A 40-year-old man who rarely sought medical care went to a corporate hospital after his feet began to swell. Tests found high blood sugar and protein in his urine, indicating kidney damage. He was diagnosed with diabetic nephropathy, although he had not noticed typical symptoms of diabetes.
Doctors say diabetes is sometimes detected only after it has affected the kidneys, heart, eyes or nerves, particularly when people do not get regular blood sugar checks.
“High blood sugar can damage the eyes, kidneys, heart and peripheral nerves. In some cases, problems in these organs become evident before diabetes is diagnosed,” said Osmania General Hospital superintendent and endocrinologist Dr Rakesh Sahay.
Early screening and proper blood sugar management can help prevent or limit organ damage, he said. Sahay also said obesity was increasing diabetes risks among children and that health teams were visiting urban and rural schools to promote awareness and healthier lifestyles.
Dr Aarathi Bellary, a consultant in internal medicine at a private hospital, said diabetic neuropathy can cause tingling, numbness and burning in the hands and feet. It may develop before or after diabetes is diagnosed.
She said she was seeing young people with frozen shoulders whose HbA1c levels were between 6 and 6.5. This could be an early musculoskeletal sign associated with metabolic changes and prediabetes, she said. Physiotherapy can help, but diet and the underlying metabolic issue also need attention.
Retinopathy and heart complications are often seen in people who have had poorly controlled diabetes for years, Bellary said. She recommended annual kidney, heart and eye checks to detect problems early, adding that treatment needs careful monitoring when kidney disease is present.
Even a small cut, blister or unnoticed wound on the foot can lead to serious infection and, in some cases, amputation, said Dr P.C. Gupta, a vascular and endovascular surgeon and clinical director at a private hospital. Nerve damage can reduce sensation, allowing injuries to worsen without the person noticing.
People with diabetes should seek medical advice for wounds that do not heal, cold feet, skin colour changes or reduced sensation, Gupta said. He recommended a comprehensive foot examination at least once a year, with more frequent checks for those with nerve damage, circulation problems or a history of ulcers. Early referral to a vascular specialist is important if blood flow to the foot is reduced.
Poor blood sugar control, smoking, foot deformities, calluses, unsuitable footwear and a history of ulcers or amputation can raise the risk of foot problems, he said.
Dr Radhika Mali Reddy, a senior consultant in plastic and reconstructive surgery and diabetic foot surgery, advised people with diabetes to inspect their feet daily for cuts, swelling and skin changes. They should avoid walking barefoot, wear well-fitting footwear and seek medical attention promptly for injuries. She cautioned against removing calluses or treating deep wounds at home.
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