The missed window: Why half of India’s people with diabetes learn too late

Picture a door representing a healthier, longer life. Initially wide open, it invites you in, but it gradually narrows each year if no action is taken. For millions of Indians with undiagnosed diabetes, that door is closing quickly. When they finally step through, they face not only the diagnosis but also the burden of severe complications.

That “door” is what health experts refer to as the early detection window, and in India, sadly, half of all people with diabetes miss out on it.
When the story starts early- even before the diagnosis
Do you know that, for many people, the journey with diabetes starts quietly years before any test results show up? Slowly and steadily, the blood sugar begins to rise, and gentle changes occur within the blood vessels,¹ nerves,² and organs.³

At first, nothing feels out of place. Life goes on, juggling deadlines, family commitments, weddings to attend, and late-night meals with friends, without a hint of what’s to come.

Then, one day, someone goes to the clinic complaining of some complications affecting some organ, like the kidneys or liver, or even the heart. After tests, the diagnosis is diabetes, and not the early stage, but the type that has already caused damage.

Why warning signs go unheard
It’s natural to feel okay when you’re not experiencing symptoms. However, with diabetes, this feeling can sometimes be misleading and dangerous. Many people in India are diagnosed late for reasons like:

• Invisible markers: Early diabetes rarely causes pain or obvious discomfort.⁴ Weight is a primary target in diabetes, which is often overlooked.

• Low priority for preventive care: Annual health check-ups are not regularly scheduled.⁵

• Busy urban lifestyles: Long work hours and fast food habits push health off the priority list.⁶

• Genetic susceptibility: South Asians tend to develop diabetes earlier and experience a faster progression compared to other populations.⁷
  

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The domino effect of delay
When diagnosis is delayed, chances are high that the body has often been battling high blood sugar for years. This can set off a chain reaction, including:

• Strain on the kidneys that can progress to chronic disease.⁸

• Nerve damage in the feet, thereby increasing the risk of infections.⁹

• Narrowing of arteries, raising the risk of heart attack and stroke.¹⁰
  

These risks are no longer just later-stage concerns; doctors are now observing them in people within just a few years of their diagnosis, particularly among younger adults.

The natural partners in your health: GLP-1 and insulin hormone
Insulin is an essential hormone. It helps your body turn food into energy and manages your blood sugar levels. If you have diabetes, your body can’t make enough insulin or can’t use it properly.

But it’s worth pausing to talk about a little-known ally your body already has: GLP-1 (glucagon-like peptide-1). It is a hormone made in your intestine and released after meals. It helps your body work smarter by: ^10-12

• Prompting insulin release when needed

• Slowing digestion so blood sugar rises more steadily

• Signalling fullness to help prevent overeating

• Supporting healthy blood vessels and reducing inflammation
  

Think of it as a behind-the-scenes helper, quietly working to keep blood sugar and cardiovascular health in balance. Even so, no hormone can fully protect you if you’re unaware of your risk and skip regular screenings.

Catching diabetes before it catches you
The good news is that the missed window doesn’t have to remain missed. Here’s how you can keep it open longer:

• Get screened if you have risk factors such as family history, excess weight, a sedentary lifestyle, or high blood pressure.^{5, 13, 14}

• Know your key health numbers, including blood sugar, cholesterol, and blood pressure.¹⁵

• Make preventive checkups a regular habit rather than an afterthought.⁵

• Pay attention to subtle signs like fatigue, frequent thirst, or blurry vision. They are worth investigating.¹⁶

• Stay consistent with your health efforts, as maintaining health requires ongoing commitment over months and years, not just occasional actions.⁵

The choice is in the timing
Diabetes may be common in India, but late diagnosis doesn’t have to be. The earlier it’s found, the more control you have over your future. The later it’s found, the more you’re reacting instead of preventing.

The window is open right now, but will you walk through it before it starts to close?

References

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12. 4186-96. 12. Zhang X, Cao C, Zheng F, Liu C, Tian X. Therapeutic Potential of GLP-1 Receptor Agonists in Diabetes and Cardiovascular Disease: Mechanisms and Clinical Implications. Cardiovascular drugs and therapy. 2025.
13. Kyrou I, Tsigos C, Mavrogianni C, Cardon G, Van Stappen V, Latomme J, et al. Sociodemographic and lifestyle-related risk factors for identifying vulnerable groups for type 2 diabetes: a narrative review with emphasis on data from Europe. BMC Endocrine Disorders. 2020;20(1):134.
14. Preventio CfDCa. Monitoring Your Blood Sugar: CDC; 2024
15. Sarah SC, Jean ML. Blood glucose, blood pressure, and cholesterol testing among adults with diabetes before and during the COVID-19 pandemic, USA, 2019 vs 2021. BMJ Open Diabetes Research & Care. 2023;11(3):e003420.
16. Clark NG, Fox KM, Grandy S, Group ftSS. Symptoms of Diabetes and Their Association With the Risk and Presence of Diabetes: Findings from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). Diabetes Care. 2007;30(11):2868-73.

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