Diabetes in Hyderabad: A Patient's Plain-Language Guide to Managing Blood Sugar

India has over 100 million people living with diabetes — more than any other country in the world. In Telangana and Hyderabad, rates are among the highest nationally. And yet, in my clinic, I regularly meet patients whose diabetes was undetected for years — simply because they had no symptoms and never got tested.

Understanding Diabetes

In type 2 diabetes (the most common type, making up over 90% of cases), your body either doesn't make enough insulin or can't use it efficiently. Insulin is the hormone that moves sugar from your blood into your cells for energy.

When insulin doesn't work properly, blood sugar stays high. Over months and years, this elevated sugar quietly damages the blood vessels and nerves supplying the kidneys, eyes, heart, and feet — all without any obvious symptoms until serious complications appear.

Key Tests: How Diabetes Is Diagnosed

Following the API (Association of Physicians of India) and ICMR guidelines, diabetes is confirmed by:

• Fasting blood glucose ≥ 126 mg/dL on two separate occasions
• Post-meal blood glucose ≥ 200 mg/dL at 2 hours
• HbA1c ≥ 6.5%

Pre-diabetes (fasting glucose 100–125 mg/dL, or HbA1c 5.7–6.4%) is the most important stage to catch — because it is fully reversible with lifestyle changes before it becomes full diabetes.

What Is HbA1c — And Why Does It Matter?

HbA1c (glycated haemoglobin) is your average blood sugar over the past 3 months. Think of it as your diabetes report card. A single fasting sugar reading on one morning can be misleading — HbA1c gives the complete picture.

• Below 5.7% — Normal
• 5.7–6.4% — Pre-diabetes
• 6.5% and above — Diabetes
• Treatment target — Below 7.0% (API recommendation)

We check HbA1c every 3 months for patients on treatment. This one number tells us whether the entire management plan is working.

Diet: What To Eat and What To Avoid

A diabetes diet does not mean eating tasteless food. It means being mindful of the type and amount of carbohydrates you eat:

• Reduce white rice, maida, and refined flour — they cause rapid blood sugar spikes. Try smaller portions, or swap some rice for millets (ragi, jowar, bajra), which are slower to absorb
• Eat more vegetables, leafy greens, and dal — these are high in fibre, which slows glucose absorption
• Avoid fruit juices, sugary drinks, and sweets — these cause the fastest blood sugar spikes
• Regular small meals — large gaps between meals cause dangerous blood sugar swings
• Fruits in moderation — guava, pear, and apple are better choices than mango, banana, or grapes

Exercise: The Free Medicine

30 minutes of brisk walking every day can lower your HbA1c by 0.5–1.0% — equal to the effect of many medications. Exercise makes your body's cells more responsive to insulin. It helps with weight loss, which further improves blood sugar control.

Start with 10 minutes a day if you haven't been active. The benefits begin immediately, even before the weight loss starts.

Medications

When lifestyle changes alone are not enough, medications are added. Modern diabetes drugs — including SGLT-2 inhibitors and GLP-1 analogues — not only lower blood sugar, but also protect the heart and kidneys. Your doctor will choose the right medication based on your HbA1c, kidney function, heart risk, and overall health.

Never stop diabetes medication suddenly without consulting your doctor, even if you feel completely fine.

Annual Checks: Protecting Your Organs

Diabetes complications develop silently. Every year, everyone with diabetes should have:

• Kidney function test (creatinine, urine microalbumin)
• Eye examination for diabetic retinopathy
• Foot examination for nerve damage (neuropathy)
• Lipid profile (cholesterol and triglycerides)
• Blood pressure check

Catching these complications early — before they cause symptoms — is when treatment is most effective and least expensive.

"In 12 years of practice, I have seen patients completely reverse their pre-diabetes with 3 months of disciplined diet and exercise. If you act before diabetes is confirmed, you may prevent it entirely. A simple HbA1c test is all it takes to know where you stand."

Dr. Anand Karnam at Sri Anand Child and Neuro Center, Chanda Nagar provides diabetes management — including HbA1c monitoring, medication review, diet counselling, and complications screening. Serving Miyapur, Ameenpur, Lingampally, Patancheru and all of western Hyderabad. Call +91 90633 66983.

Medically reviewed by Dr. Anand Karnam, MBBS · DNB · DrNB · FWHS. Follows API and RSSDI (Research Society for the Study of Diabetes in India) diabetes management guidelines. Endorsed by IMA (Indian Medical Association) standards of care.