-by Dr Sourya Rongala, Paari School of Business., SRM University – AP (Amaravati)
There was a time when diabetes was considered a disease of old age. A diagnosis usually meant an elderly parent being told to reduce sugar in tea, avoid sweets and “take care.”
That India is changing.
Today, diabetes is no longer waiting for old age. It is increasingly becoming part of the lives of working professionals, urban families and younger adults. India has the largest number of adults living with diabetes in the world—an estimated 90 million people aged 20–79 in 2024. Even more worrying, around 46 million of them are estimated to be undiagnosed.
These are not just statistics. Behind every number is a person, a family and eventually, potentially, a healthcare burden.
Diabetes is particularly dangerous because it can remain remarkably quiet. A person may continue working, travelling, eating and living normally while elevated blood sugar gradually damages the body. By the time complications become visible, the problem may have been developing for years.
So how did we get here?India has changed dramatically. Our cities have expanded, our work has become increasingly sedentary, and convenience has become the organizing principle of everyday life. We order food with a tap, take cabs for short distances, spend hours behind screens and increasingly structure our leisure around sitting.
None of these changes alone cause diabetes. But together, they have created an environment in which physical inactivity, unhealthy diets and excess weight can become easier to sustain.
And our bodies have not evolved at the same speed as our lifestyles.This is why India’s diabetes crisis cannot simply be reduced to a warning about eating sweets.It is a larger problem involving urban planning, food environments, workplace culture, consumer behavior and public health.
Consider the modern office worker. Breakfast may be rushed, lunch may happen at a desk, meetings may consume the afternoon, and commuting may leave little energy for exercise. Dinner arrives through a delivery app. A lifestyle that would once have required considerable movement can now be managed almost entirely from a chair.
The convenience economy has made life easier. But it has also quietly removed movement from everyday life.
The consequences can be severe. Uncontrolled diabetes can increase the risk of heart disease, stroke, kidney disease, vision loss and nerve damage. It also creates a substantial economic burden through healthcare expenses, lost productivity and the need for long-term care.
The International Diabetes Federation estimates that India’s diabetes-related healthcare expenditure was about US$11.5 billion in 2024 and projects it could rise substantially by 2050.
But there is an important reason not to view this as an inevitable future.
Type 2 diabetes can often be prevented or delayed. Regular physical activity, healthier diets, maintaining a healthy weight and early detection can make a significant difference.
The challenge is that prevention cannot remain merely an individual’s responsibility.
Telling people to exercise is easy. Designing cities where walking is safe and convenient is harder.
Telling families to eat healthier is easy. Making healthier food affordable and accessible is harder.
Telling employees to look after their health is easy. Creating workplaces that do not normalize sitting for ten hours a day is harder.
India’s real diabetes challenge, therefore, is not simply the number of people who have the disease today. It is the direction in which the next generation is heading.
A 25-year-old today could potentially spend the next 25 years accumulating metabolic risk without realising it.
That is the danger ahead.
We have the tools to detect diabetes. We know many of the factors that increase risk. We know that prevention and early intervention matter.
What we need now is urgency.
Because the greatest danger is not that India has millions of people living with diabetes.
It is that we become so accustomed to the numbers that they stop frightening us.
