Diabetes has become a major health concern in India. According to the International Diabetes Federation, in 2024, close to 90 million Indians were living with diabetes, and by 2050, the number is projected to cross 156 million. Thankfully, diabetes is manageable with appropriate care, but the approach varies depending on its type. In this guide, we'll discuss the different types of diabetes, their causes, symptoms, and relevant management approaches.

What is Diabetes?

Diabetes is a chronic condition that requires long-term management to keep blood glucose within a healthy range and reduce the risk of complications.

Most of the food we consume gets converted into glucose - the body's energy source. Insulin - a hormone produced by pancreas - plays a key role in this process, by helping glucose move from the bloodstream into cells.

When the body does not produce enough insulin or is unable to use it effectively, the condition is called diabetes.

Persistently high blood glucose can cause glucose build up in the bloodstream, damage blood vessels and nerves, and affect organs such as the eyes, kidneys and heart.

Diabetes can develop in different forms, depending on how the body produces or uses insulin.

Types of Diabetes

Diabetes has several types, with type 1, type 2 and gestational diabetes accounting for the main clinical categories. Prediabetes does not qualify as diabetes, but it indicates an increased risk of developing type 2 diabetes, and therefore, deserves equal attention.

1. Type 1 Diabetes

Type 1 diabetes is an autoimmune condition in which the immune system attacks the insulin-producing beta cells in the pancreas. As these cells become damaged, the pancreas produces little or no insulin.

Causes and Risk Factors

The exact reason why the immune system attacks these cells remains unclear. Researchers link type 1 diabetes to a combination of genetic susceptibility and environmental factors. Having a close relative with type 1 diabetes may increase the risk, but family history alone does not determine whether someone will develop the condition.

Type 1 diabetes often develops during childhood or adolescence, but adults can also develop it.

Symptoms

Type 1 diabetes can develop quickly, causing noticeable symptoms such as:

• Excessive thirst

• Frequent urination

• Increased hunger

• Unexplained weight loss

• Fatigue

• Blurred vision

• Irritability or changes in mood

Severe insulin deficiency can cause diabetic ketoacidosis (DKA), a serious complication that requires urgent medical attention. Warning signs include nausea, vomiting, abdominal pain, deep or rapid breathing and confusion.

Management

People with type 1 diabetes need insulin therapy because their bodies cannot produce sufficient insulin. Doctors may also recommend regular blood glucose monitoring, a balanced eating plan and physical activity to support glucose control.

Treatment requires ongoing adjustment because insulin needs can change with food intake, exercise, illness and other factors.

2. Type 2 Diabetes

Type 2 diabetes occurs when the body develops insulin resistance, meaning cells respond less effectively to insulin. The pancreas initially tries to compensate by producing more insulin. Over time, insulin production may not keep pace with the body's needs, causing blood glucose to rise.

Type 2 diabetes accounts for the majority of diabetes cases.

Causes and Risk Factors

Several factors can increase the risk of type 2 diabetes, including:

• Excess body weight or obesity

• Physical inactivity

• Family history of type 2 diabetes

• Increasing age

• High blood pressure

• Abnormal cholesterol or triglyceride levels

• A history of gestational diabetes

• Certain conditions associated with insulin resistance

Genetic and environmental factors can also influence an individual's risk.

Symptoms

Type 2 diabetes often develops gradually, and some people may not notice symptoms for a long time. When symptoms occur, they can include:

• Increased thirst

• Frequent urination

• Persistent tiredness

• Blurred vision

• Slow-healing cuts or wounds

• Recurrent infections

• Unexplained weight loss in some cases

• Tingling or numbness in the hands or feet

Because symptoms may remain mild or absent, routine blood glucose testing plays an important role in detecting type 2 diabetes early.

Management

Doctors tailor treatment to blood glucose levels, overall health and individual risk factors. Management may include:

• A balanced, nutritious diet

• Regular physical activity

• Weight management where appropriate

• Blood glucose monitoring

• Oral or injectable diabetes medicines

• Insulin when other approaches do not provide adequate control

Regular follow-up allows doctors to review glucose levels and modify treatment as needed.

3. Gestational Diabetes

Gestational diabetes develops during pregnancy when hormonal changes make the body's cells less responsive to insulin. As a result, the body needs more insulin to keep blood glucose levels within the normal range. The pancreas usually increases insulin production to meet this demand, but in some pregnancies, it cannot produce enough insulin, causing blood glucose levels to rise.

When Does It Develop?

Doctors usually screen for gestational diabetes during the second trimester, although they may test earlier when someone has a higher risk.

Symptoms

Gestational diabetes often causes no noticeable symptoms. Some pregnant women may experience increased thirst or more frequent urination, but these symptoms can also occur during a normal pregnancy.

For this reason, appropriate screening remains important even when the pregnant woman feels well.

Risk Factors

The likelihood of gestational diabetes can increase with factors such as:

• Overweight or obesity

• Previous gestational diabetes

• A family history of type 2 diabetes

• Previous delivery of a baby with high birth weight

• Certain ethnic backgrounds

• Increasing maternal age

Management

Doctors monitor blood glucose and recommend treatment based on individuals' needs. Management may include dietary changes, appropriate physical activity and regular blood glucose monitoring. Some pregnant women may also need medicines or insulin to maintain blood glucose within the recommended range.

Managing gestational diabetes can help reduce the risk of pregnancy and birth complications. Blood glucose usually returns to the normal range after delivery, but having gestational diabetes increases the mother's future risk of developing type 2 diabetes. Doctors may therefore recommend follow-up blood glucose testing after pregnancy.

