Diabetes mellitus (Type 1 and Type 2)

Diabetes — "sugar" in everyday speech, *madhumeha* / *sakkare* in our region — is a condition where the body cannot keep blood-sugar levels in the healthy range. The cause is either: (1) the pancreas not producing enough insulin (Type 1, usually diagnosed in childhood), or (2) the body's cells not responding to the insulin that is produced (Type 2, the much more common form in adults). India has more than 100 million people with diabetes today; Karnataka is among the higher-prevalence states. Tier-2 cities like Gulbarga are seeing diabetes diagnosed at younger ages than a decade ago — patients in their 30s, often with no family history.

How we diagnose it

Three tests confirm a diabetes diagnosis at Asian Hospital:

• Fasting blood sugar (≥ 126 mg/dL on two occasions = diabetes).
• HbA1c (≥ 6.5% = diabetes). HbA1c shows your average sugar over the last 3 months — a single high reading after a heavy lunch doesn't fool it.
• Post-prandial / OGTT when the picture is borderline.

If you have classic symptoms — weight loss, excessive thirst, frequent urination, fatigue — one elevated test is enough to start treatment. We also screen for diabetes opportunistically in every adult over 30 who comes for a check-up.

Treatment

The framework we use is lifestyle + medication + monitoring:

• Lifestyle — calorie awareness, low refined-carb diet, 30 min of brisk walking 5 days a week. We don't tell patients to "stop eating rice / roti" — that is unsustainable. Instead we work on portion size, plate composition, and timing.
• Oral medication — metformin is first-line for almost everyone. Newer drugs (SGLT2 inhibitors like dapagliflozin, DPP-4 inhibitors, GLP-1 agonists like semaglutide) are added based on the patient's heart / kidney risk profile.
• Insulin — needed for all Type 1 patients, and for Type 2 patients whose sugar isn't controlled on oral medication. Modern insulin pens make this simpler than the old vial-and-syringe; reception teaches the technique at the time of first prescription.
• Monitoring — HbA1c every 3-6 months; annual screen for the three "silent" complications — kidney (urine ACR + creatinine), eye (retinal photography), foot (sensation + pulses).

Why complications screening matters

Uncontrolled diabetes damages small blood vessels everywhere — kidneys, eyes, nerves, heart. The cruel reality is that this damage is silent for years. By the time a patient notices, the damage is often advanced. Annual screening catches it early, when it can still be reversed. Asian Hospital's complications-screening package includes all three checks plus a cardiology consultation in a single visit, priced around ₹4,500.

If you are over 30 and haven't had your sugar checked in the last 3 years, please book a check-up. Early-stage diabetes is highly responsive to lifestyle change — and the longer it goes undiagnosed, the harder it is to undo.