Type 2 diabetes doesn’t appear overnight. It usually builds quietly for years, through a stage called prediabetes, before it’s diagnosed, often after damage to the heart, kidneys, eyes or nerves has already begun. That long, silent run-up is also an opportunity: the earlier you act, the more you can change.
That’s the idea behind this year’s World Diabetes Day on 14 November. The International Diabetes Federation’s theme for 2026–27 is “Early Action on Diabetes”, focusing on screening, early diagnosis and reducing risk. The IDF notes that almost half of people with diabetes are undiagnosed, and about 1 in 8 people worldwide are at high risk of developing type 2 diabetes.
In India, the scale is especially large. The ICMR-INDIAB study estimated that 101 million Indians have diabetes and 136 million have prediabetes. This guide follows the three steps of early action: know your risk, get tested, and, if you have prediabetes, take the steps that are proven to lower your chances of it becoming diabetes.
At a glance
- Know your risk. Age, a family history of diabetes, extra weight around the waist and an inactive lifestyle are the biggest risk factors. The Indian Diabetes Risk Score (below) takes two minutes.
- Get tested. A fasting blood glucose or HbA1c test is quick and widely available. Adults aged 30 and over in India are advised to be screened, and younger people with risk factors should be too.
- Prediabetes is an early warning, not diabetes. An HbA1c of 5.7–6.4% or a fasting glucose of 100–125 mg/dL means your risk is raised, and there’s time to act.
- Lifestyle changes work. In a landmark US trial, modest weight loss and 150 minutes of activity a week cut the risk of type 2 diabetes by 58%. An Indian trial found lifestyle changes cut risk by about 28%.
- Small changes add up: brisk walking, fewer refined carbohydrates and sugary drinks, more vegetables and pulses, good sleep and not smoking.
- Already have diabetes? Early action still counts. Good control and regular eye, kidney and foot checks prevent complications, and some people with recent type 2 diabetes can reach remission with significant weight loss.
Step 1: Know your risk
You can’t change your age or your genes, but knowing where you stand tells you how urgently to act.
The main risk factors
- Age: risk rises from your 30s onwards.
- Family history: a parent, brother or sister with type 2 diabetes.
- Weight around the waist: belly fat is more closely linked to diabetes than overall weight. South Asians tend to develop diabetes at a lower body weight than Europeans.
- Physical inactivity: long hours sitting and little regular exercise.
- Diabetes in pregnancy (gestational diabetes), or PCOS.
- High blood pressure, high triglycerides or low HDL cholesterol.
- Poor sleep and smoking.
- Fatty liver, or long-term use of certain medicines such as steroids or some antipsychotics.
Check your Indian Diabetes Risk Score
The Indian Diabetes Risk Score (IDRS), developed by the Madras Diabetes Research Foundation, is a simple screening tool used across India. It uses four questions, with points for each answer. Add up your points:
| Question | Your answer | Points |
| Your age | Under 35 | 0 |
| 35–49 | 20 | |
| 50 or over | 30 | |
| Waist (women) | Under 80 cm | 0 |
| 80–89 cm | 10 | |
| 90 cm or more | 20 | |
| Waist (men) | Under 90 cm | 0 |
| 90–99 cm | 10 | |
| 100 cm or more | 20 | |
| Physical activity | Regular vigorous exercise or strenuous work | 0 |
| Regular moderate exercise | 10 | |
| Regular mild exercise | 20 | |
| No exercise, mostly sitting | 30 | |
| Family history of diabetes | Neither parent | 0 |
| One parent | 10 | |
| Both parents | 20 |
What your score means:
- Under 30: lower risk. Keep up healthy habits and get tested as recommended for your age.
- 30–50: moderate risk. Get a blood test and work on activity and waist size.
- 60 or more: high risk. Get a fasting glucose or HbA1c test soon.
Measure your waist midway between your lowest rib and the top of your hip bone, standing relaxed and breathing out. The score is a guide to who should be tested, not a diagnosis. A low score doesn’t rule out diabetes, so get tested if you have symptoms or other risk factors.
Step 2: Get tested
Many people with type 2 diabetes or prediabetes have no symptoms, which is why the IDF puts screening and early diagnosis at the centre of this year’s campaign. India’s national programme offers screening for adults aged 30 and over at Ayushman Arogya Mandirs and government health facilities, and tests are also widely available at private labs.
