\n Diabetes and pre-diabetes have emerged as major global health challenges, with numbers rising at an alarming rate across continents. Pre-diabetes, a stage where blood sugar levels are elevated but not yet in the diabetic range, often progresses silently into full-blown diabetes, if ignored. India now ranks among the countries most affected. According to recent surveys, more than one in six Indian adults is living with diabetes, and 130 million Indians are in the pre-diabetic stage without even knowing it.
The rise of diabetes and pre-diabetes in India is driven by a mix of lifestyle, environmental, and genetic factors. Rapid urbanisation has brought sedentary habits, reduced physical activity, and long hours of desk-bound work. At the same time, diets high in refined carbohydrates, sugars, and processed foods have replaced traditional, fibre-rich meals. Obesity- especially abdominal fat, is now a major risk factor, while stress and irregular sleep further worsen the problem.
Diabetes exists in two primary forms: type 1 and type 2. Type 1 diabetes occurs when the body cannot produce insulin, a hormone essential for allowing cells to absorb glucose from the bloodstream. In contrast, type 2 diabetes arises when the body produces insulin but cannot use it effectively—a condition known as insulin resistance.
Insulin acts as the signal that enables cells to take up glucose and convert it into energy. In insulin resistance, this signal becomes weakened. As a result, glucose remains in the bloodstream even though insulin levels may be normal or sometimes excessively high. Persistently elevated insulin—often driven by factors such as excess body fat, diet rich in simple carbohydrates, and inactivity—is believed to gradually reduce the body's sensitivity or the ability to react to insulin. Indians have a genetic predisposition to develop insulin resistance at lower body weights than many other populations. Combined with rapid urbanization, dietary shifts, and sedentary lifestyles, these factors have created a "perfect storm," driving rising diabetes rates across both metropolitan areas and smaller towns.
Diabetes, if left uncontrolled, carries serious health risks that can affect nearly every organ system. Persistently high blood sugar damages small blood vessels, leading to complications such as retinopathy that threatens vision, nephropathy that impairs kidney function, and neuropathy that causes pain, numbness, or loss of sensation in the limbs. Larger blood vessels are also affected, significantly increasing the risk of heart disease, stroke, and peripheral artery disease. Poor wound healing and greater susceptibility to infections are common, sometimes resulting in amputations.
In women, diabetes raises complications during pregnancy. Beyond physical health, the condition reduces quality of life, creates long-term dependency, and places a heavy financial burden on families. Without timely management, these consequences can be devastating, underscoring the importance of early diagnosis and sustained control.
India today faces one of the highest diabetes burdens in the world, with both urban and rural populations increasingly affected. According to the National Family Health Survey (NFHS-5), around 16% of Indian adults live with diabetes, while millions more remain undiagnosed or in the pre-diabetic stage. The prevalence is far from uniform: in urban centres such as Chennai, Delhi, and Goa, rates often cross 20–25%, while states like Lakshadweep record over 23% of adults with diabetes. In contrast, some less urbanised states in the northeast still report relatively lower figures. Pre-diabetes, too, shows wide variation, ranging from less than 5% in certain tribal belts to nearly 40–50% in metropolitan regions. This uneven spread highlights how lifestyle, economic development, and urbanisation strongly influence the disease pattern across India, with metropolitan cities at the epicentre but smaller towns and rural areas rapidly catching up.
The best approach towards diabetes is prevention. At the prediabetes stage, it is possible to reverse the condition completely. Regular screening, especially for those with family history or other risk factors, helps catch pre-diabetes before it progresses. A balanced diet, daily physical activity, weight control, and stress management remain the strongest shields against the disease. With early detection, simple lifestyle changes, proper supplementary support with food and nutraceuticals and consistent medical care, its risks can be greatly reduced.
Once prediabetes has moved to become full blown diabetes, it is a lifelong condition. For those already diagnosed, timely treatment and regular monitoring can prevent serious complications and ensure a healthy, active life.
References
1. Prevalence and complications of diabetes mellitus In India - A systematic review. Retrieved from https://www.researchgate.net/publication/367916935
2. Nature Scientific Reports (2023). Retrieved from https://www.nature.com/articles/s41598-023-29978-y
3. PubMed Central. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7871157/
4. Annals of Epidemiology, ScienceDirect. Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S1047279721000375