Health Original explainer
About 101 million Indians live with diabetes. Here is why the numbers keep rising, and what actually helps.
Ask a doctor in any Indian city what fills the waiting room, and diabetes will be near the top of the list. A national study published in 2023 estimated that about 101 million adults in India live with diabetes, roughly one in nine adults. Another 136 million have prediabetes, the stage before diabetes, when blood sugar is higher than normal but not yet in the diabetes range. India now has more people living with diabetes than almost any other country, and the numbers are still climbing.
The rise is not a mystery, and it is not about one cause. It is the result of genes, food, work, cities and longer lives, all arriving at once. The good news is that much of it can be slowed down, and for many people delayed for years. This article explains what diabetes is, why India is so affected, and what actually helps.
Diabetes is a condition in which the level of sugar, called glucose, in the blood stays too high. Normally, a hormone called insulin helps move sugar from the blood into the body's cells, where it is used for energy. In diabetes, the body either does not make enough insulin or cannot use it properly. Sugar then builds up in the blood, and over years that damages blood vessels and nerves.
There are different types. Type 1 diabetes usually starts in childhood or young adulthood, when the body stops making insulin altogether, and it needs insulin treatment for life. Type 2 diabetes, which accounts for the large majority of cases in India, usually develops in adults. The body still makes insulin but does not respond to it well. A third type, gestational diabetes, appears during pregnancy and usually goes away after delivery, though it raises the risk of type 2 diabetes later in life.
Many people have no symptoms at first. That is why surveys keep finding that a large share of cases are undiagnosed. The International Diabetes Federation estimated in 2024 that about 43 per cent of Indian adults with diabetes did not know they had it.
Indians tend to develop diabetes at a lower body weight and a younger age than people in many other countries. Doctors describe a thin-fat pattern: a person can look slim and still carry fat around the waist and inside the abdomen, where it does the most harm. In the same 2023 national study, abdominal obesity was found in about 39.5 per cent of adults, and generalised obesity in 28.6 per cent.
Food and work have changed faster than bodies have. White rice, refined flour, sugary drinks and fried snacks are cheap and everywhere, while jobs have become more desk-bound and walking has shrunk. Cities add another push: long commutes, little open space, late dinners and short sleep. None of these alone causes diabetes, but together they raise the risk, especially for people with a family history of it.
The national average hides big differences. The 2023 study found diabetes in 26.4 per cent of adults in Goa and only 4.8 per cent in Uttar Pradesh. Rates are generally higher in cities than in villages, but the gap is closing as rural diets and lifestyles change too. High blood pressure travels with diabetes: the study found it in 35.5 per cent of adults, about 315 million people.
There is no single food or herb that prevents diabetes, despite what social media claims. What works is unglamorous and well tested: keeping weight in check, moving more, and eating differently. Brisk walking for about 30 minutes a day, five days a week, is one of the most effective steps. Studies of people with prediabetes have shown that weight loss and regular activity can delay diabetes for years.
Screening matters because early diabetes has no symptoms. The Indian Council of Medical Research recommends testing for all adults above 30, and earlier for people with a family history, extra weight around the waist, high blood pressure, or diabetes during a past pregnancy. A simple blood test at a clinic or a health camp is enough to start.
For people who already have diabetes, medicines work, but only when taken regularly. Most people also need regular checks of the eyes, kidneys and feet, because that is where long-term damage shows up first. The government's National Programme for Prevention and Control of Non-Communicable Diseases screens for diabetes at primary health centres, and medicines are available at many public facilities.
Uncontrolled diabetes slowly damages the small blood vessels in the eyes and kidneys, the nerves in the feet, and the large vessels that feed the heart and brain. It is a leading cause of kidney failure and vision loss in India, and it sharply raises the risk of heart attacks. The damage takes years, which is exactly why it is easy to ignore, and why regular checks matter more than willpower alone.
Diabetes in India is a large problem, but it is not a hopeless one. The same study that counted 101 million cases also showed that the biggest risk factors, weight, inactivity and diet, are things people and families can change, especially when caught early. The first step is the simplest: get tested, know your number, and act on it.
This article is general information, not medical advice. If you have symptoms or a family history of diabetes, speak to a doctor about testing and treatment.
This explainer was written by The Daily Short's desk from the sources listed above. It is general information, not professional advice. Spot an error? See our Corrections Policy or tell us via the Contact page and we will correct it. Follow our official Instagram @thedaily.short.