Which test?
| Test | Normal | Prediabetes | Diabetes |
| HbA1c (no fasting needed) | Below 5.7% | 5.7–6.4% | 6.5% or higher |
| Fasting blood glucose | Below 100 mg/dL | 100–125 mg/dL | 126 mg/dL or higher |
| 2-hour glucose tolerance test | Below 140 mg/dL | 140–199 mg/dL | 200 mg/dL or higher |
These are the American Diabetes Association thresholds, widely used in India. A result in the diabetes range usually needs a repeat test to confirm.
HbA1c isn’t reliable for everyone. Iron-deficiency anaemia, which is common in India, can falsely raise HbA1c, and thalassaemia trait or other haemoglobin variants, recent blood loss or transfusion, advanced kidney disease and pregnancy can also make it misleading. If any of these apply to you, ask your doctor whether a fasting glucose or glucose tolerance test would be more accurate.
When to get tested
- If you’re 30 or over: at least every three years if your results are normal, or more often if your doctor advises.
- At any age if you’re overweight (for South Asians, a BMI of 23 or more) and have another risk factor, or your IDRS is 60 or more.
- Every year if you have prediabetes.
- During pregnancy, as part of routine antenatal care, because gestational diabetes usually causes no symptoms.
- 6–12 weeks after giving birth, and then regularly, if you had gestational diabetes.
- Straight away if you have symptoms such as excessive thirst, frequent urination, unexplained weight loss or blurred vision. Our guide to the early signs of diabetes explains what to look for.
Step 3: Act on prediabetes
Prediabetes doesn’t always progress to diabetes, and for many people blood sugar can return to the normal range. Two landmark trials show what’s possible.
What the evidence shows
The US Diabetes Prevention Program (2001) followed 3,234 overweight adults with impaired glucose tolerance, a form of prediabetes. Those in the lifestyle group aimed to lose about 7% of their body weight through a healthier, lower-fat diet and to be active for around 150 minutes a week, mostly by walking. They cut their risk of developing type 2 diabetes by 58%, and by 71% in people over 60. Most kept off about 5% of their weight, a modest amount.
The Indian Diabetes Prevention Programme (2006) tested lifestyle changes in 531 Asian Indians with impaired glucose tolerance. Advice on diet and physical activity reduced the risk of diabetes by 28.5% over three years, similar to the effect of the medicine metformin, and combining the two added no extra benefit. Interestingly, the participants didn’t lose weight, which suggests that better eating and more activity help even before the scale moves.
What to do: practical steps
Move more, most days
- Build up to at least 150 minutes of moderate activity a week, such as brisk walking, cycling, swimming or dancing, plus muscle-strengthening exercises on two days.
- Take a short walk after meals. Even 2–5 minutes of light walking after eating helps lower the rise in blood sugar.
- Break up long periods of sitting every 30–60 minutes.
Eat for steadier blood sugar
- Fill half your plate with vegetables, a quarter with protein (dal, chana, rajma, paneer, eggs, fish or chicken) and a quarter with whole grains or millets.
- Cut back on refined carbohydrates such as white rice, maida, biscuits and bakery snacks, and keep rice and roti portions moderate.
- Swap sugary drinks, packaged juices and sweetened chai for water, buttermilk or unsweetened tea. Jaggery and honey are still sugar; our guide to jaggery vs sugar explains why.
- Limit fried snacks and ultra-processed foods, in line with the ICMR-NIN Dietary Guidelines for Indians.
Aim for modest weight loss if you’re overweight
Losing 5–7% of your body weight, for example 4–5 kg if you weigh 75 kg, is enough to make a real difference. Focus on your waist rather than the scale. Avoid unsupervised crash diets, especially if you take medicines for diabetes or blood pressure; our post-Diwali reset explains a steadier approach.
Look after sleep, stress and smoking
- Aim for seven or more hours of sleep. Short sleep is linked to higher hunger and poorer blood sugar control; see our guide to improving sleep quality.
- Find a stress outlet that works for you, whether that’s walking, yoga, breathing exercises or time with friends.
- If you smoke, get help to stop.
Retest and review
Retest your HbA1c or fasting glucose after 3–6 months of changes, then at least yearly. Your doctor may also discuss metformin if your risk is high. Our tips on managing diabetes through lifestyle and nutrition apply to prediabetes too.
Already have diabetes? Early action still matters
The IDF stresses that early detection can prevent emergencies such as diabetic ketoacidosis and delay complications affecting the heart, kidneys, eyes and nerves. If you’ve recently been diagnosed, the years right after diagnosis are a valuable window.
