Eight states report zero diabetes cases, raising questions about screening adequacy versus actual disease absence.
Published Sep 29, 2025 | 7:00 AM ⚊ Updated Sep 29, 2025 | 7:00 AM
Synopsis: Kerala leads India with a 32.2% pre-diabetic rate among adolescents, far exceeding the national average of 10.4%, despite robust healthcare. The state also records high cholesterol levels in children and teens. Southern states show varied metabolic health, with Andhra Pradesh at 4.0% pre-diabetes. Regional disparities highlight uneven screening and environmental factors driving India’s adolescent health crisis.
Kerala records the highest pre-diabetic rates among Indian adolescents at 32.2 percent, affecting nearly one in three teenagers aged 10-19 years, according to data released by the Ministry of Statistics and Programme Implementation (MoSPI), Government of India, in “Children in India 2025” published on 25 September, 2025.
The analysis reveals that Kerala’s pre-diabetic prevalence surpasses the national average of 10.4 percent by more than three times, marking the state as the worst performer nationally despite its advanced healthcare infrastructure.
Across southern India, health indicators vary dramatically between states. Tamil Nadu reports 9.2 percent pre-diabetic adolescents, while Telangana records 8.6 percent and Karnataka 7.1 percent. Andhra Pradesh shows the lowest regional rate at 4.0 percent.
Kerala dominates multiple problematic categories. The state registers 15.4 percent of children aged 5-9 years with high total cholesterol levels, nearly five times the national average of 3.2 percent. Among adolescents, 13.9 percent show elevated cholesterol levels compared to the national figure of 3.7 percent.
Karnataka presents concerning age-related deterioration patterns. Low HDL cholesterol affects 27.8 percent of children but jumps to 38.9 percent among adolescents. High triglyceride levels similarly increase from 22.1 percent in children to 36.5 percent in teenagers.
Pre-diabetes occurs when fasting plasma glucose levels exceed 100 milligrams per deciliter but remain below 126 mg/dl.
This condition signals impaired glucose tolerance and represents a critical warning stage before type 2 diabetes development. Without intervention, pre-diabetic individuals face significantly elevated risks of progressing to full diabetes within five to ten years.
High-density lipoprotein (HDL) cholesterol functions as protective cholesterol that transports harmful cholesterol away from arteries to the liver for disposal. HDL levels below 40 mg/dl indicate increased cardiovascular disease risk.
Low-density lipoprotein (LDL) cholesterol, often termed “bad cholesterol,” builds up in artery walls when levels exceed 130 mg/dl, creating blockages that restrict blood flow.
Total cholesterol measurements above 200 mg/dl signal elevated cardiovascular risk. Triglycerides, another fat type in blood, become problematic when exceeding 130 mg/dl in adolescents or 100 mg/dl in children, indicating poor dietary patterns and metabolic dysfunction.
Delhi leads hypertension rates among adolescents at 10.1 percent, more than double the national average of 4.9 percent. Northern states show elevated rates, with Uttar Pradesh recording 8.6 percent and Manipur 8.3 percent.
Southern states demonstrate better blood pressure control. Kerala registers merely 0.5 percent hypertensive adolescents despite leading pre-diabetic rates. Tamil Nadu reports 4.3 percent, Karnataka 3.1 percent, and Andhra Pradesh 5.2 percent. Telangana records the highest southern rate at 6.7 percent.
Hypertension diagnosis requires systolic blood pressure readings above 139 millimeters of mercury or diastolic pressure exceeding 89 mmHg. Early-onset hypertension significantly increases lifetime cardiovascular disease risk and often indicates underlying metabolic problems.
National data reveals widespread lipid disorders among children aged 5-9 years. High triglycerides affect 34.0 percent of children, representing the most common lipid abnormality. Low HDL cholesterol impacts 26.1 percent of children, indicating widespread protective cholesterol deficiency.
Regional clustering suggests environmental or dietary factors drive these patterns. Northeastern states consistently report higher rates across multiple parameters, while some northern states show better lipid profiles.
