Diabetes has emerged as a silent epidemic in India, claiming nearly 6.5 lakh lives in 2021 alone. Alongside China, Pakistan, and the US, India has one of the highest diabetes rates globally. Studies reveal a surge in its prevalence across the nation. A recent report showed that nearly half (49.43%) of the Indian population tested had abnormal blood glucose levels, with 27.18% diagnosed with diabetes and 22.25% categorised as prediabetic. This aligns with findings published in The Lancet, which highlighted that in 2022, one-quarter of adults living with diabetes globally resided in India.
Diabetes was relatively rare in India until the 1970s. Two major events reshaped the landscape, paradoxically improving economic conditions while fuelling a diabetes epidemic. The Green Revolution of the 1960s transformed India from a food-deficient country reliant on imports to one that achieved self-sufficiency in food production. While this alleviated widespread hunger, it also introduced dietary shifts that inadvertently sowed the seeds for long-term health challenges.
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The economic liberalisation of 1991 further accelerated these changes. Rapid economic growth brought rising incomes, which fostered a preference for high-calorie, processed foods. This dietary transformation, coupled with increasingly sedentary lifestyles, created the perfect condition for an obesity epidemic, which is a major risk factor for Type 2 diabetes.
Lifestyle and environmental triggers
Today, the situation is alarming. In urban India, more than a quarter of adults aged 20 and above suffer from Type 2 diabetes. Among those aged 50 and above, the figure rises to nearly half. While rural areas were once insulated from such health crises, they are now experiencing a surge in diabetes cases, demonstrating that the epidemic knows no geographic boundaries.
The rising prevalence of diabetes in India is intricately linked to urbanisation and industrialisation, which have profoundly altered lifestyles. Obesity, especially visceral fat accumulation around the liver, is a key risk factor, stemming from diets rich in sugar, fats, and calories. These dietary habits are compounded by sedentary lifestyles, with long hours of inactivity becoming the norm. Additionally, cultural practices, such as India’s affinity for unhealthy evening snacks, exacerbate the situation, making the problem deeply ingrained in daily life.
Another factor is the genetic predisposition of Indians toward insulin resistance, which is more pronounced when combined with environmental triggers. Recent research has also highlighted air pollution as an emerging risk factor. Studies conducted in New Delhi and Chennai reveal that pollutants act as endocrine disruptors, impairing the normal functioning of the pancreas and liver, thereby increasing vulnerability to Type 2 diabetes.
The unchecked rise in diabetes has far-reaching consequences. Beyond individual suffering, the disease places a tremendous burden on the healthcare system and the economy. Diabetes-related complications, such as heart disease, kidney failure, blindness, and amputations, not only reduce quality of life but also diminish the productivity of the working-age population. The age group most affected is between 15 and 64, which comprises the backbone of India’s workforce. With stress levels, physical inactivity, and urban migration contributing to the epidemic, the economic ramifications are dire.
Diabetes prevention and control
Addressing diabetes in India requires a complex approach that encompasses policy reforms, education, lifestyle changes, and healthcare improvements. On the policy front, introducing taxes on sugary drinks and processed foods can play a pivotal role in curbing unhealthy consumption. Multinational companies often exploit the Indian market by dumping products with excessively high sugar content, as highlighted by the Access to Nutrition Initiative. Penalising such practices can help protect consumers and reduce the incidence of diet-related diseases.
Education and awareness campaigns are equally critical. Integrating diabetes prevention education into school curriculums can empower young individuals to make informed lifestyle choices. Parents and caregivers also need to be educated about the harmful effects of feeding sugary snacks and drinks to children. This early intervention can break the cycle of poor dietary habits that often carry into adulthood.
Promoting healthier lifestyles is another essential aspect. Nationwide campaigns that encourage balanced diets, physical activity, and stress management can significantly reduce the risk of diabetes. Stress, in particular, is a silent contributor to the epidemic, and targeted initiatives to address it can yield substantial benefits. Informing parents, teachers, and children about the importance of a nutritious diet and regular exercise is crucial in combating childhood obesity, which frequently leads to adult-onset diabetes.
Finally, strengthening the healthcare system is imperative. Making diabetes management affordable and accessible can help those already afflicted by the disease. Early detection through regular screenings and community health programs can mitigate the risk of complications. At the same time, encouraging individuals to adopt disciplined habits—such as adhering to prescribed medications, maintaining healthy diets, and undergoing regular check-ups—can improve long-term outcomes.
Empowering future generations
The fight against diabetes must begin with the younger generation. Instilling healthy eating habits and the importance of physical activity from a young age can help prevent childhood obesity, which often tracks into adulthood. Informing children and their families about the consequences of poor dietary choices is vital. Educating parents and grandparents, who often unwittingly encourage unhealthy snacking habits in children, can be a game-changer in altering long-standing behaviours.
An India free from diabetes-related complications is within reach, but it requires collective effort. Lifestyle modifications, coupled with robust policy measures, can significantly reduce the disease’s prevalence. Even for those already diagnosed, managing blood sugar levels, blood pressure, and cholesterol—along with disciplined habits like proper diet, exercise, and sleep—can prevent complications and, in some cases, reverse the condition.
India stands at a crossroads in its fight against diabetes. With concerted efforts from individuals, healthcare providers, and policymakers, the nation can aspire to a healthier future, free from the burden of this silent epidemic.