Addressing India's

Diabetes Dilemma

Never Too Early To Test But May Be Too Late To Treat
Article by: Sushmita Sharma

Shilpi Arya, 28, started noticing a sudden drop in her weight in September 2021. At first, she didn’t think much of it, attributing it to pandemic stress and poor diet. However, it became a concern when she developed symptoms like weakness and blurred vision. Multiple tests later, she was diagnosed with Type 2 diabetes. Being in her late twenties, the diagnosis came as a shock.


Shilpi is among 100 million people in India, who presently have diabetes. India is grappling with a staggering diabetes burden. With 101 million diabetes cases, the nation has earned the unfortunate title of the ‘diabetes capital of the world’.

A study published in ‘The Lancet Diabetes and Endocrinology’ reveals that a staggering 136 million Indians, accounting for 15.3% of the population, may be living with prediabetes. This situation underscores the urgency of diabetes awareness and intervention.

On this World Diabetes Day, OnlyMyHealth tries to raise awareness about diabetes through credible information coming from doctors and experts, and first-hand experiences of patients. We wanted to shed light on the importance of timely testing for the condition. We aim to encourage proactive health management and early diagnosis to promote overall well-being.

The Diabetes Epidemic in India

According to the Indian Journal of Ophthalmology, 77 million people in India were living with diabetes in 2019, a number projected to surpass 134 million by 2045. Out of these 57% remain undiagnosed. It is projected that by 2035, diabetes will be responsible for the deaths of approximately 592 million individuals globally.

Rising Cases Of Diabetes In India

Source: Indian Journal of Ophthalmology

Taran Singh, a 32-year-old businessman had no family history of diabetes. So, when he was diagnosed with high blood sugar at 29, he was quite taken aback.

“I was unable to believe that I was diabetic at such an early age. I might have discovered it even later if I hadn't gone for a diabetes screening. My doctor informed me that obesity was the contributing factor to my diabetes diagnosis”, Singh told OnlyMyHealth.

Data from World Health Organization (WHO), reveals that Noncommunicable Diseases (NCDs), which are non-transmissible chronic conditions, were responsible for 74% of worldwide deaths in 2019. Among them, diabetes led to 1.6 million fatalities, making it the ninth most common cause of death on a global scale.

Rising Prevalence Of Diabetes In India

  • 7.1%
  • 8.3%
  • 8.6%
  • 8.7%
  • 8.8%
  • 8.9%
Source: Indian Journal of Ophthalmology]

Fueling the Fire: Factors Behind India's Diabetes Surge

Many factors contribute to the surge in diabetes cases in India. There has been an increasing prevalence of Type 2 diabetes, especially in urban settings, according to the Journal of the Association of Physicians of India. This trend is linked to shifts in lifestyle and environmental factors resulting from industrialisation and urbanisation, including sedentary habits and a diet rich in calories and fats.

This trend can be attributed to a combination of genetic predisposition and modern lifestyle factors, said Dr Venkatesh Billakanti, Consultant Physician (Internal Medicine), Yashoda Hospitals, Hyderabad.

There has been a significant rise in obesity in India, with 23% of women and 22.1% of men being overweight, as stated in a journal published in The Lancet.

“The obesity epidemic in India, with more individuals falling into the overweight or obese category, significantly contributes to the diabetes burden”, added Dr Billakanti.

According to StatPearls, a leading healthcare database, diabetes risk substantially rises in men and women with increasing BMI (from below 18.5 kg/m to over 35 kg/m). For men, the risk goes up from 7-70%, and for women, it goes from 12-74%. Therefore, diabetes screening is recommended for all obese patients.

To understand whether people understand the extent and severity of the problem or not, the OnlyMyHealth team stepped out in Delhi. The prevalent consensus was that people were aware of a ‘disease’ called diabetes, but had little understanding of its nuances. Watch the video below:

One common thread was that most people knew diabetes revolved around something related to blood sugar levels, but didn’t know how often they should test, who can get it, or what causes diabetes.

A crucial thing to understand before understanding diabetes is what makes for normal blood sugar levels.

Understanding Blood Sugar Levels

The normal range for blood sugar levels is 70-140 mg/dL, with fasting levels below 100 mg/dL generally considered normal for most individuals, said Dr Archana Batra, Nutritionist and Certified Diabetes Educator, Gurugram.

It's important to note that after meals, blood sugar levels may increase temporarily but usually return to normal within a few hours, she added.

Signs to Watch Out For

It is crucial to understand your body’s signals to identify potential health concerns. Here are some symptoms of diabetes that you should know:

“I noticed symptoms like increased thirst, frequent urination, fatigue, and blurry vision. This prompted me to get tested and I found that I was diabetic,” said Malti Ghosh, a 50-year-old homemaker, diagnosed with type 2 diabetes at 49 years of age.

