Every year on 14 November, the birthday of Frederick Banting, who co-discovered insulin, the world marks World Diabetes Day. The International Diabetes Federation has chosen “early action on diabetes” as the focus for 2026–27, and for India that message is especially urgent.
The ICMR-INDIAB study, published in 2023, estimated that about 101 million people in India live with diabetes and about 136 million more have prediabetes. Many in both groups don’t know it. Prediabetes is the stage where blood sugar is higher than normal but not yet in the diabetes range. It is also the stage where lifestyle changes work best.
This post explains how to spot the risk early, which tests to ask for, and what the numbers mean.
Why prediabetes is a window, not a verdict
Type 2 diabetes usually builds over years. The body’s cells slowly become less responsive to insulin, and the pancreas works harder to keep up. During this time, sugar levels creep up quietly.
Large studies show this progression can often be slowed or prevented:
- In the US Diabetes Prevention Program, people with prediabetes who lost about 7% of body weight and walked about 150 minutes a week cut their risk of developing diabetes by 58% over about three years.
- The Indian Diabetes Prevention Programme found that lifestyle changes reduced the risk by about 28% in Indian adults with impaired glucose tolerance.
Early action works, but only if you know where you stand.
Signs that may point to high sugar
Prediabetes usually has no symptoms. When sugar climbs higher, people may notice:
- Feeling thirsty often and passing urine more, including at night.
- Tiredness that doesn’t match the day’s activity.
- Blurred vision that comes and goes.
- Slow-healing cuts, frequent boils or skin infections.
- Repeated urinary or fungal infections.
- Tingling or burning in the feet.
- Unexplained weight loss in some people.
Some skin clues can show up earlier: darker, velvety patches on the back of the neck or in the armpits (acanthosis nigricans) are linked to insulin resistance.
Who should get tested
Talk to your doctor about a sugar test if any of these apply:
- You are over 30. Many Indian experts suggest screening from this age because type 2 diabetes appears earlier in South Asians.
- You have extra weight around the waist. A waist above about 90 cm in men or 80 cm in women is the cut-off often used for Indians.
- A parent or sibling has diabetes.
- You have high BP, high cholesterol or fatty liver.
- You had diabetes during a past pregnancy.
- You have PCOD/PCOS.
- You are physically inactive.
The sugar tests, explained simply
| Test | How it’s done | Normal | Prediabetes | Diabetes |
|---|---|---|---|---|
| Fasting plasma glucose | After 8+ hours without food | Below 100 mg/dL | 100–125 mg/dL | 126 mg/dL or more |
| HbA1c | Any time, no fasting | Below 5.7% | 5.7–6.4% | 6.5% or more |
| OGTT (2-hour glucose) | 2 hours after a 75 g glucose drink | Below 140 mg/dL | 140–199 mg/dL | 200 mg/dL or more |
| Random glucose | Any time | – | – | 200 mg/dL or more with symptoms |
These cut-offs follow international (ADA) criteria that Indian guidelines also use. A diagnosis of diabetes usually needs two abnormal results, unless symptoms are clear.
What about “PP” sugar? Many Indian labs offer a “post-prandial” test about two hours after a normal meal. It is a useful check of how your body handles food, but it isn’t standardised like the OGTT, because every meal is different. Your doctor may use it alongside fasting sugar and HbA1c.
HbA1c has limits. It reflects average sugar over roughly three months. Anaemia, some haemoglobin variants, recent blood loss or kidney disease can make it read falsely high or low, so doctors sometimes confirm with a glucose test.
Glucometer readings at home are for monitoring, not diagnosis. If you get a high reading, get a lab test.
Early action: what actually helps
- Lose a little weight if you carry extra. Even 5–7% of body weight makes a measurable difference.
- Move most days. Aim for 150 minutes a week of brisk walking or similar, plus some muscle-strengthening work twice a week. A 10–15 minute walk after main meals helps blunt sugar spikes.
- Change the plate, not just the sweets. Fill half with vegetables, a quarter with protein (dal, chana, paneer, eggs, fish), and a quarter with whole grains like millets or roti. Keep white rice, maida and sugary drinks small.
- Sleep 7–8 hours. Short sleep raises insulin resistance.
- Stop tobacco. Smoking raises diabetes risk and its complications.
- Recheck. People with prediabetes should usually be retested every year, or as their doctor advises.
Where Ayurveda fits
Ayurveda groups conditions with excess urination and sweetness under prameha, with madhumeha closest to diabetes. It links them to heavy, sweet, oily food, daytime sleep and lack of exercise, which is strikingly similar to modern risk factors. Its emphasis on daily exercise, lighter meals and routine supports early action. Herbs are discussed in Post 7 of this series, along with important safety points for people already on medicines.
The bottom line
This World Diabetes Day, the most useful thing you can do is find out your numbers. A fasting sugar and HbA1c test take minutes. If you are in the prediabetes range, you have a real chance to change the course with weight, movement, food and sleep, long before diabetes takes hold.
This article is for general information and is not a substitute for medical advice. Diagnosis of diabetes needs laboratory tests and a doctor’s assessment.
Can prediabetes go back to normal?
Yes, many people return to normal sugar levels with weight loss and activity, though the risk remains, so regular checks still matter.
Is fasting sugar alone enough?
Not always. Some people have normal fasting sugar but high after-meal sugar. HbA1c or an OGTT gives a fuller picture.
I’m thin. Can I still get diabetes?
Yes. Many Indians develop diabetes at a lower weight than people in Western countries, partly because of more fat around the organs. Waist size matters as much as weight.
How often should I test if I’m healthy?
If your results are normal and you have risk factors, testing every one to three years is common. Your doctor will guide you.
Related reading
- डायबिटीज़ के शुरुआती लक्षण और जांच: कब कौन सा टेस्ट करवाएं और नंबर का मतलब
- Diwali Ke Baad Sugar Badh Gayi? Agle 7 Din Ka Plan: Walk, Plate, Timing Aur Dawa
- Ayurvedic Herbs for Blood Sugar: Gudmar, Vijaysar, Karela and Methi – What Evidence Shows and How to Stay Safe
- Gum Disease and Diabetes: The Two-Way Link Every Diabetic Should Know
- Why Does Blood Sugar Go Up During Navratri Vrat? A Diabetic’s Guide to Fasting Safely