Study finds diabetes soaring in India as treatment coverage lags

India had the highest number of adults with diabetes in 2022, estimated at 212 million, followed by China with 148 million, according to a new study published in The Lancet. Other countries with high diabetes prevalence include Pakistan, Indonesia, and Brazil. In India, diabetes rates have risen sharply, reflecting global trends, particularly in low- and middle-income countries.
However, treatment coverage remains alarmingly low. By 2022, only 27.8 per cent of women and 29.3 per cent of men with diabetes in India were receiving treatment. This marks only a modest improvement since 1980, when treatment coverage stood at 21.6 per cent for women and 25.3 per cent for men.

India is responsible for 30 per cent of the world’s untreated diabetes cases, amounting to 133 million people—the highest number globally. In comparison, China has 7.8 crore (78 million) untreated cases. A significant proportion of untreated cases in India remain undiagnosed, further straining healthcare systems.

In South Asia, the median age of diabetes onset is younger than in high-income countries, where the median age is over 65. In India, lifestyle changes and limited access to early diagnosis are contributing to the rising prevalence.

Globally, the total number of adults with diabetes surpassed 82.8 crore (828 million) in 2022, more than four times the number in 1990. Of this total, over a quarter (21.2 crore) lived in India, followed by China (14.8 crore), the USA (4.2 crore), Pakistan (3.6 crore), Indonesia (2.5 crore), and Brazil (2.2 crore).

The study also found that 44.5 crore (445 million) adults aged 30 or older with diabetes (59 per cent of all cases) were not receiving treatment, such as oral hypoglycaemic drugs or insulin—3.5 times the number in 1990. India accounts for 13.3 crore (133 million) of these untreated cases, more than 50 per cent higher than China’s 7.8 crore (78 million). Other countries with high numbers of untreated cases include Pakistan (2.4 crore) and Indonesia (1.8 crore).

While some regions, such as Western Europe, Central and Eastern Europe, and Latin America, have seen improvements in treatment coverage, sub-Saharan Africa, South Asia, and Pacific island nations continue to struggle.

In sub-Saharan Africa and South Asia, more than 94 per cent of untreated diabetes cases remain undiagnosed. In these regions, improving early diagnosis and case detection is seen as crucial to increasing treatment coverage.

The study also reported significant increases in diabetes rates in India. The diabetes rate among women rose from 11.9 per cent in 1990 to 23.7 per cent in 2022, one of the largest increases across all countries. For men, the rate increased from 11.3 per cent in 1990 to 21.4 per cent in 2022.

From 1990 to 2022, the age-standardised prevalence of diabetes increased in 131 countries for women and in 155 countries for men, with the largest increases in low- and middle-income countries in Southeast Asia (e.g., Malaysia), South Asia (e.g., Pakistan), the Middle East and North Africa (e.g., Egypt), and Latin America (e.g., Jamaica, Costa Rica).

While some countries saw stabilisation or a decrease in prevalence, such as Japan, Spain, and France, the overall global trend has been an increase in diabetes rates, particularly in regions with growing populations and aging demographics.

The number of untreated cases continues to rise, with India contributing to the largest share of untreated diabetes cases globally. In 2022, 44.5 crore adults aged 30 or older with diabetes were not receiving treatment, a dramatic increase from 1990. Improvements in treatment coverage have been seen in some regions, including Central and Western Europe and parts of Latin America, but many countries, particularly in sub-Saharan Africa, South Asia, and parts of the Pacific, continue to face low treatment coverage.

India now accounts for 26 per cent of the world’s diabetes cases—the highest proportion of any country. The largest increases in diabetes prevalence have been observed in Southeast Asia, South Asia, and the Middle East, with countries like Pakistan, Malaysia, and Egypt also showing significant rises.

While treatment coverage has improved in some regions, it remains critically low in countries like India, contributing to the growing number of untreated cases. The study stresses the urgent need for improved diabetes diagnosis and early detection, particularly in South Asia. The authors advocate for better case detection, lifestyle changes, and greater access to care as key to preventing early onset and managing diabetes effectively.

The report also highlights the importance of making healthy diets more accessible, as many in India struggle to afford nutritious food.