Several states report zero diabetes cases among adolescents, including Andhra Pradesh, Bihar, Delhi, Himachal Pradesh, Jammu & Kashmir, Karnataka, Nagaland, and Uttar Pradesh. These findings likely indicate underdiagnosis rather than actual absence of disease, given the presence of significant pre-diabetic populations in these regions.
Tripura records the highest diabetic rate at 4.9 percent, exceeding the national average of 0.6 percent by more than eight times. Tamil Nadu and Telangana report diabetes rates of 1.0 and 1.1 percent respectively, suggesting more comprehensive screening programs.
The diagnostic disparities highlight uneven healthcare access and screening capabilities across states. Kerala’s high pre-diabetic detection rate may reflect superior healthcare infrastructure and screening programs rather than worse population health.
Health patterns shift significantly between childhood and adolescence. Triglyceride abnormalities decrease from 34.0 percent in children to 16.1 percent in adolescents, while total cholesterol problems slightly increase from 3.2 to 3.7 percent. HDL problems remain consistently high across age groups.
These transitions suggest critical intervention windows during teenage years. Karnataka’s dramatic worsening between age groups indicates specific factors affecting adolescent health in the state.
Kerala combines extreme metabolic problems with excellent cardiovascular outcomes. The state records the highest pre-diabetes and cholesterol rates nationally but maintains the lowest hypertension rates at 0.5 percent. This pattern suggests early-stage metabolic dysfunction before cardiovascular complications develop.
Karnataka shows dramatic health worsening from childhood to adolescence. Children display relatively normal lipid profiles, but adolescents develop severe HDL and triglyceride abnormalities. This pattern indicates critical health transitions during teenage years requiring targeted interventions.
Tamil Nadu maintains moderate risk levels across all parameters with the highest regional diabetes rate at 1.0 percent. The state shows consistent lipid abnormalities in both age groups and moderate hypertension rates.
Telangana demonstrates low cholesterol issues across age groups but records the highest southern hypertension rate at 6.7 percent and significant diabetes prevalence at 1.1 percent.
Andhra Pradesh shows the lowest regional pre-diabetic rate at 4.0 percent and reports zero diabetes cases, though this likely reflects screening gaps rather than disease absence.
The survey data encompasses children and adolescents nationwide, revealing that metabolic health problems affect significant populations across age groups with dramatic state-wise variations that highlight India’s complex health landscape.
Beyond Kerala’s crisis-level 32.2 percent pre-diabetic rate, northeastern states demonstrate disproportionately high prevalence. Sikkim records 25.8 percent, while Mizoram shows 23.7 percent pre-diabetic adolescents. Gujarat registers 20.9 percent, and West Bengal 22.1 percent, all significantly exceeding national averages.
Diabetes patterns show similarly extreme disparities. Tripura leads nationally with 4.9 percent diabetic adolescents, followed by Meghalaya at 3.0 percent and Gujarat at 2.9 percent. Eight states report zero diabetes cases, raising questions about screening adequacy versus actual disease absence.
States showing better lipid profiles include Jharkhand with low rates across most categories, and southern states like Maharashtra and Telangana maintaining relatively controlled cholesterol levels.
Goa presents an anomaly with the nation’s highest LDL cholesterol rate among adolescents at 15.3 percent, despite maintaining lower rates in other lipid categories. This pattern suggests specific dietary or lifestyle factors unique to the state.
Hypertension suggests urban environments and specific regional factors contribute significantly to early-onset hypertension. Delhi’s urban density and pollution levels may contribute to its elevated rates, while rural states like Haryana and Punjab show better cardiovascular outcomes.
Certain states emerge as high-risk across multiple health categories. West Bengal, Sikkim, and northeastern states consistently rank among the worst performers in lipid disorders while showing varied patterns in diabetes and hypertension.
West Bengal combines extreme lipid abnormalities with low hypertension rates, suggesting early-stage metabolic dysfunction before cardiovascular complications manifest. This pattern mirrors Kerala’s profile, indicating possible common underlying factors.
(Edited by Amit Vasudev)
