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The overlooked silent symptoms of diabetes

The overlooked silent symptoms of diabetes

The symptoms are considered to be ‘silent’ since people with the disease continue living their lives as usual without realising that their blood glucose levels are high
Photo by Goutham V

Being diagnosed with diabetes was quite hard to digest for Deepika, a 38-year-old fitness enthusiast, who could not believe that her frequent urination and increased hunger and thirst were among the common symptoms of diabetes. Though she had the symptoms for five years, it was only when she fell severely ill and was taken to the hospital emergency room that she learnt about her unnoticed condition.

Deepika, who is a resident of Mysuru in Karnataka and a mother of two, says she loves to stay fit and has not once missed her fitness-training sessions. So, she was shocked to hear about her diabetes diagnosis. “I felt I had a near-death experience after I landed in the ICU for four days,” she says. “All I knew was I had fatigue and was feeling nauseous for days. My husband rushed me to the hospital. I wished I knew the symptoms much earlier and I could have been prevented from going through such a horrific phase. I kept asking the doctors, ‘Why me?’ I was so fit, I regularly exercised, and I didn’t understand why I was diagnosed with diabetes.”

The doctors told Deepika her blood sugar levels were 660 and she had to be put on insulin immediately. It took four days for her sugar levels to come back to normal and for her to be discharged from the hospital. “Due to Covid-19 cases, I couldn’t meet my children as the hospital did not allow anyone to visit,” she says. “The doctors asked me if my parents had diabetes — they were diagnosed only after crossing the age of 50 and only my father was on insulin while my mother managed with just medicines. I was informed about the symptoms, and I realised that I had all of them for the last five years but did not know that it was due to diabetes. If I only I had recognised a little earlier, I could have changed [my lifestyle] and controlled [the condition] with my diet.”


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Diabetes is popularly known as a silent killer, says Dr Jothydev Kesavadev, chairman of Jothydev’s Diabetes Research Centre, Thiruvananthapuram, Kerala. He says the classical symptoms of diabetes are not experienced during the early years of the disease. “The typical symptoms of diabetes include polydipsia (increased thirst and drinking more water), craving for sweet drinks, polyuria (excessive urination) and polyphagia (always feeling hungry and eating more food) and losing body weight,” he says.

Dr J Jayaprakashsai, consultant diabetologist, Apollo Sugar Clinics, Banjara Hills, Hyderabad, Telangana, says diabetes symptoms are considered ‘silent’ because people with the disease continue living their lives as usual without realizing that their blood glucose levels are high. He says this can cause various complications, because there is no pain and the symptoms are tough to perceive.

Symptoms of diabetes

Here are some of the top symptoms to watch out for:

  • Increased or frequent urination
  • Increased hunger
  • Increased thirst
  • Unexplained weight loss
  • Fatigue
  • Blurred vision
  • Slow healing of cuts and wounds
  • Numbness or tingling in feet or hands
  • Yeast infections (especially genital infections)
  • Skin discolouration

Dr Jayaprakashsai says there are many risk factors, and hence certain precautions are mandatory:

  • Everyone above 40 years of age should get tested. More so if one has sedentary lifestyle, is obese or has a high BMI (is overweight)
  • Everyone should be cautious and go for regular health checks, if they have a family history of diabetes, high blood pressure, heart disease or stroke

Dr Kesavadev says some people can recognize diabetes before its symptoms and certain signals need to be observed. “When someone is overweight and obese, that is probably the forerunner of diabetes,” he says. “With history of diabetes in very close relatives, even a mild degree of being overweight can put someone at high risk of developing diabetes.”

Dr Kesavadev says a change in the power of the eye lens can also be a symptom of uncontrolled/high sugar. “Itching and slightly painful lesions over the genital area — tip of the penis (balanoposthitis), vagina — is rather common but not specific to diabetes. Pain and restrictions of movement of shoulder joints (frozen shoulder) can also be a symptom of uncontrolled diabetes,” he says.

Early signs of Type 2 Diabetes

“Haven’t you seen some people feeling symptoms of low sugar — such as tremors and sweating — and treating it with extra food and extra sugar?” says Dr Kesavadev. “This again is an early signal of evolving type 2 diabetes, especially in those who are overweight for their height with a significant abdominal obesity. Consuming more food and sugar will only speed up the process of further evolution to full-blown diabetes. Some people can develop early symptoms of neuropathy such as numbness and a tingling sensation in the lower extremities.”

Dr Kesavadev says that uncontrolled blood pressure, high cholesterol and fatty liver are all factors that can increase the risk of developing type 2 diabetes. He advises exercising and following a healthy diet as the solutions.

Dr Jayaprakashsai said that tremors, sweating and low sugar are related to diabetes and signify a condition called ‘hypoglycaemia’. “This condition is mostly due to the medication used in diabetes — both certain oral anti-diabetic medications and insulin. Other reasons can be not eating sufficient food, postponing or skipping a meal, increasing exercise or physical activity without lowering or adjusting medication. Lastly, alcohol intake also causes hypoglycaemia. It’s tricky with alcohol, because there can be a hypoglycaemic attack and sugar levels may spike if you are consuming too many snacks or heavy food with it,” he says.

Early diagnosis of diabetes is the key

Dr Kesavadev says the only way to identify diabetes is by performing executive tests at a hospital two to three times a year based on one’s risk. “This should start from the age of 20 onwards,” he says. “The doctor can let you know your risk and suggest the frequency of repeating the executive tests.”

Dr Jayaprakashsai says if during a routine health check one discovers that sugar levels are out of control, first and foremost they should consult their physician, diabetologist or endocrinologist, and start the medication accordingly. “Seeking dietary advice from a trusted dietician along with consulting your physician can help you achieve goals faster,” he says. “If you lead a sedentary lifestyle, it’s good to include exercising, yoga or walking in your daily routine.”

What are the main medical tests for diabetes?

He says it is important to keep one’s weight under control. “So, one should take care of one’s BMI or body mass index (that is, keep weight in control as per height). Blood pressure and lipids should also be kept in check. Tests for random blood sugar, postprandial sugar and fasting blood sugars are recommended. Similarly, apart from blood sugar tests, getting a urine examination for sugar, proteins and others is helpful,” he says.

Dr Jayaprakashsai says once a person is diagnosed with diabetes, it is advisable to go for an HbA1c test every three months. (HbA1c is a simple blood test that measures average blood sugar levels over the past three months.) An oral glucose tolerance test is helpful in identifying prediabetes and gestational diabetes, he says.

The suggested tests for a person already diagnosed with diabetes include:

  • Renal function tests
  • Lipid profile
  • Thyroid function tests
  • Liver function tests
  • Serum electrolytes (if needed)
  • Complete urine and blood examination.

Dr Jayaprakashsai says podiatric care (which includes tests for peripheral neuropathy and peripheral vascular disease) for the feet, and fundoscopy for the eyes (to check for retinopathy) are recommended annually.


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  1. Irrespective of the age, we have to look out for all these symptoms and keep our health at check at all times. Thank you so much for this.

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