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Type 2 Diabetes: Early Signs, HbA1c and Fasting Sugar Tests, Daily Care

Learn the early signs of type 2 diabetes, what HbA1c and fasting sugar results mean, how daily care works and which warning signs need urgent help in Bangladesh.

Type 2 diabetes is a common long-term health condition. Many people have it without knowing. This guide covers the early signs, the blood tests doctors use (HbA1c and fasting sugar), how daily care works, and when to get urgent help.

What is type 2 diabetes?

In type 2 diabetes, the body cannot use the hormone insulin properly, does not make enough of it, or both. This leads to blood sugar (glucose) levels that stay too high.

The World Health Organization (WHO) says more than 95% of people with diabetes have type 2. It used to be called “adult-onset” diabetes, but it is now increasingly seen in children too.

How common is it in Bangladesh?

The national Bangladesh Demographic and Health Survey (BDHS) 2017–18 tested fasting blood sugar in 11,952 adults. After adjusting for age, about 9.2% of adults had diabetes and another 13.3% had prediabetes, meaning sugar that is higher than normal but not yet in the diabetes range. Among people with diabetes, 61.5% did not know they had it. These figures come from the 2017–18 survey.

A more recent national study looked at 2,300 young people in Bangladesh aged 10 to 34. It found that 4.5% had type 2 diabetes and 18.4% had prediabetes. About two in three of those with diabetes (66.3%) were newly diagnosed during the study.

Who is at higher risk?

  • Being overweight, especially carrying extra weight around the waist
  • Not being physically active
  • A family history of diabetes
  • Age over 45 (though children and younger adults can get it too)
  • Prediabetes found on an earlier test
  • Diabetes during pregnancy, or giving birth to a baby weighing 9 pounds (about 4 kg) or more
  • High blood pressure, heart disease, stroke or polycystic ovary syndrome (PCOS)
  • Asian background, which US health authorities list as carrying a higher risk
  • Dark, thick, velvety skin on the neck or armpits (called acanthosis nigricans)

In the national study of young people in Bangladesh, low physical activity, smokeless (chewed) tobacco, extra weight around the waist and high blood pressure were among the main risk factors.

Early signs of type 2 diabetes

Signs often come on slowly. Not everyone gets symptoms, and many people have type 2 diabetes without realising. That is why testing matters. When signs do appear, they can include:

  • Feeling thirsty all the time
  • Passing urine more often than usual, especially at night
  • Feeling very tired
  • Losing weight without trying
  • Feeling more hungry than usual
  • Blurred vision
  • Cuts or wounds that take longer to heal
  • Itching around the genitals, or repeated thrush (a yeast infection)
  • Numbness or tingling in the hands or feet

If you have any of these signs, or you have several of the risk factors above, ask a doctor for a blood sugar test.

Tests: HbA1c and fasting blood sugar

Diabetes is diagnosed with blood tests. The main tests are listed below.

HbA1c (also called A1C)

This test measures how much sugar is attached to haemoglobin in your red blood cells. It shows your average sugar level over the past 3 months. You do not need to fast for it. Doctors also use HbA1c to check how well diabetes is controlled. Most people with diabetes have it checked at least twice a year.

HbA1c is not suitable for diagnosing diabetes in everyone, for example in children or during pregnancy. Your doctor may then use a different test.

Fasting plasma glucose (fasting sugar)

This test measures your blood sugar after you have had nothing to eat or drink except water for at least 8 hours.

Random blood sugar and glucose tolerance test

A random blood sugar test can be done without fasting. In an oral glucose tolerance test (OGTT), your blood sugar is measured 2 hours after a glucose drink.

What the numbers usually mean

Test Normal Prediabetes range Diabetes range
HbA1c Below 6.0% (41 mmol/mol or below) 6.0% to 6.4% (42–47 mmol/mol) 6.5% or above (48 mmol/mol or above)
Fasting sugar 6.0 mmol/L or below 6.1 to 6.9 mmol/L (some services start this range lower) 7.0 mmol/L or above (126 mg/dL)
2-hour OGTT 7.7 mmol/L or below 7.8 to 11.0 mmol/L 11.1 mmol/L or above (200 mg/dL)
Random sugar Interpreted by your doctor Interpreted by your doctor 11.1 mmol/L or above (200 mg/dL), usually with symptoms

Different guidelines use slightly different cut-offs, especially for the prediabetes range. Do not diagnose yourself from one number. If you have no symptoms, a doctor will usually repeat a test before confirming diabetes.