4. Prediabetes

Prediabetes occurs when blood glucose levels remain higher than the normal range but do not yet meet the criteria for diabetes. It signals an increased risk of developing type 2 diabetes and other metabolic health problems.

Causes and Risk Factors

Prediabetes shares many risk factors with type 2 diabetes. Excess weight, physical inactivity, family history, increasing age and a history of gestational diabetes can increase the likelihood of developing it.

Symptoms

Most people with prediabetes do not experience clear symptoms. Blood glucose testing often identifies the condition before it progresses to type 2 diabetes.

Management

Early action can help delay or prevent progression to type 2 diabetes. Doctors may recommend:

• Regular physical activity

• A balanced diet

• Weight management where appropriate

• Regular blood glucose monitoring

• Follow-up assessments based on individual risk

Prediabetes provides an opportunity to address risk factors before blood glucose reaches the diabetic range.

Less Common Types of Diabetes

Not every case of diabetes falls into the three main categories. Less common forms can develop because of specific genetic or medical factors.

• Monogenic diabetes: It results from a change in a single gene that affects how the pancreas produces or uses insulin. Doctors may suspect this form when diabetes develops at an unusually young age or shows a strong pattern across generations.

• Pancreatogenic diabetes: It can develop when conditions affecting the pancreas, such as chronic pancreatitis or pancreatic surgery, interfere with insulin production.

• Drug-induced diabetes: It can occur when certain medicines affect blood glucose regulation. Doctors consider the person's medication history when they assess the possible cause of elevated blood glucose.

Identifying these less common forms matters because the underlying cause can influence treatment decisions.

When Should You See a Doctor?

Diabetes can develop gradually, so some people may overlook early signs. A medical evaluation can help identify abnormal blood glucose and determine whether further testing or treatment is necessary.

A person should consult a doctor if they experience:

• Persistent thirst or frequent urination, especially without an obvious reason

• Unexplained weight loss despite maintaining usual eating habits

• Ongoing fatigue that does not improve with adequate rest

• Blurred vision or other unexplained changes in eyesight

• Repeated infections or wounds that take longer than expected to heal

• Abnormal blood glucose readings from a previous test or home monitoring

• Possible diabetes symptoms during pregnancy

• A strong family history of diabetes or other risk factors that may warrant screening

Prompt medical assessment becomes particularly important when symptoms appear suddenly or become severe. Early diagnosis allows doctors to start appropriate management and address risk factors before high blood glucose causes long-term complications.

Diagnosis of Diabetes

Doctors diagnose diabetes through blood glucose tests rather than symptoms alone. The choice of test depends on the person's symptoms, health history and circumstances.

Fasting Blood Glucose Test

This test measures blood glucose after the person fasts for a specified period, usually overnight. Doctors use the result to identify normal glucose levels, prediabetes or diabetes.

HbA1c Test

The HbA1c test measures the percentage of haemoglobin attached to glucose. It reflects average blood glucose levels over approximately the previous two to three months and does not usually require fasting.

Oral Glucose Tolerance Test

During an oral glucose tolerance test, doctors measure blood glucose after fasting and again after the person drinks a glucose-containing solution. The test shows how effectively the body handles a sudden increase in glucose.

Doctors commonly use this test when assessing gestational diabetes, following pregnancy-specific testing protocols.

Random Blood Glucose Test

A random blood glucose test measures glucose at any time of the day, regardless of when the person last ate. Doctors may use it when someone has symptoms that suggest diabetes and needs prompt assessment.

Doctors interpret test results according to established diagnostic criteria and may repeat testing when necessary to confirm a diagnosis. They may also use additional investigations when the type or underlying cause of diabetes remains unclear. At Ujala Cygnus, our in-house diagnostic services facilitate timely assessment and help our doctors develop an appropriate treatment plan based on the individual's condition.

Diabetes Prevention

Not every form of diabetes can currently be prevented. However, people can take steps to reduce their risk of certain types and identify abnormal blood glucose early.

Type 1 Diabetes

Current evidence does not provide a reliable way to prevent type 1 diabetes. People with symptoms should seek medical assessment rather than trying to prevent the condition through lifestyle changes.

Type 2 Diabetes

People can often lower their risk of type 2 diabetes by:

• Staying physically active

• Eating a balanced diet rich in vegetables, whole grains and other nutrient-dense foods

• Maintaining a healthy weight

• Limiting excess intake of highly processed foods and added sugars

• Managing blood pressure and cholesterol

• Attending recommended diabetes screening, particularly when risk factors are present

People with prediabetes can benefit from early lifestyle changes, which may help delay or prevent progression to type 2 diabetes.

Gestational Diabetes

No approach can prevent every case of gestational diabetes. However, maintaining a healthy weight before pregnancy, staying active and following medical advice during pregnancy can help manage risk.

People who have previously experienced gestational diabetes should also discuss appropriate follow-up testing with their doctor because their future risk of type 2 diabetes increases.

Managing Diabetes With Specialist Care at Ujala Cygnus

Diabetes requires regular monitoring and ongoing care because blood glucose levels, symptoms and treatment needs can change over time. At Ujala Cygnus Hospitals, our endocrinologists help individuals manage these changes and maintain better control of their condition.

Our specialists develop a personalised diabetes management plan based on the type of diabetes, blood glucose levels, symptoms, overall health and treatment needs. They review the individual's progress during follow-up visits and adjust medicines, lifestyle recommendations or other aspects of the care plan when required. Our endocrinology team provides continued guidance to help individuals manage diabetes as their needs change. If you are looking for personalised support to manage diabetes, call us at 9146691466 or book an online appointment with our specialists.