Managing household chores with the fatigue and low energy levels that come with diabetes is something Malti continues to struggle with, even after two years of her diagnosis. “I must pay close attention to my diet and meal timing to maintain stable blood sugar levels while staying active at home”, she added.

Know The Risks: Factors Paving the Way for Diabetes

Here are some key factors that increase the risk of diabetes and play a pivotal role in its development:

"My family history and a lack of physical activity contributed to my diabetes diagnosis. It's a daily challenge, but I've learned to manage it through a balanced lifestyle," said Bishu Barai (60), CISF Officer speaking to OnlyMyHealth

“In my journey, I came to know about my condition through routine check-ups and blood tests. As I shared earlier, we have a history of diabetes in our family, so we make sure that routine check-ups are being made. At this age, I don’t want to develop any more complications so I follow a healthy lifestyle, focusing on a balanced diet, regular exercises, and prescribed medications”, said Barai.

Barai's story underscores the significance of diabetes screening, especially when it is hereditary, as a proactive measure to avoid complications and promote overall well-being.

“Dealing with diabetes means checking my blood sugar levels daily. I'm now proactive about my children's health, encouraging them to lead healthy lives. We regularly check their blood sugar levels as a precaution, looking out for their future. Despite the challenges, we stay positive, aiming to manage diabetes well through lifestyle changes and medical guidance”, added Barai.

The Importance of Recognising Prediabetes

Transitioning from academia to the professional world can present unforeseen challenges, as Shreya Choudhuri (29) discovered in 2019. She said, “Amidst the demands of a new life, I found solace in comfort eating, leading to weight gain and emotional distress.”

"I've gradually put on weight. I used to weigh 55 kg, and now I'm at 70 kg," she said. The impact of this lifestyle on her health was evident, but the fear of confronting a possible diagnosis of diabetes kept her from seeking medical help.

Fast forward to 2022, Shreya's fears came true when her elevated blood sugar levels confirmed that she was in a prediabetic state, a condition characterised by higher-than-normal blood sugar levels but not yet at the threshold of Type 2 diabetes.

Dr Billakanti emphasised the importance of early detection, “Identifying prediabetes allows for early intervention, which can help prevent or delay the onset of Type 2 diabetes and mitigate the risk of complications, including cardiovascular diseases, kidney damage, nerve damage, eye problems, and more”, added Dr Billakanti, Consultant Physician, emphasising the importance of early detection.

Benefits of Prediabetes Testing

Dr Billakanti enumerates the benefits of prediabetes testing:

The Complex Web of Diabetes Complications

Ram Rati, 93 years old who underwent cataract surgery due to diabetes two years ago said, “I came to know that I had diabetes, only when there was a health checkup set up in my locality. This was 16 years ago.”

By the time she was diagnosed with elevated glucose levels reaching 300 mg/dL, and as a side effect of high blood sugar levels, Ram Rati developed a cataract in her right eye.

“The other eye needs to get operated as well, but the procedure is on hold due to my current condition”, she added. Ram Rati needs medication and needs to consistently monitor her blood sugar levels. She also developed high blood pressure and osteoarthritis.

Dr Billakanti underscores that untreated or poorly managed diabetes can lead to various further complications. These include:

“During the pandemic, I got to know that my sugar level has increased. Managing diabetes became challenging, especially as I developed high blood pressure,” said Montu Biswas, a 55-year-old General Physician.

“I've maintained transparency with my employer and patients regarding my health conditions, ensuring they're aware of my needs and limitations. I schedule regular breaks to check my blood sugar levels and take necessary medications. I also make sure to have healthy snacks on hand to prevent blood sugar fluctuations during the workday”, he added.

Biswas also manages high blood pressure through a low-sodium diet, consistent medication, and stress-reduction techniques like meditation and deep breathing.

Reversing Prediabetes: A Glimpse of Hope

This story is one of hope, for anyone suffering from prediabetes.

"I was living with prediabetes in my early 50s, and the fear of developing diabetes was always on my mind”, said Anita Chandra, a 62-year-old, retired PIB employee

However, her determination led to a transformative two-year journey. She adopted a balanced diet packed with whole grains, lean proteins, and plenty of vegetables.

“I managed to lose extra weight through exercise and portion control. I dedicatedly followed a healthier lifestyle, which played a crucial role in reversing pre-diabetes. Even now I make sure to monitor my blood sugar levels”, said Chandra.

“Prediabetes can be reversed, however, things are different when it comes to diabetes”, said Swathi Bathwal, a Dietitian and Diabetes Educator, highlighting the difference between prediabetes and diabetes.

She explained, “Both conditions involve insulin resistance, where insulin doesn't work efficiently. In prediabetes, beta cells in the pancreas are still producing sufficient insulin, while in diabetes, these cells are significantly damaged.”