Remission is possible for some people with type 2 diabetes
In the UK DiRECT trial, adults diagnosed with type 2 diabetes within the previous six years followed a medically supervised, low-calorie, meal-replacement programme. After one year, 46% were in remission, with blood sugar in the non-diabetic range without medication, compared with 4% of those receiving usual care. Remission happened only in people who lost weight, and was most likely in those who lost 15 kg or more.
This isn’t a do-it-yourself diet. Participants stopped their diabetes and blood pressure medicines under close medical supervision, with regular support from a nurse or dietitian. Very low-calorie diets can cause low blood sugar and other problems if you take diabetes medicines, so talk to your doctor before trying any intensive programme. Remission is also less likely the longer you’ve had diabetes, and it isn’t possible in type 1 diabetes. Our guide to type 1 vs type 2 diabetes explains the difference.
Remission isn’t a cure. Blood sugar can rise again if weight is regained, so people in remission still need at least a yearly HbA1c, and eye, kidney and foot checks. DiRECT was also carried out in the UK, mostly in people of European origin, so results may differ in other populations, including South Asians.
Regular checks prevent complications
Whatever your treatment, these checks help catch problems early, when they’re easiest to treat:
- HbA1c every 3–6 months, against a target agreed with your doctor
- Blood pressure at every visit, and cholesterol at least once a year
- An eye check (retina) at diagnosis of type 2 diabetes, then at least once a year
- Kidney tests (urine albumin and a blood test for kidney function) at least once a year
- A foot check at every visit, and check your own feet daily for cuts, blisters or colour changes
- Dental check-ups, because gum disease is more common in diabetes
Keep taking your medicines as prescribed, and don’t stop or change them without talking to your doctor.
The bottom line
This World Diabetes Day, early action means three simple steps. Know your risk: take two minutes to work out your Indian Diabetes Risk Score. Get tested: a fasting glucose or HbA1c test is quick and widely available. And if your result shows prediabetes, treat it as a chance to act, not a cause for alarm. Trials in the US and India show that regular activity, better eating and modest weight loss can lower the risk of type 2 diabetes substantially. If you already have diabetes, early, steady action protects your heart, kidneys, eyes and feet for the years ahead.
Pro Tip: Use the GOQii App to track your steps, meals, weight and sleep, so you can see how your habits change between blood tests. Your GOQii Personalised Health Coach can help you set realistic activity and eating goals, whether you’re working to reverse prediabetes or managing diabetes alongside your doctor.
Frequently asked questions
What is the theme of World Diabetes Day 2026?
The theme set by the International Diabetes Federation for 2026 and 2027 is “Early Action on Diabetes”. It focuses on screening, early diagnosis and reducing the risk of type 2 diabetes, so that complications can be prevented or delayed.
Can prediabetes be reversed?
Often, yes. Many people with prediabetes can bring their blood sugar back to the normal range with regular physical activity, healthier eating and modest weight loss. Even when blood sugar doesn’t fully return to normal, these changes lower the risk of progressing: in the US Diabetes Prevention Program, lifestyle changes cut the risk of developing type 2 diabetes by 58%.
How long does it take to reverse prediabetes?
It varies from person to person. HbA1c reflects your average blood sugar over the previous two to three months, so a retest about three months after you start making changes shows whether they’re working. After that, retest at least once a year.
What is the Indian Diabetes Risk Score?
The Indian Diabetes Risk Score is a simple screening tool from the Madras Diabetes Research Foundation. It scores your age, waist size, physical activity and family history of diabetes. A score of 60 or more means high risk, and you should get a blood sugar test.
How much weight do I need to lose to prevent diabetes?
If you’re overweight, losing about 5 to 7% of your body weight, such as 4 to 5 kg if you weigh 75 kg, can significantly lower your risk. In an Indian trial, healthier eating and more activity reduced risk even without weight loss.
Who should get tested for diabetes?
In India, adults aged 30 and over are advised to be screened. Anyone younger who is overweight and has another risk factor, such as a family history of diabetes, PCOS or diabetes in pregnancy, should also be tested, as should anyone with symptoms.
Can type 2 diabetes go into remission?
For some people, yes. In the UK DiRECT trial, 46% of people diagnosed within the previous six years were in remission after a year on a medically supervised low-calorie programme. Remission is linked to significant weight loss and should only be attempted with medical supervision.
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Disclaimer: The information provided in this blog is for general awareness and educational purposes only. It is not intended to replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalised medical guidance or concerns related to your health.
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