Published Apr 15, 2026 | 7:30 AM ⚊ Updated Apr 15, 2026 | 7:30 AM
Diabetes and heart diseases.
Synopsis: South India’s cities are showing sharply divergent disease patterns, with risks emerging earlier and often remaining undetected, according to Apollo Hospitals’ 2026 report. From high diabetes in Madurai to rising cholesterol in Hyderabad, the data highlights a growing, fragmented metabolic burden.
In Warangal, Telangana, hypertension was found in more than half the people screened. In the same state, Hyderabad stands at 27.3 percent.
In Trichy, Tamil Nadu, abnormal cholesterol was recorded in 76.6 percent of those tested – the highest of any city in the dataset.
Two small South Indian cities. Two numbers. And the beginning of a question about where South India’s urban health is heading, and how fast it is getting there.
New data from Apollo Hospitals’ Health of the Nation 2026 report suggests that while the region is often treated as a uniform epidemiological block, its cities are expressing sharply different disease patterns, shaped by diet, lifestyle, access, and local health behaviour.
The report, released on 7 April, draws on more than three million preventive health assessments conducted across the hospital network in 2025.
It finds that risks are emerging earlier, often without symptoms, and are frequently missed by routine screening.
At a broad level, the findings are already concerning. Nearly half of the working population screened had prediabetes or diabetes, eight in ten were overweight, and one in four had high blood pressure.
Among people under 30, one in five was prediabetic, a stage where intervention can still reverse the condition.
But beneath these national trends lies a more complex regional story.
“Genuine health is personal, proactive, and highly precise. Since no two lives are the same, our approach to prevention must be as individual as the people we serve. We are pushing the boundaries of science—from gut microbiome health to advanced long-term risk patterns—because a comprehensive health check is the ultimate act of self-stewardship,” said Dr Prathap C Reddy, Founder Chairman, Apollo Hospitals, in a statement.
Before the numbers, the context matters.
The dataset is not a population-level survey. It reflects individuals who walked into Apollo Hospitals facilities for health checks – urban, economically active, and health-aware. Some arrive with prior diagnoses. Others come through corporate programmes. Many are testing proactively.
That makes this a self-selected cohort.
But if anything, that sharpens the concern. These are people already engaged with the healthcare system. If this group shows widespread metabolic risk, the broader population is likely further along the same path.
In Telangana, Hyderabad presents what appears to be a moderate profile at first glance. Diabetes prevalence stands at 25.3 percent, and hypertension at 27.3 percent – numbers that do not immediately stand out in a regional comparison.
Yet, the city carries one of the highest dyslipidaemia burdens in South India, at 70.6 percent, alongside an obesity rate of 81.3 percent. This combination points to cardiovascular risk accumulating quietly, without the more visible signal of elevated blood sugar.
Less than 200 kilometres away, Warangal tells a very different story. Hypertension affects 52.6 percent of those screened – nearly double Hyderabad’s rate within the same state.
The divergence is not easily explained.
The report does not attribute it to a single factor, but points broadly to diet, lifestyle, and access. The scale of the gap, however, suggests that city-level health dynamics are far more complex than state averages indicate.
A similar pattern emerges in Karnataka.
In Bangalore, diabetes stands at 17.5 percent and hypertension at 23 percent, among the lowest in the South. In Mysore, hypertension rises sharply to 43.7 percent, with diabetes at 32 percent.
Two cities, one state, and a 20 percentage point difference in blood pressure. These contrasts are not statistical noise. They are signals of distinct local health trajectories.
If Karnataka and Telangana illustrate divergence, Tamil Nadu shows clustering.
Cities such as Madurai (36.4 percent), Trichy (34.1 percent), and Karaikudi (34.2 percent) record some of the highest diabetes prevalence rates in South India.
Trichy stands out further, with dyslipidaemia at 76.6 percent—the highest across the dataset—and obesity at 84.1 percent. Together, these indicators describe a compounding metabolic burden, where multiple risk factors reinforce each other.
In Chennai, the pattern shifts slightly. Diabetes is lower at 25.4 percent, but anaemia reaches 38 percent, among the highest in South India.
This has diagnostic implications.
The report notes that in patients with severe anaemia, HbA1c—the standard test used to measure long-term blood sugar—can underestimate true glucose levels by up to 1.4 percentage points. In cities like Chennai, where anaemia is widespread, diabetes may be underdetected even among those who undergo screening.
“These differences are driven by diet, lifestyle, and access, not just genetics,” the report states.
In Andhra Pradesh, the variation is subtler but still significant.
Nellore records the highest obesity rate in South India at 85.3 percent, alongside dyslipidaemia of 73.8 percent and hypertension at 29.2 percent. The combination points towards elevated cardiovascular risk.
In Visakhapatnam, diabetes stands at 25.8 percent, anaemia at 26 percent, and obesity at 80.5 percent, presenting a more balanced but still high-risk profile.
Kakinada, meanwhile, shows an unusual dip in dyslipidaemia at 38.3 percent, significantly lower than neighbouring cities.
These differences emerge despite broadly similar dietary cultures, suggesting that even small variations in lifestyle, economic profile, or healthcare access can produce distinct disease signatures.
Across South India, Kochi provides a useful reference point.
Diabetes stands at 18.5 percent, hypertension at 30.6 percent, anaemia at 11.6 percent, and dyslipidaemia at 38 percent – the lowest among southern cities in the dataset.
Kerala’s long-standing investments in education, public health, and healthcare access are often cited as contributing factors.
But the numbers are not benign. Nearly three in four people screened in Kochi are overweight or obese, indicating that even the region’s best-performing city is carrying a significant metabolic burden.
Beyond geography, the report highlights a shift in when disease begins.
Among individuals under 30, one in five was prediabetic. Early intervention proved effective, with 28 percent of those who acted reversing to normal blood sugar levels. Among those over 50, only 7 percent achieved reversal.
Screening among 20,000 students aged 17 to 25 found that two in three already had at least one health risk.
The working population, with an average age of 38, showed widespread risk accumulation. Eight in ten were overweight, nearly half had prediabetes or diabetes, and one in four had high blood pressure.
The report also points to a gap between what routine tests detect and what actually exists.
Among individuals with ultrasound-confirmed fatty liver, 74 percent had normal liver enzyme levels. Among asymptomatic individuals who underwent coronary calcium scoring, 45 percent showed early signs of atherosclerosis.
This suggests that a large proportion of disease remains invisible under standard screening protocols.
“Healthy longevity is not a matter of chance, it is a matter of early, continuous action,” said Sangita Reddy, Joint Managing Director, Apollo Hospitals.
“The right health check, at the right time, can detect heart disease and cancers at Stage 1 when they are most treatable. India cannot afford to remain symptom-led; we must become predictive, continuous, and deeply personal in how we approach health.”
Long-term data tracking over 1,79,000 individuals reveals that disease progression follows a consistent sequence.
Weight gain and elevated blood pressure appear first, within about 1.4 years of a normal check-up. Liver abnormalities and cholesterol follow at around three years. Blood sugar rises last.
This sequence reframes how chronic disease develops.
By the time diabetes is diagnosed, the body has often already spent years accumulating metabolic damage.
“Genuine health is personal, proactive, and highly precise,” said Dr Reddy. “Since no two lives are the same, our approach to prevention must be as individual as the people we serve.”
(Edited by Dese Gowda.)
