Silent Signs of Diabetes: Why You Can Feel Fine and Still Have It

Plenty of people find out they have type 2 diabetes at a routine check-up, not because anything felt wrong. That’s not a fluke. Early diabetes is often genuinely symptom-less, which is exactly why knowing the risk factors matters as much as knowing the symptoms.

About 9.1% of Singapore residents aged 18 to 74 have diabetes, according to the National Population Health Survey 2024. This article covers why it can hide, what symptoms to watch for, who should get screened in Singapore, and what to ask at that appointment.

Why Diabetes Can Be Completely Silent

People with type 2 diabetes can feel well and have no symptoms at all, according to HealthHub. Blood sugar can climb gradually over years before it’s high enough to cause anything you’d notice.

This is exactly why screening matters more than waiting for symptoms. “Screenings play an important role in detecting diabetes before it can wreak havoc,” said Dr Emily Ho, a senior consultant at SGH’s Department of Endocrinology, in a HealthXchange interview. “Early detection will allow us to treat the condition early and avoid the complications of diabetes such as long-term damage to the eyes, kidneys, nerves, heart and blood vessels,” she added.

The Symptoms, When They Do Appear

Some people do get symptoms, usually once blood sugar has been elevated for a while. The Singapore Heart Foundation and HealthXchange list a consistent set. Use the checklist below to see if any apply to you:

Diabetes symptom check

Tick any that apply to you right now.

Frequent urination, especially at night Feeling thirsty even after drinking plenty of water Feeling tired Blurred vision Slow-healing cuts and wounds Feeling hungry all the time despite eating Losing weight without trying Itching, particularly around the genital area

No single symptom confirms diabetes. A cluster, especially thirst, frequent urination, and fatigue together, is worth discussing with a doctor.

Understand Health

Download this checklist (PDF)

Free to save or print. For personal awareness only, not a diagnosis.

Dr Teh Ming Ming explains the mechanism behind the first two on HealthXchange: “When you have diabetes, there is too much glucose in your blood. Your kidneys usually filter glucose, but most of the glucose is reabsorbed, so that in those without diabetes, no glucose appears in the urine. But if the blood glucose levels are too high, the kidneys are unable to keep up and excess glucose will appear in the urine.” That excess glucose in the urine pulls extra water out with it, which is why frequent urination and constant thirst usually show up together.

No single symptom here is unique to diabetes. A cluster of them, especially thirst, frequent urination, and fatigue together, is a stronger reason to get checked than any one on its own.

Risk Factors Worth Knowing, With or Without Symptoms

Since symptoms are unreliable, HPB’s risk factor list is the more useful checklist. You’re at increased risk if you:

Have a parent or sibling with diabetes
Have a BMI of 23.0 kg/m² or higher (this Asian-specific threshold is lower than the general population cut-off, because Asians tend to develop diabetes at a lower BMI)
Lead an inactive lifestyle
Have high blood pressure or abnormal blood cholesterol
Have a history of gestational diabetes, or gave birth to a baby weighing more than 4 kg
Are 40 years old or above
Have previously been told you have impaired glucose tolerance or impaired fasting glucose

Ethnicity matters too. A national polyclinic health guide notes that Indians have the highest diabetes prevalence in Singapore, compared with Chinese and Malay residents. Long-term population modelling flags a similar pattern, projecting that Indian and Malay residents will bear a disproportionate share of Singapore’s future diabetes burden.

Doctor discussing blood test results with a patient — Photo by Vitaly Gariev on Unsplash

Getting Screened in Singapore

Under HPB’s Screen for Life programme, Singaporeans aged 40 and above are recommended to screen for diabetes once every three years. Subsidised rates run as low as $0 to $5. If you’re 18 to 39, you can complete the Diabetes Risk Assessment on HealthHub; if it flags you as higher risk, you become eligible for subsidised screening too.

Screening typically uses a fasting blood glucose test or an HbA1c blood test, followed by a glucose tolerance test where needed. MOH’s screening guidance for doctors says an HbA1c of 6.0% or below correlates well with no diabetes, and 7.0% or above correlates well with diabetes. A result from 6.1% to 6.9% needs a follow-up fasting glucose or glucose tolerance test. On HealthHub, a fasting glucose below 6.1 mmol/L is normal, 6.1 to 6.9 mmol/L is pre-diabetes, and 7.0 mmol/L or higher points to diabetes. Your doctor will interpret your own results and the next steps.

What to Ask at a Screening Visit

A short list of questions makes the appointment more useful:

Which test is right for me, and how often should I repeat it?
What target range should I aim for, given my age and risk profile?
If my result is pre-diabetes, what’s the plan for the next few months, diet, activity, weight, and follow-up testing?
Should I also be checked for blood pressure, cholesterol, kidney function, eye health, or foot health?

Practical Takeaways

Don’t wait for symptoms. HealthHub is explicit that many people with type 2 diabetes have none.
Know your own risk factors, not just the classic symptom list. BMI, family history, and gestational diabetes history matter even if you feel completely fine.
A cluster of symptoms is more meaningful than one. Thirst, frequent urination, and fatigue together deserve a check, more than any single symptom in isolation.
Use the DRA if you’re under 40. It’s free, online, and can flag risk early enough to matter.
Bring questions to your screening, not just your arm for the blood draw.

Frequently Asked Questions

If I feel completely fine, can I still have diabetes?

Yes. HealthHub states plainly that people with type 2 diabetes can feel well and have no symptoms at all. That’s the reason screening exists as a recommendation for everyone 40 and above, not just people who feel unwell.

Is one symptom enough to worry about?

Most of these symptoms have other, more common causes, tiredness alone rarely means diabetes. A cluster of symptoms together is a better reason to get checked than any single one.

I’m under 40 with no symptoms. Should I still care about this?

If you have a risk factor, such as a BMI of 23 or above, a family history, or a history of gestational diabetes, yes. HPB’s Diabetes Risk Assessment is built for exactly this group.

The Bottom Line

Diabetes doesn’t reliably announce itself, which is what makes it dangerous rather than obviously alarming. The symptoms are worth knowing. Your risk factors and your screening schedule may matter even more, since neither depends on waiting to feel unwell first. For the dietary side of prevention, see our piece on eating right for diabetes prevention. For a closer look at one of the biggest everyday contributors to blood sugar, see white rice and diabetes risk.