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One in 5 older Indian adults had diabetes in 2019, says Lancet study: Should there be universal screening?

Now 94 per cent of those who became aware about their condition are undergoing treatment. So awareness can change the health map

Significantly, two out of five people with diabetes (or 40 per cent of those diagnosed) were unaware of their condition. (File Photo)

At least one in five people aged 45 and older had diabetes in India in 2019, according to a new paper published in ‘The Lancet Global Health’ journal. Significantly, two out of five people with diabetes (or 40 per cent of those diagnosed) were unaware of their condition.

However, 46 per cent of the people identified regained control of their blood sugar levels, 59 per cent achieved blood pressure control and six per cent took a lipid-lowering medication to reduce the risk of cardiovascular disease. “Moving forward with the epidemiological transition and economic development, we anticipate that this trend will continue,” Dr T V Sekher, Professor at International Institute for Population Sciences, Mumbai, and one of the principal authors of the study, told The Indian Express. “Only about half of these people are aware of their condition and even fewer achieve targets for glycaemic control, blood pressure control and use of lipid-lowering medications. Our findings emphasise the urgent need to scale up policies to better prevent, detect, manage and control diabetes among middle-aged and older adults in India,” he said.

The Lancet paper is based on the findings from the Longitudinal Aging Study in India (LASI) that surveyed nearly 60,000 adults in India aged 45 years and older between 2017 and 2019 to estimate the prevalence, awareness, treatment and control of diabetes. “LASI is a nationally as well as state level representative survey and includes all health conditions of individuals. We were able to analyse them along with diabetes (like BMI, hypertension and so on). It has also analysed the difference between the self-reported and measured diabetes prevalence,” Dr Sekher said.

States in southern India tend to have a higher rate of diabetes after adjusting for age. (Illustration by Angshuman Maity)

What are findings?

As per the findings, an estimated 20 million Indians have undiagnosed diabetes. Overall, eight per cent of the elderly (60-plus) subjects have been found to be undiagnosed. The prevalence of untreated diabetes among older adults (aged 45 and above) is five per cent and that of under-treated diabetes is 47 per cent. About 36 per cent are adequately treated.

The study also found that rates of diabetes were similar among men and women (19.6 per cent of men vs 20.1 per cent of women). Urban diabetes prevalence (30 per cent) was approximately twice as high as rural prevalence (15 per cent). “Around 60 per cent of individuals are aware of their diabetes. So there is a need for better awareness campaigns and universal screening for diabetes. The silver lining is that among those who are aware about their diabetes, LASI found that 94 per cent are undergoing treatment. This is the most important finding. Once people are aware, then treatment coverage is good,” Dr Sekher explained.

What about state wise prevalence?

The study also provides updated evidence on the patterns of diabetes within India. States in southern India tend to have a higher rate of diabetes after adjusting for age, while others in central and northeastern India have a lower rate. The states/UTs with the highest age-adjusted diabetes rates among adults aged 45 and above were Chandigarh (36.9 per cent), Kerala (36.0 per cent) and Puducherry (36 per cent). The states with the largest number of adults having diabetes were Tamil Nadu (6.1 million people), Maharashtra (5.8 million people) and Uttar Pradesh (4.7 million people).

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LASI used the blood samples for testing their HbA1c (an integrated measure of diabetes over the previous 90 days) in a laboratory (ICMR- NITVAR, Pune). This is a more accurate and appropriate method for testing diabetes compared to field-level testing of random glucose levels (most other large surveys used this method in India).

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