A person with diabetes can lose some feeling in their feet without realising it. A blister from a new pair of shoes, a small cut from walking barefoot or even a sharp object lodged in the heel may go unnoticed. The injury is there, but the usual warning signal, pain, never quite reaches the brain.
It is an unsettling complication, particularly because it can develop gradually. And it says something about diabetes that often gets lost in conversations about insulin, sugar levels and diet: the disease can affect parts of the body that seem to have very little to do with the pancreas.
The eyes are one example. So are the kidneys. The liver, heart and brain are also affected, while some people develop digestive problems because the nerves controlling their stomach stop working properly.
The damage is not always sudden, nor does everyone with diabetes develop all these complications. But years of poorly controlled blood sugar can leave a mark on several organs, sometimes before a person notices anything unusual.
India’s diabetes numbers make this a particularly relevant conversation. The ICMR-INDIAB study, published in The Lancet Diabetes & Endocrinology in 2023, estimated that 101 million Indians had diabetes and another 136 million had prediabetes. The study covered more than 113,000 people across the country. These numbers are not simply about how many people need to monitor their glucose levels. They also point to a much larger population that needs to understand the complications associated with the condition.