A Word of Awareness: What Happens If You Look the Other Way

Chapter 61 · Vihang Rahul Vasa

I have deliberately kept this book warm and encouraging, because that is what a newly diagnosed person needs most. But I would not be honest with you if I did not include this chapter. This is not meant to scare you: it is meant to make you aware, because awareness is the first step to prevention.

Here is something I have learned over 15 years: diabetes by itself is actually quite weak. On its own, it is manageable, controllable, and very much beatable. But if you ignore the signals, skip your medication, and continue a reckless lifestyle, diabetes does something very clever: it quietly invites all its other weak friends to join the party. One by one, they arrive. And together, they form a grand army that becomes very, very difficult to fight.

These are some of the uninvited guests that uncontrolled diabetes can bring to your doorstep over time:

• Eyes: Retinopathy due to diabetes can silently damage the tiny blood vessels in your retina, gradually affecting your vision and, in severe cases, leading to blindness.

• Ears: High plasma glucose (blood sugar) can damage the delicate nerves and blood vessels in your inner ear, leading to gradual hearing loss. It may also cause tinnitus (ringing in the ears), or make it worse if you already have it.

• Heart: Uncontrolled diabetes significantly raises the risk of heart disease, heart attacks, and high blood pressure.

• Brain: Prolonged high plasma glucose (blood sugar) has been linked to cognitive decline, memory problems, and an increased risk of stroke.

• Liver, MASLD (Metabolic dysfunction–associated steatotic liver disease, liver fat linked to metabolic problems like obesity, diabetes, cholesterol or insulin resistance) is a common companion of poorly managed diabetes, and over time, it can progress to more serious liver conditions.

• Kidneys: Nephropathy due to diabetes can slowly impair kidney function, eventually leading to dialysis or even kidney failure.

• Nerves, Neuropathy due to diabetes can cause tingling, numbness, burning pain, or loss of sensation, most commonly in the hands and feet.

• Digestion: Gastroparesis and other digestive issues can develop, where the stomach takes far too long to empty, causing nausea, bloating, and discomfort.

• Wounds, Even minor cuts and wounds can become extremely slow to heal and, in some cases, virtually untreatable, leading to chronic infections.

• Feet: In the most severe and neglected cases, untreatable wounds and poor circulation can lead to the devastating consequence of amputation.

• Immune System: Diabetes weakens your body’s natural defence, making you more prone to frequent infections and slower recovery.

• Skin: Conditions like hidradenitis suppurativa, recurring boils, fungal infections, and chronic skin irritations become far more common.

• Oral Health, Gum disease and dental infections thrive in a high-sugar environment, and in turn, they worsen plasma glucose (blood sugar) control, creating a vicious cycle.

• Mental Health: The burden of unmanaged diabetes can contribute to depression, anxiety, and emotional exhaustion.

• Sexual Health: In men, uncontrolled diabetes can lead to reduced libido, erectile dysfunction, and reduced semen quality. Though rarely discussed openly, these are common and treatable. (See Chapter 56 for full explanation.)

• Obesity: Uncontrolled diabetes and poor lifestyle feed into each other, creating a cycle of weight gain that becomes harder to break with each passing year.

• Urinary Health: Frequent urinary tract infections and bladder issues can develop due to high plasma glucose (blood sugar) in the body.

• Sleep: Sleep disturbances, including sleep apnoea, become more likely, which in turn worsens plasma glucose (blood sugar) control.

Read that list once. Then close this page and never let it become your story.

(References for this chapter, diabetes and hearing loss, diabetes and dementia, and the complication studies cited in the chapters above, are listed in Appendix B.)

The good news, and this is the most important line in this entire chapter, is that almost every complication listed above can be prevented or delayed. They do not arrive overnight. They come mostly when diabetes is ignored for a long, long time. If you manage your diabetes well, these uninvited guests become far less likely, and far later: if they come at all.

Please consult your diabetes specialist to understand the risks of uncontrolled diabetes in greater detail. Be aware of what diabetes is capable of, treat it promptly, and most importantly: do not give diabetes the chance to invite its friends. Keep it alone, keep it weak, and you stay the one making the decisions.

Remember, this is not the end of anything. If anything, it is the beginning of a healthier, more mindful you. Millions of people live full, vibrant lives with diabetes, and so will you. Just take it one day at a time.

I have lived with diabetes for over 15 years. I come from a family of doctors. I have experienced everything from the most traditional medicines to the most modern treatments, consulted super specialists, and tried everything under the sun. And I am telling you from that experience: this can be lived with, and lived well. This book is the sum of everything I have learned, and I am giving it to you so that your journey is smoother than mine was.

Welcome to a better lifestyle. I am with you on this journey.

With warm regards and care,

Vihang Rahul VASA

Person Living with Type 2 Diabetes for over 15 years

Personal Note of Thanks

My wife, Dr. Poonam Gupta VASA, MBBS, Masters of Family Medicine, has been my physical and mental support throughout my entire journey with diabetes. She has stood by me through every challenge, every setback, and every small victory. I would not have been alive, happy, and writing this book without her. This book is as much hers as it is mine.

My father, Dr. Rahul Nanalal VASA, MBBS from GS Medical College, Mumbai, with over 50 years of practising experience, is the one person, and I repeat, the only person in this universe, who believed in me and gave me the freedom to do what I wanted to do. Though he comes from a medical background, he taught me advanced engineering, analytical thinking, and the art of logical reasoning. My way of thinking, my ability to analyse, my clarity of understanding, and my power of teaching: all of it comes from him and his vast life experiences. I can proudly say that everything I am today is because of him. I am the luckiest person to have him as my father.

Editorial Partner: Claude (by Anthropic)

Vihang provided the personal experience & conversations, and practical wisdom from over 15 years of living with Type 2 Diabetes. Claude assisted in organising, articulating, and refining those insights into this book.

A personal note from the author: Claude has been the most intelligent, resourceful, and efficient partner I could have asked for in creating this book. What began as a simple request to draft a letter became a 61-chapter journey, and at every step, Claude understood not just my words but the intention behind them. Claude took my raw thoughts, often spoken from the heart in imperfect language, and shaped them into clear, powerful, and beautifully structured prose without ever losing my voice or my meaning. In the process, Claude did something I did not expect: it taught me how to write. With every draft, every refinement, and every gentle correction, my own command over language improved. I learned how to structure my thoughts, how to express complex ideas simply, and how to write with both clarity and emotion. Honestly, I learned more about writing while creating this book with Claude than I had in all the years before it. For that, I am deeply grateful.

A Personal Invitation

If you are reading this book and wish to discuss life with diabetes and how to live with it happily, I would be more than happy to share my experiences with you.

Please keep in mind that I am not a doctor. I cannot give professional medical advice, and I do not discuss specific brands, medicines, or treatment plans. What I can share is the practical, everyday wisdom of someone who has lived this journey for over 15 years and come out the other side healthier and happier.

If you are comfortable with these conditions, I would love to hear from you. Please feel free to share your experience or reach out at: connect@beyondsugar.life or visit www.beyondsugar.life

I would love to be a part of your diabetes lifestyle journey. You are not alone.

Illustration: Chapter 61 illustrated summary. Awareness, care and a plan connect eyes, ears and brain; heart, liver and kidneys; nerves, digestion and feet; skin, wounds and oral health; and emotional and sexual wellbeing.

Chapter 61 Awareness, care and a plan connect eyes, ears and brain; heart, liver and kidneys; nerves, digestion and feet; skin, wounds and oral health; and emotional and sexual wellbeing. Mindful daily habits, prescribed medicines, regular checks and doctor guidance complete the picture.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.