Knowledge Nugget | India second in global adults diabetes burden — Study. Check out facts, data, and latest insights

Why in the news?

At 90 million, India ranked second in the number of adults living with diabetes in 2024. China was first at 148 million and the US ranked third at 39 million, according to a study published in The Lancet Diabetes and Endocrinology journal.

Key takeaways:

What is Diabetes?

According to WHO, “Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycaemia, also called raised blood glucose or raised blood sugar, is a common effect of uncontrolled diabetes and over time leads to serious damage to many of the body’s systems, especially the nerves and blood vessels.”

Combined with reduced blood flow, neuropathy (nerve damage) in the feet increases the chance of foot ulcers, infection, and the eventual need for limb amputation. Diabetic retinopathy is an important cause of blindness and occurs as a result of long-term accumulated damage to the small blood vessels in the retina. Diabetes is among the leading causes of kidney failure.

Symptoms of diabetes include:

• feeling very thirsty
• needing to urinate more often than usual
• blurred vision
• feeling tired
• losing weight unintentionally

What does the study reveal?

Researchers said countries with large populations, such as China, India, the US, and Pakistan, contribute a very large share of the number of people with diabetes worldwide. They projected that Pakistan could surpass the US by 2050.

Over 11 per cent of the world’s adult population, or 589 million adults aged 20-79, were affected by the metabolic disorder in 2024 and nearly 13 per cent (853 million adults) are projected to be affected by 2050, the study said.

“In 2024, one in nine adults worldwide was living with diabetes. The number of adults with diabetes in 2024 exceeded 500 million and is projected to rise to close to 900 million by 2050,” the authors wrote.

“In 2024, the largest number of adults with diabetes aged 20-79 years was in China (148 million), followed by India (90 million), and the US (39 million),” they said.

Over four-fifths of the world’s diabetes population, or 80.64 per cent, were estimated to be living in low and middle-income countries in 2024. The countries could also be expected to see more than 95 per cent of the global increase in cases by 2050.

The increase reflects population growth, population ageing, and ongoing urbanisation, all of which contribute to the rising number of cases of the chronic condition, the researchers said. Monitoring diabetes burden around the world requires support for data collection in resource-poor settings, which are expected to experience substantial increases in diabetes prevalence, they said.

Prevalence was found to peak at nearly 25 per cent among the world’s adults aged 75-79. Diabetes prevalence was also higher among men than women, and in urban than rural areas, the study found.

Middle-income countries had the highest prevalence (11.46 per cent of adults aged 20-79), followed by high-income (10.21 per cent) and low-income countries (7.47 per cent).

The team added that the diabetes epidemic has continued unchecked since the turn of the millennium, and stronger efforts are needed to slow its progression, with strategies tailored appropriately across countries and population groups.

More on Diabetes

Types of Diabetes?

Type 1 diabetes

Type 1 diabetes (previously known as insulin-dependent, juvenile or childhood-onset) is characterized by deficient insulin production and requires daily administration of insulin.

Type 2 diabetes

Type 2 diabetes affects how your body uses sugar (glucose) for energy. It stops the body from using insulin properly, which can lead to high levels of blood sugar if not treated.

Over time, type 2 diabetes can cause serious damage to the body, especially nerves and blood vessels. Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children.

Gestational diabetes

Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes. Gestational diabetes occurs during pregnancy. Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of type 2 diabetes in the future.

Prediabetes

People with prediabetes have blood glucose levels that are higher than normal but not high enough to be diagnosed with type 2 diabetes. If you have prediabetes, you have a higher risk of developing type 2 diabetes in the future.

Monogenic diabetes

A less common type of diabetes which is caused by a change in a single gene.

Type 5 diabetes

Last year, the International Diabetes Federation (IDF) has officially recognised Type 5 diabetes as a distinct form of the disease. It is a form of diabetes affecting lean and malnourished teenagers and young adults in low- and middle-income countries. Type 5 diabetes causes pancreatic beta cells to function abnormally, leading to insufficient production of insulin. In Type 2, the body resists insulin action despite producing it.

BEYOND THE NUGGET: The other Lancet paper and government’s initiative

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

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.

According to the study, 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 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).

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 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).

The Central Board of Secondary Education (CBSE) recently directed its affiliated schools to establish sugar boards to monitor and reduce sugar intake in children. The board noted a significant increase in type 2 diabetes among children over the past decade.

Health is a State subject. However, the Union Health Ministry provides technical and financial support to States and Union Territories under the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD), implemented through the National Health Mission (NHM).

The programme focuses on strengthening infrastructure, human resources, screening, early diagnosis, referral, treatment, and health promotion for major non-communicable diseases, with special emphasis on diabetes and hypertension, based on the needs and proposals of States and Union Territories.

Under NHM, a population-based initiative for the prevention, control, and screening of diabetes has been rolled out as part of Comprehensive Primary Health Care. Individuals aged 30 years and above are targeted for screening.

To achieve universal screening, the Ministry of Health and Family Welfare launched a nationwide NCD Screening Campaign for diabetes and hypertension last year, conducted across Ayushman Arogya Mandirs (AAMs) and other health facilities under NP-NCD.

Patients diagnosed with diabetes under the NP-NCD programme are provided free medicines and regular follow-up services at various levels of public health facilities.

Post Read Question

Consider the following statements:

1. In Type 2 diabetes the body resists insulin action despite producing it.

2. Type 5 diabetes causes pancreatic beta cells to function abnormally, leading to insufficient production of insulin.

Which of the above given statements is/are correct?

(a) 1 only

(b) 2 only 

(c) Both 1 and 2

(d) Neither 1 nor 2

(Sources: India home to world’s second largest diabetes population in 2024, who.int, One in 5 older Indian adults had diabetes in 2019, says Lancet study, indiascienceandtechnology.gov.in)

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