Published Jan 30, 2026 | 7:00 AM ⚊ Updated Jan 30, 2026 | 7:00 AM
Representational image (Creative Commons)
Synopsis: India’s diabetes crisis has become a serious issue affecting millions of lives across age groups, regions, and socioeconomic levels. It is shaped by how the body responds to food in the context of physical inactivity, stress, sleep patterns, and long-term lifestyle habits.
India’s diabetes crisis is no longer a distant threat; it has become a serious issue affecting millions of lives across age groups, regions, and socioeconomic levels. India has the highest number of diabetics worldwide.
According to an article published in The Lancet, an estimated 212 million adults were reported to have diabetes in 2022. Alarmingly, 62 percent of diabetes cases within India were not treated, placing the country with the highest rate of untreated diabetes in the world.
A growing body of evidence shows that the epidemic’s roots lie not just in sugar consumption but in a complex interplay of lifestyle shifts, urbanisation, genetic predispositions, and systemic health challenges that demand urgent attention.
As a nutritionist, I can say India’s diabetes burden cannot be explained by sugar intake alone. It is shaped by how the body responds to food in the context of physical inactivity, stress, sleep patterns, and long-term lifestyle habits.
Urbanisation and nutrition transitions have shifted metabolic balance, making Indians vulnerable to insulin resistance even at lower body weight. Sustainable diabetes prevention and control depend on aligning diet with daily movement, stress regulation, and early screening, creating a stronger metabolic foundation to reduce long-term disease risk.”
A recent report by The Lancet illustrates the huge challenge posed by Diabetes in India. To put the scope of the challenge into perspective, it was reported that there are approximately 20 percent Indians aged 45 and older living with diabetes or nearly 50 million adults.
Although diabetes is categorised as a category of “non-communicable” disease, it continues to be a challenge in terms of diagnosis; approximately 40 percent of all individuals with diabetes are unaware of having the disease.
Therefore, millions of people are living with high blood sugar levels without receiving appropriate medical and lifestyle support.
Simply stating ‘high sugar equals diabetes’ does not give you a fair understanding of what causes India’s obesity and diabetes epidemic. As many leading endocrinologists working with lifestyle risk factors note, there are many different interrelated causes of this rapidly growing problem:
1. Changing diets and nutrition transitions
The dietary habits of modern Indians have shifted dramatically over the past few decades. Where once they had traditional meals which were high in dietary fibre, now processed foods, refined carbohydrates, sugars, sweetened drinks, and mostly high-caloric Western-style diets are replacing them. The increasing consumption of such diets translates into an increase in both the number of calories consumed and the amount of glycaemic load, which in turn contributes to insulin resistance.
Furthermore, it is also believed that a major reason for this difference is that Indians tend to develop diabetes at a significantly lower body mass index (BMI) than do people from Western countries. This phenomenon has sometimes been called the “thin-fat” Indian phenotype, which reflects the difference in body fat distribution, insulin sensitivity, and metabolic profiles in Indian people compared to Western countries.
2. Sedentary lifestyles and urbanisation
Sedentary behaviour and urban migration severely lower people’s physical activity levels. A large percentage of adult populations are moving towards a sedentary lifestyle, and only a few are engaging in moderate and vigorous exercises, which are risk factors associated with developing type 2 diabetes.
The shift from physically active jobs to desk-bound roles, alongside increasing motorised transport and reduced recreational activity, compounds risk. Even when the individual has a low body weight according to Western standards, the lack of movement fosters insulin resistance, central obesity, and metabolic dysregulation.
3. Genetics meets environment
The genetic background of India also plays a significant part. South Asians are genetically predisposed to develop insulin resistance and cardiovascular disease early in their lives compared to other groups. In addition to this genetic foundation, the increased exposure to modern risk factors such as high-calorie intake, inactive lifestyles, and stress increases the risk of diabetes problems, especially in younger age groups.
The healthcare challenges and awareness gaps also hinder effective diabetes control measures. Most people in India may face low rates of screening, inconsistent access to diagnostics like HbA1c testing, uneven treatment initiation, and weak disease management infrastructure, particularly in rural areas. The extent of these gaps escalates the risk of complications such as heart disease, kidney failure, neuropathy, and vision loss, which puts additional strain on the overall health system.
The comprehensive approach to managing diabetes should place equal importance on making lifestyle changes as well as seeking medical attention. A community education and awareness programme will help make people aware of the benefits of eating a healthy diet, being physically active, managing their weight, reducing their stress levels and getting regular screenings.
Additionally, enhancing access to affordable diagnostic treatments and preventative care in underserved communities is imperative to stem future growth in cases.
India’s diabetes epidemic is largely a product of both lifestyle and societal changes. With coordinated efforts spanning education, healthcare infrastructure, and policy reform, the country can confront this epidemic with the urgency and nuance it deserves.
(Views are personal.)