Prediabetes can be reversible through lifestyle changes, including exercise and dietary modifications. These changes improve insulin resistance”, added Bathwal.

Bathwal recommends several ways to enhance insulin resistance:

Swathi Bathwal

Reversing diabetes is rarer, but possible, as described by Dr Satyam Chakraborty, Consultant Endocrinologist, Fortis Hospital, Kolkata.

“A 34-year-old woman, struggling with a weight of 124 kg was on multiple medications for diabetes and hypertension without much success”, said Dr Satyam Chakraborty, Consultant Endocrinologist, Fortis Hospital, Kolkata, sharing a remarkable diabetes remission story.

In the face of this challenging scenario, the doctor prescribed a comprehensive lifestyle modification plan. He recounts the common tendency for patients to disregard such advice, but this patient was among the few who wholeheartedly embraced the changes.

“In just one and a half years, she lost a substantial amount of weight (from 124 kg to 68 kg), no longer needed antihypertensive medications, and reduced her diabetes medication to a minimal dose. Her blood pressure normalised, and her HbA1c (blood test to assess 2-3 month average blood glucose levels) dropped significantly from 7.9 to 5.4”, added Dr Chakraborty.

Dr. Satyam Chakraborty

Who Can Reverse Diabetes?

Dr Batra highlighted that reversing diabetes is a complex topic. She said, “While diabetes remission may be more challenging for older adults due to disease progression and other health factors, adopting a healthy lifestyle can still significantly improve their condition.”

Dr Batra emphasises that reversing diabetes is more feasible for Type 2 diabetes. She added, “Lifestyle changes, such as a healthy diet, regular exercise, and weight management, can lead to diabetes remission in some cases. However, Type 1 diabetes, which involves the destruction of insulin-producing cells, is not reversible.”

Pooja Goel (45), a Patient Care Coordinator at Felix Hospital, Noida, faced symptoms of weakness and dizziness, leading to her diabetes diagnosis at the age of 31. She was initially given medicines and advised to follow a healthy diet and lifestyle to manage diabetes. However, things went downhill when her sugar levels soared to 800 mg/dL.

She said, “I was afraid to take insulin as I feared being dependent on it. However, the doctors helped me realise that with early intervention and proper treatment, there was still hope”

“Once I started taking insulin, I started feeling better. After two years, my insulin therapy was stopped with the help of a healthy lifestyle, diet, and medications”, added Goel.

Pooja Goel

Breaking the Pattern: Why Do People Delay Diabetes Testing?

One of the key issues plaguing the population is their delay in testing. People often don’t take symptoms seriously enough, till their condition is critical. Dr Chakraborty sheds light on a systemic issue prevalent in healthcare systems in developing nations.

He highlights how government health programs primarily focus on communicable diseases, leaving non-communicable diseases like diabetes with a lack of public awareness. “There is a need to emphasise the importance of maintaining a healthy body weight and undergoing regular tests, especially if there's a family history of diabetes,” he said.

Demystifying Diabetes: Which Age Group Is At Risk?

Diabetes can affect people of all ages. Dr. Batra said, “Type 1 diabetes is often diagnosed in children and young adults, resulting from the immune system attacking insulin-producing cells. In contrast, Type 2 diabetes, more common in adults, develops due to insulin resistance or inadequate insulin production.”

On the other hand, many women can also develop diabetes during pregnancy, a condition known as gestational diabetes. Therefore, all pregnant women need to be screened for gestational diabetes between 24-28 weeks of pregnancy.

Insulin and Beyond: The Role of Medication and Treatment in Diabetes Management

"Diabetes requires supervised treatment by an endocrinologist or diabetologist," explains Dr Adarsh KS, Consultant – Diabetes and Endocrinology, Manipal Hospital, Old Airport Road, Bengaluru. He further emphasises that blood sugar levels need to be well controlled according to individualised targets, and patients should regularly undergo screening tests for diabetes-related complications.

“While Type 1 diabetes always requires insulin, some people with Type 2 diabetes might need it when lifestyle changes and oral medications (three or more oral anti-diabetic agents) aren't sufficient to manage their blood sugar levels”, added Dr Adarsh.

A Smart Disease With No Quick Fix

Dr. Satyam Chakraborty

Dr Chakraborty describes diabetes as a ‘smart’ disease due to its unique pattern of development. He highlighted, “It silently infiltrates the body, waiting for a significant period before manifesting. When it finally does, it often leads to various complications, including kidney problems, amputations, and even issues like erectile dysfunction.” He underscores the importance of understanding that diabetes is a lifelong management game, not a quick fix.

In a nation where diabetes casts a growing shadow, it's crucial to understand the importance of diabetes awareness and early intervention. It's a reminder that while it's never too early to test, it might be too late for treatment, underlining the urgency of proactive health management.


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