This article is part of South First’s year-long Beat Obesity, Lower Diabetes (BOLD) series, an attempt to keep the lens steady, week-after-week analysis on what is changing, what is not, and what must.
Published Jan 24, 2026 | 7:00 AM ⚊ Updated Jan 24, 2026 | 5:51 PM
In patients with screen-heavy, sedentary routines, doctors often first notice elevated fasting insulin levels, even when glucose appears normal. Credit: iStock
Synopsis: Doctors are increasingly diagnosing diabetes in patients without traditional risk factors like poor diet, obesity, or family history. Sedentary routines, irregular sleep, and digital lifestyles drive insulin resistance through metabolic underuse, disrupted circadian rhythms, and hormonal imbalance. Early warning signs include elevated insulin, lipid changes, and fatty liver. Experts stress consistent sleep, meal timing, and movement as preventive strategies.
Diabetes is no longer showing up only where doctors expect it to. Increasingly, patients walk into clinics with no dramatic dietary excesses, no strong family history, and sometimes not even excess weight.
Yet their blood reports tell a different story—insulin resistance has already set in, quietly and steadily.
What links many of these patients is not what they eat, but how they live: long hours seated in front of screens, irregular sleep driven by devices, minimal physical movement, and constant cognitive engagement without physical release.
These are not lifestyle “choices” in the casual sense—they are structural features of modern work and digital life. Clinicians are now seeing diabetes emerge from this environment. Not suddenly, and not dramatically—but predictably.
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When diet, genes don’t explain insulin resistance
Dr. Uthra, Consultant, Dr. Mohan’s Diabetes Specialties Centre says a growing number of her patients do not fit the traditional diabetes risk profile. “We are seeing patients where diet and genetics alone don’t fully explain the insulin resistance,” she told South First.
In these cases, the problem is not excess calories but prolonged metabolic underuse—bodies that are rarely required to move, adapt, or recover.
She explains that long hours of sitting slow down glucose uptake by muscles, which are the body’s largest glucose consumers. When muscles remain inactive for most of the day, glucose clearance becomes inefficient, pushing the pancreas to produce more insulin. Over time, this constant demand leads to insulin resistance.
“What we are dealing with is lifestyle opacity,” Dr. Uthra explains. Much of the metabolic stress is invisible—no binge eating, no obvious weight gain—but the internal machinery is under strain.
Patients often assume they are healthy because they eat “normally,” yet their daily routines deprive the body of movement, rhythm, and recovery.
In these individuals, waist circumference is a more sensitive indicator of metabolic risk than body weight alone, as it captures visceral fat accumulation even when BMI is normal. A growing waistline can therefore signal insulin resistance well before blood sugar levels increase.
This is why diabetes now appears in people who feel blindsided by the diagnosis. The disease has been developing quietly, shaped by years of sedentary behaviour rather than sudden dietary failure, she adds
Early warning signs appear long before sugar levels rise
One of the most important clinical shifts, Dr. Uthra says, is recognizing that diabetes does not begin with high blood sugar. “By the time fasting blood sugar becomes abnormal, insulin resistance has often been present for years,” she says.
In patients with screen-heavy, sedentary routines, doctors often first notice elevated fasting insulin levels, even when glucose appears normal.
Lipid changes—especially higher triglycerides and lower HDL cholesterol—are also early indicators. Mild elevations in liver enzymes may point to fatty liver disease, another marker of metabolic stress.
“These are not random findings,” Dr. Uthra explains. They reflect a system under constant low-grade pressure. Sitting for long hours reduces muscle insulin sensitivity, while irregular routines disrupt hormonal balance. The body compensates silently until it no longer can.
She also points out that BMI often fails to capture this risk. “We see many patients with normal BMI who develop diabetes,” she says.
Waist circumference, in contrast, helps identify hidden visceral fat and reduced muscle mass, offering a clearer picture of metabolic health than BMI alone.
Increased visceral fat, reduced muscle mass, and prolonged inactivity create a metabolically unhealthy profile despite normal weight. In such cases, body composition matters far more than the number on the scale.