Daily management

Type 2 diabetes is a lifelong condition. It can be managed with lifestyle changes, medicines when needed, and regular check-ups. Without good care, diabetes can lead to blindness, kidney failure, heart attack, stroke and amputation of the lower leg or foot.

Food

  • Eat a healthy diet.
  • A doctor or dietitian can help you plan meals around foods you already eat.

Activity and weight

  • Be physically active regularly.
  • Aim for a healthy body weight. Ask your doctor what activity and weight goals are right for you.

Tobacco

Do not smoke and do not use other tobacco, including chewed tobacco. WHO lists avoiding tobacco as one of the ways to prevent or delay type 2 diabetes.

Medicines

Many people with type 2 diabetes need medicine as well as lifestyle changes. Your doctor decides which treatment is right for you. Talk to your doctor before making any change to your medicines.

Checking and follow-up

  • Check your blood sugar at home only if your doctor advises it, as often as they tell you to.
  • Have HbA1c tests and check-ups at the times your doctor sets.
  • Ask your doctor about regular checks for problems with the eyes, kidneys, heart, nerves and feet.
  • Check your feet every day. Diabetes can reduce blood supply to the feet and cause a loss of feeling, so foot injuries may not heal well.
  • If you plan to fast during Ramadan, or if you are pregnant or planning a pregnancy, talk to your doctor well in advance.

Warning signs: get urgent medical care

Very high blood sugar can lead to two emergencies: diabetic ketoacidosis (DKA), where harmful acids called ketones build up in the blood, and hyperosmolar hyperglycaemic state (HHS), which causes severe dehydration. Both can be life-threatening. Go to the nearest hospital emergency department straight away if a person with diabetes has:

  • Confusion, drowsiness, or is hard to wake
  • Fainting, a seizure (fit) or loss of consciousness
  • Fast, deep breathing or shortness of breath
  • Breath that smells fruity
  • Repeated vomiting or nausea, or stomach pain
  • Strong thirst and passing a lot of urine, with signs of dehydration such as a dry mouth

Also get prompt medical help for chest pain, sudden weakness on one side of the face or body, sudden loss of vision, or a foot wound that is red, swollen, smelly or turning dark. Some diabetes medicines can make blood sugar go too low. Ask your doctor which warning signs to watch for and what to do.

If you are not sure what to do, you can call Shasthyo Batayon 16263, the government health call centre. In an emergency, do not wait on the phone. Go to hospital.

Which doctor should you see?

  • General practitioner or medicine specialist (internal medicine): a good first step for testing, diagnosis and routine follow-up.
  • Endocrinologist (a specialist in hormones and diabetes, sometimes called a diabetologist): for hard-to-control sugar, young-onset diabetes, insulin decisions or several complications.
  • Ophthalmologist (eye specialist): for regular eye checks and any change in vision.
  • Nephrologist (kidney specialist): if tests show kidney problems.
  • Cardiologist (heart specialist): for chest pain, heart disease or high heart risk.
  • Dietitian or nutritionist: for a practical eating plan.
  • Surgeon or foot-care team: for foot ulcers or infections that are not healing.
  • Gynaecologist or obstetrician: for diabetes in pregnancy or before planning one.

You can use the ratings.com.bd directory to find these specialists near you.

Key points

  • Many people in Bangladesh have type 2 diabetes without knowing it. A blood test can find it.
  • HbA1c shows your average sugar over the past 3 months. Fasting sugar is measured after at least 8 hours without food or drink other than water.
  • A healthy diet, regular activity, not using tobacco and regular check-ups are the base of daily care. A doctor decides on medicines.
  • Confusion, drowsiness, fast breathing, fruity breath or vomiting in a person with diabetes is an emergency.

Sources

This article is general information and does not replace advice from a doctor who knows your health.

Find a doctor

Browse Diabetes doctors in Bangladesh on ratings.com.bd, with chambers and, where listed, visiting hours and phone numbers.

Sources

This article is general information, not medical advice. It was written by AI from the sources above. It did not pass the automatic check, and an administrator chose to publish it; no doctor or editor has reviewed it. For a diagnosis or treatment, see a registered doctor.

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