientation and seizures.

Long – term complications:

• Neuropathy: Nerve damage causing numbness or tingling.
• Nephropathy: Kidney damage, potentially leading to dialysis or kidney transplant.
• Retinopathy: Persistent high glucose levels can damage the small blood vessels of the retina, and may lead to blindness.
• Cardiovascular Disease: Increased risk of coronary artery disease, heart attack, stroke and atherosclerosis (hardening or narrowing of the blood vessels).
• Foot Problems: In advanced cases, infections and ulcer wounds that heal poorly may require amputation.
• Sexual dysfunction – Nerve and blood damage to the genital tissues can cause erectile dysfunction in men and vaginal dryness in women.
• Osteoporosis – It mainly occurs in people with type 1 diabetes as insulin is crucial for bone growth and strength.
• Gum periodontal disease

Complications for gestational diabetes:

For gestational diabetes, if blood sugar isn’t managed, there are various complications that can arise which will affect the mother and the baby.

For the baby:

• High birth weight – If your blood sugar level is high, it may cause your baby to grow too large. Due to the large size, the baby can become stuck in the birth canal or have birth-related injuries.
• Premature birth – High blood sugar levels increase the women’s risk of early labour or delivery (before the due date).
• Stillbirth – Untreated gestational diabetes may result in a baby’s death either before or shortly after birth.
• Obesity and type 2 diabetes later in life – Babies have a higher risk of being obese and having type 2 diabetes later in life.
• Breathing difficulties – The newborn baby may suffer from respiratory distress syndrome, where the lungs are underdeveloped due to a premature birth.
• Neonatal hypoglycaemia: Low blood sugar can occur in the baby shortly after birth and, if severe, may cause seizures.

For the mother:

• Preeclampsia: This is a serious blood pressure condition that develops after the 20th week of pregnancy, where there is high blood pressure and high protein levels in the urine. It can lead to seizures and strokes.
• Hypertension – If the blood pressure becomes too high, it can lead to complications like preeclampsia, placental abruption, and preterm delivery.
• Future diabetes – If you experience gestational diabetes in your first pregnancy, you’re more likely to get it again during a future pregnancy. You also have a higher risk of getting type 2 diabetes as you get older.
• Increased risk of Cesarean section – Due to the baby’s size, the chances of delivering the baby through C – section become very high for pregnant women with gestational diabetes.

The reassuring part: with early detection and a good care plan, most women with gestational diabetes go on to have healthy pregnancies and healthy babies.

Ways to lower risk of diabetes

While an autoimmune form of diabetes and can’t be prevented, there are lifestyle choices you can take to manage Type 1 diabetes. These measures can also be taken to lower your risk Type 2 diabetes and gestational diabetes later in life. If you find yourself experiencing the early symptoms of diabetes, you must:

1. Be more physically active:

Doing physical activity regularly helps reduce insulin resistance, which allows you to keep your blood sugar within the normal range. The International Diabetes Federation recommends physical activity at least 3 to 5 days a week for a minimum of 30-45 minutes. These include activities like walking, swimming, running, biking, etc.

If you are new to exercise, begin with shorter sessions and gradually increase the duration and intensity. If you are carrying, talk with your doctor to find what exercise is appropriate for your pregnancy and ensure that it is an activity you enjoy.

2. Eat healthy foods:

Be mindful of what you are eating, but also of portion sizes. Eat a variety of healthy, fibre-rich foods like fruits, non – starchy vegetables, legumes and wholegrains. Fibres help reduce blood sugar levels and manage blood pressure.

Other additions include unsaturated fats (e.g. groundnut oil, mustard oil, sesame oil), nuts and seeds, lean meats and fatty fish. Limit your intake of sugary drinks and food, processed foods, refined carbs (white bread, white rice, pastries, etc.) and alcohol.

For pregnant women, your friends and family may advise you to “eat for two,” but do not increase your portion sizes without consulting your doctor.

3. Weight management:

Maintaining a healthy weight is crucial for lowering your risk of developing diabetes. If you are overweight, talk with your doctor to set a weight loss goal that’s healthy for you.

One of the most effective ways to prevent gestational diabetes is by maintaining a healthy weight before pregnancy. If you’re already pregnant, talk to your doctor about healthy weight gain during pregnancy.

Managing diabetes at any stage of life can be challenging. To get the guidance and help that is best for you, reach out to Kanaga Hospital to plan your next steps.

Concerned about your blood sugar? Talk to our diabetes team

Managing diabetes at any stage of life can be challenging. To get the guidance and help that is best for you, reach out to Kanaga Hospitals to plan your next steps. Kanaga Hospitals, Kovur, Chennai  |  [7-131, Kundrathur Main Rd, Kovur, Mangadu, Chennai, Tamil Nadu 600128]  |  [9500135319]

Frequently Asked Questions

1. What are the early signs of diabetes?

The early signs of diabetes include frequent urination, increased thirst, increased hunger, unexplained weight loss, fatigue, blurred vision, slow-healing wounds, frequent infections, tingling in the hands and feet, and darkened skin patches. Some people have no symptoms at all, so testing is important.

2. Are there different symptoms for type 1 and type 2 diabetes?

Symptoms may overlap, but type 1 diabetes often has a quicker onset, while type 2 can develop gradually and go unnoticed for years.

3. Do people with diabetes need to take insulin injections?

It depends on what form of diabetes you have. People with type 1 diabetes always need insulin, but most people with type 2 diabetes and gestational diabetes can manage the condition with diet, activity, and oral medication. Insulin is recommended only if blood sugar levels remain high even after making lifestyle changes.

4. How frequently should I get tested for diabetes?

Indians are advised to start screening from around the age of 30, or earlier if they are overweight, have a family history of diabetes, PCOS, high blood pressure or a past history of gestational diabetes. If your results are normal and you have no risk factors, your doctor may suggest repeating the test every one to three years. If you have prediabetes, test at least once a year.

5. Are there early signs of gestational diabetes?

Gestational diabetes is typically asymptomatic and the most reliable way to confirm if a mother is experiencing it is through a glucose challenge test and oral glucose tolerance test (OGTT).

6. How is gestational diabetes treated?

The primary goal of treatment is to keep blood glucose levels within a normal range to protect both the mother and baby. Treatment typically involves diet management, physical activity and regular blood sugar monitoring. If sugar levels stay high, your doctor may prescribe insulin or other medicines.

7. Does only type 1 diabetes happen in children?

No. Type 1 is more common in children, but type 2 diabetes is rising among children too, usually around puberty and especially in children with obesity. See the “Risk in children” section above for the factors that raise the risk.

8. Does gestational diabetes go away after pregnancy?

Yes, blood sugar levels typically return to normal shortly after delivery. However, you are at higher risk of developing type 2 diabetes in the future. This is why doctors recommend taking a glucose test 6–12 weeks post pregnancy, and routine screenings every 1–3 years.

9. Can I have diabetes and not know it?

Yes. Type 2 diabetes and gestational diabetes often cause no noticeable symptoms in the early stages, which is why screening is advised for anyone with risk factors.

10. What is a normal blood sugar level?

For most adults, a fasting blood sugar below 100 mg/dL and an HbA1c below 5.7% are considered normal. See the diagnosis table above for prediabetes and diabetes ranges.

Related reading: Top 10 Diabetes Hospitals in Chennai | Best Paediatric Hospital in Chennai