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Sleep timing, not sleep quantity, is breaking metabolic rhythm
Late-night screen exposure affects metabolism not simply by reducing sleep hours, but by disrupting the body’s internal clock.
Dr Benhur Joel Shadrach, interventional pulmonology and sleep medicine specialist, explains that the human body runs on a biological rhythm in which certain hormones are meant to dominate during the day and others at night.
“We have a biological clock running in our body,” he told South First. “Certain hormones and chemical messengers are active in the daytime, and some others are active at night.”
Staying awake late alters this balance. Melatonin—the hormone responsible for sleep timing—gets suppressed, while appetite-related hormones shift in the wrong direction.
According to Dr Benhur, late-night wakefulness increases ghrelin, the hunger hormone, and reduces leptin, which signals fullness. “When you are awake, you tend to eat more,” he explains.
He adds that, late night, your entire digestive system—the liver and pancreas—will slow down. When we eat at that time, they are forced to work again.”
This leads to increased hepatic glucose production and prolonged elevation of blood sugar levels. Over time, repeated exposure creates insulin resistance not only in muscles but also in fat tissue.
Dr. Benhur says these sleep-linked metabolic problems are showing up most often in people with modern work routines.
Long hours of sitting, back-to-back meetings, late workdays, and irregular eating have become normal.
Social habits add to it—late dinners, parties, alcohol, and eating simply because food is available, not because the body is ready for it.
Over time, this mix of sitting too long, eating too late, and sleeping at odd hours quietly pushes the body toward insulin resistance, he notes
Blue light, cortisol, and why digital sleep disruption is underestimated
Dr. Benhur says digital sleep disruption is often misunderstood because its effects are cumulative rather than immediate. “This doesn’t happen overnight or with a single exposure,” he notes. “It’s a cumulative effect when we are habitually staying up late at night and using blue screens.”
Blue light, he explains, has a shorter wavelength than other visible light, which makes it particularly stimulating to the brain. “It stimulates the neurons through the optic nerve and activates the hypothalamus–pituitary–adrenal axis,” he says.
Once this stress axis is activated, cortisol levels rise at a time when they should naturally be falling.
Elevated cortisol at night keeps the body in a prolonged state of alertness, suppressing melatonin, reducing insulin sensitivity, and increasing hepatic glucose production. Over time, this hormonal pattern closely resembles the metabolic disruption seen in circadian rhythm disorders.
“Over a long period of time, it can become comparable to shift work disorder,” Dr. Benhur says.
While many people associate metabolic risk with night-shift jobs, digitally driven lifestyles can create a similar internal disruption—without being recognised as such in routine medical assessments.
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How to reduce digital sleep damage without drastic lifestyle changes
Dr. Benhur says the problem may be widespread, but the solutions don’t require drastic lifestyle changes. “I think we should stick to our old schedules,” he says.
One of the most effective steps is fixing meal timing. “Avoid heavy food after sunset,” he advises. Finishing dinner early and leaving a two-to-three-hour gap before sleep allows proper digestion.
Late-night oily, spicy, or heavy meals place extra strain on the digestive system and increase reflux and metabolic stress.
Sleep habits matter just as much. Dr. Benhur recommends 6.5 to 8 hours of good-quality sleep at the right time, along with strict limits on screen exposure before bed.
“Make sure you are not exposed to blue light from mobiles, laptops, or other gadgets at least one hour before sleep,” he says. Instead, he suggests dim lighting, reading, and relaxation to help the mind unwind.
Importantly, he says this doesn’t mean giving up work or social life. Small, steady changes make a real difference. Breaking long sitting hours with short walks or stretches during the day improves how the body handles sugar.
On late workdays or social evenings, keeping meals light, limiting alcohol, and avoiding heavy food close to bedtime can reduce metabolic strain.
Consistency is key. Keeping regular meal times, protecting sleep timing—even on social days—and reducing late-night screen use help hormones settle into a healthier rhythm.
“When this becomes a routine, stress levels and metabolism automatically improve,” Dr. Benhur explains. Even mild exercise and consistent daily habits, practiced regularly, can significantly improve blood sugar control and long-term metabolic health.
(Edited by Amit Vasudev)
