Explained: Why Indian kids show diabetes signals early

Why is diabetes so common in Indians? A three-decade study tracking more than 700 Pune families has found a tendency towards high glucose in early childhood in many individuals.

5 min readPuneUpdated: Nov 13, 2021 12:12 PM IST

Students participate in a diabetes awareness rally in Mumba. (Express Photo: Narendra Vaskar)

A three-decade study tracking more than 700 Pune families, now going into the third generation, has sought to understand why diabetes is so common in Indians, and found a tendency towards high glucose in early childhood in many individuals. The authors have called for a diabetes prevention strategy from early life. This comes close on the heels of a recent recommendation by experts to lower the screening age for diabetes from 30 to 25 years.

How were these families tracked?

At the Diabetes Unit of KEM Hospital, Pune, scientists have been carrying out research for 35 years to understand why diabetes is so common in Indians. In 1993, they embarked on the Pune Maternal Nutrition Study (PMNS) across six villages near Pune, and have followed more than 700 families since. They have tracked women from before they became pregnant and during their pregnancy, and their children through childhood, puberty and now as adults.

The study, ‘Poor In Utero Growth, Reduced b-Cell Compensation and High Fasting Glucose from Childhood are Harbingers of Glucose Intolerance in Young Indians’, by Dr C S Yajnik, Director of the diabetes unit at KEM hospital, and co-authors, has been published in Diabetes Care, a journal of the American Diabetes Association.

What are the findings?

Researchers measured glucose and insulin concentrations and other vital data at ages 6, 12, and 18. At 18 years, 37 per cent of men and 18 per cent of women had elevated glucose levels (prediabetes). This was despite half these participants being underweight (body mass index less than 18.5 kg/sq. m.)

Children with sub-optimal growth in the womb carry high levels of risk factors for diabetes from early childhood, including high circulating glucose levels.

The tendency towards high glucose was visible even when measured at ages 6 and 12. The researchers concluded that this was driven by a poorly functioning pancreas, which could not cope with the demands of increasing age, and that this very likely reflects poor growth of the pancreas during foetal life as part of general growth failure. When maternal glucose is minimally increased during pregnancy, even this stresses the baby’s pancreas.

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How widespread is diabetes in India?

According to the World Health Organization (WHO), India has an estimated 8.7 per cent diabetic population in the age group 20-70, with around 77 million people with diabetes.

A first national nutrition survey (2016-18) by the Union Ministry of Health and Family Welfare, UNICEF and Population Council among children and adolescents, too, found that diabetes is affecting children in a big way. Released in 2019, the survey said that almost 1 in 10 children (ages 5-9) were pre-diabetic, and 1 per cent was already diabetic.

The rising prevalence of diabetes is driven by a combination of factors — rapid urbanisation, sedentary lifestyle, unhealthy diet, tobacco use, and increasing life expectancy.

What is the current strategy for screening?

The current recommendation from the government to begin screening for diabetes is at age 30.

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Diabetes prevention trials still mainly target middle-aged individuals who already have obesity and advanced metabolic abnormalities, Dr Yajnik said.

“An integrated life course approach is required and prevention has to start at the community level and not just in the clinic. What we need are public health experts, not just doctors, to tide over this problem,” Dr Yajnik said. “Constructing such evidence is beyond the scope of clinicians and will take a long time. We need to act sooner than later,” he said.

Dr Shashank Joshi, Chairman, International Diabetes Federation, South East Asia, said: “This is predominantly in the research domain. We do not have sufficient data to translate in the public health domain, especially in a resource-limited country like India. We need robust translational research that is reproducible, affordable and has hard evidence from a public health standpoint.”

A new report published in the journal Diabetes and Metabolic Syndrome–Clinical Research and Reviews, too, shows a trend of the increasing prevalence of diabetes in younger age groups in the last decade. After analysing data from various diabetes centres, researchers found that 77.6 per cent of those below 30 were either overweight or obese.

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The report’s lead author, Dr Anoop Misra, had said the government should lower the age of screening.

Dr Joshi said: “This is a country-wide study and several others have recommended screening above 25 years in resource-limited countries including India. The focus is also on women and child health. Maternal nutrition during pregnancy should be focussed upon as a preventive measure.”

Anuradha Mascarenhas

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune. With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments. She also takes a keen interest in covering women's issues . Professional Background Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature. Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr. Soumya Swaminathan, the former Chief Scientist at the WHO. Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives. Awards and Recognition Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024). A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021. Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards. She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.” Recent Notable Articles (Late 2025) 1. Cancer & Specialized Medical Care "Tata Memorial finds way to kill drug-resistant cancer cells" (Nov 26, 2025): Reporting on a breakthrough for triple-negative breast cancer, one of the most aggressive forms of the disease. Discipline, diet and purpose; How a 97-year-old professor defies ageing'' (Nov 15, 2025) Report about Prof Gururaj Mutalik, the first Head of Department at Pune's B J Government Medical College who at 97 credits his longevity to healthy habits and a strong sense of purpose. 2. Environmental Health (The "Breathless Pune" Series) Long-term exposure even to 'moderate' air leads to chronic heart, lung, kidney issues" (Nov 26, 2025): Part of an investigative series highlighting that even "safe" pollution levels are damaging to vital organs. "For every 10 µg/m3 increase in PM2.5 level, there was 6-8% jump in medicine sales" (Nov 23, 2025): Using commercial data to prove the direct link between air quality and respiratory illnesses in Pune. 3. Lifestyle & Wellness News "They didn't let cancer, diabetes and heart disease stop them from travelling" (Dec 22, 2025): A collaborative piece featuring survivors who share practical tips for traveling with chronic conditions. At 17, his BP shot up to 200/120 mmHG; Lancet study flags why child and teen hypertension doubled between 2000 and 2020'' (Nov 12,2025)--A report that focusses on 17-year-old-boy's hypertensive crisis and reflects the rising global trend of high blood pressure among children and adolescents. 4. Scientific Recognition & Infrastructure For promoting sci-comm, gender diversity: IUCAA woman prof highlighted in Nature" (Nov 25, 2025): Covering the global recognition of Indian women scientists in gender studies and physics. Pune researchers find a spiral galaxy like the Milky Way from early universe'' (December 3, 2025)- A report on how Indian researchers discovered a massive galaxy that existed when the universe was just 1.5 billion years old , one of the earliest to have been observed so far. Signature Beat: Health, Science & Women in Leadership Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials. She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields. Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions. ... Read More