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Understanding Type 2 Diabetes and Its Early Warning Signs

Type 2 diabetes shows no symptoms in the early stages. This article discusses the subtle signs to watch out for and how you can manage the condition.

A female doctor shows blood sugar test results to an elderly patient

Type 2 diabetes is a leading health problem that affects more than 422 million people worldwide.

It is also the major cause of kidney failure, strokes, heart attacks, and blindness in the world. Fortunately, many patients can prevent or delay the onset and complications of type 2 diabetes through lifestyle changes during the early stages. However, most people fail to take advantage of this opportunity to avoid lifelong suffering by not recognising the early signs of type 2 diabetes – like Mrs. Lee.

“The key to living a long and healthy life is to ensure you don’t fall prey to type 2 diabetes”, says Mrs. Lee, who was diagnosed with the disease 15 years back and now suffers from heart ailments and kidney disease. “When I was diagnosed, there weren’t any symptoms, so I didn’t take it seriously. But now, the disease has robbed me of my health and happiness.” 

Also known as the “silent killer,” diabetes does not cause many symptoms to begin with. However, it progresses slowly over the years and can cause serious damage to all the organs in the body.

Mr. Abdullah was diagnosed with type 2 diabetes at the age of 40 years. “I had seen many of my family members suffer from complications of the disease in their old age. Some had vision loss, non-healing ulcers, and heart conditions. I decided I would not let diabetes take control of my life. Diabetes is not difficult to control if you understand the disease and meticulously take steps to keep it in control,” he explains.

“I have been very particular about monitoring my blood glucose levels, eating a healthy diet and exercising regularly. It has been 20 years since I was diagnosed, and I continue to live a healthy life pursuing all my hobbies,” he smiles.

What Causes Type 2 Diabetes?

A fat Asian lady measuring the circumference of her arm with a measuring tape
Obesity is a major risk factor for type 2 diabetes.

Insulin is a hormone that helps glucose enter the cells to produce energy. In type 2 diabetes, which is also known as type 2 diabetes mellitus or T2DM, the cells in our body do not respond normally to the insulin and are said to have “insulin resistance”.

According to Traditional Chinese Medicine (TCM), type 2 diabetes is due to internal and external factors. “Internal factors responsible for type 2 diabetes include dryness, heat, and yin (passive energy) deficiency. External causes include long-term overeating, excessive consumption of alcohol, emotional imbalance, overworking, or exposure to heat pathogens,” explains Eu Yan Sang TCM Physician Ignatius Ooi Yong Chin.  

Type 2 diabetes progresses slowly and is a life-long disease. It goes through the stages of stagnancy (pre-diabetes), heat (early-stage diabetes), deficiency (middle-stage diabetes), and damage (late-stage diabetes), according to TCM.

As of now, there is no complete cure for diabetes, but medicines can help control blood sugar levels to some extent. With regular treatment and a healthy lifestyle, patients can delay or prevent health complications caused by diabetes, as Mr. Abdullah recounted.

What Are the Symptoms of Type 2 Diabetes?

In TCM, people with the yin deficiency constitution are at a higher risk of diabetes. Common symptoms include dry mouth and throat, gravitation towards cold drinks when thirsty, slightly dry nose, dry stools, dry red tongue with little coating, and feverish sensation in chest, palms and soles.

Other possible symptoms include a flushed faceheaty sensation, dry eyes, unclear vision, slightly red lips, dehydrated skin prone to wrinkles, dizziness, ringing in the ears, disturbed sleep, and yellow-coloured urine. These individuals are usually impatient, outgoing, active, or lively, and may have a slender physique. 

“As for Western medicine, early signs of diabetes include passing a lot of urine usually at night and feeling thirsty. Other symptoms are weight loss and tiredness. People with type 2 diabetes also have slow healing of wounds,” explains Dr Tan Ee Chong, an M.D. at One Wellness Medical Clinic in Singapore.  

70-year-old Mr. Singh, who has had diabetes for the last 25 years, is a good example. “I had no idea that the small wound that occurred when a thorn pricked my wound would take almost two months to heal! I developed a swelling at the site, which then got infected and filled with pus. The doctor had to drain the pus out, leaving a large wound,” he says, adding that his blood sugar was too high, which caused infection and further delayed the healing.

Managing Type 2 Diabetes

Elderly Asian man and woman holding a glucometer in hand and looking at the reading
Keep your blood sugar in check with regular blood glucose monitoring at home.

According to Dr. Tan, your doctor will conduct tests to ascertain your blood sugar levels and determine the severity of your condition. They will examine and check if your eyes, kidneys, and sense of touch have been affected. Initial management involves diet modification and optimisation, as well as oral medication to reduce your blood sugar level. 

Additionally, you will also need to learn how to check and record your blood sugar level regularly. Your doctor will work with you as a team. He or she will assist you in monitoring your blood sugar and adjusting your medication to achieve good control.

You will also have to monitor your weight and watch for side effects of the medication or significant fluctuations in your blood sugar level, which can occur in this initial phase. If your diabetes remains uncontrolled or gets worse, you may need insulin injections or a specialist to help you with your treatments.

Lifestyle modification

A healthy diet and adequate exercise are essential to keep sugar levels under control.

“Be mindful of the total calories you consume, have frequent small means. Consume high-fibre, low-sugar, and easy-to-digest foods, and refrain from smoking and drinking,” suggests Mrs. Lee. She has started taking a 30 min walk in the morning which has helped control her blood sugar.

“Emotional stability is also important,” advises Physician Ooi. “Long-term negative emotions can weaken the immune system, cause hormonal disturbances and a spike in blood sugar levels.”  

Nutritious soups

Physician Ooi also recommends the following soup recipes to control blood sugar levels: 

  • Melon and watermelon rind soup: 50 g of melon rind and watermelon rind each, 15 g of trichosanthin. Boil the decoction in hot water.  
  • Goji berry and japonica rice porridge: Prepare porridge with 20 g of goji berries, 50 g of Japonica rice 

Alternatively, you can also opt for ready-prepared herbal formulations that improve your health and wellness. 

Today, type 2 diabetes can be controlled and managed effectively in most patients, to avoid the development of complications. With appropriate treatment and a healthy lifestyle, you can live a long and full life.


  1. Centers for Disease Control and Prevention. 2021. Type 2 Diabetes [Accessed on 9 December 2021] 
  2. Centers for Disease Control and Prevention. 2021. Diabetes risk factors. [Accessed on 9 December 2021]  

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