For the last ten years, I’ve been tracking my HbA1c levels with the discipline I once reserved only for my clinical practice. What started as a routine health metric slowly became a mirror—reflecting how stress, lifestyle choices, long work days, travel, and even sleep shaped my metabolic health. Over time, I’ve watched my numbers fluctuate, sometimes gently nudging me to course-correct, and other times reminding me that even with medical training, no one is immune to lifestyle-driven risks.
This journey is one of the reasons I have already captured it in my book Own Your Health, a book that captures not just evidence and strategy but also lived experience—how small habits, smarter choices, and awareness can transform long-term health. I have covered the basics in this 2017 article; it’s best to read it to gain more awareness. And it’s why World Diabetes Day India 2025 holds a deeper, more personal meaning for me today.
India’s Diabetes Burden: Where We Stand Today
On this World Diabetes Day India 2025, we stand at a decisive moment in its battle against a condition that is no longer episodic, urban, or age-bound. The country has made remarkable progress in awareness, diagnosis, and policy action, but the sheer scale of the epidemic continues to expand. India’s diabetic population increased from about 32.7 million in 2000 to nearly 89.8 million today—an exponential rise driven by lifestyle transitions, rapid urbanisation, genetic predisposition, and changing food environments. National programmes such as NPCDCS have integrated diabetes screening into primary care, and lifestyle literacy in urban regions is improving.
Yet studies still estimate that nearly 57 percent of adults with diabetes remain undiagnosed, showing how early detection continues to be an Achilles heel in India’s response.
The State-Level Reality: A Nation of Contrasts
India’s diabetes landscape becomes far clearer—and more concerning—when examined through a statewise lens. Some states are already facing extraordinarily high prevalence levels. Goa reports rates around 26.4 percent, Puducherry stands at nearly 26.3 percent, and Kerala approaches 25.5 percent—placing them among the highest in the country. Lakshadweep too demonstrates very high prevalence, illustrating how certain geographies are experiencing a concentrated metabolic crisis.
Meanwhile, states such as Rajasthan report lower prevalence at around 10 percent, and earlier surveys in Bihar recorded figures as low as 4.3 percent. But lower prevalence does not necessarily equate to lower risk; it often reflects under-diagnosis, delayed urbanisation, and demographic variations.
What is even more striking is the gap in awareness and control. Meghalaya, for example, records awareness levels as low as 14 percent, while Telangana exceeds 50 percent. Many states have millions living with diabetes without knowing it, and among those diagnosed, only a small fraction achieve glycaemic control. The picture is further complicated by a younger age-of-onset, rising prediabetes, higher visceral fat at lower BMI, and even environmental factors like air pollution—recently linked to elevated diabetes risk in Indian populations. Together, these factors show that while India’s progress is real, the challenge is evolving faster than our systems.
How India Must Think About the Next Decade
Looking ahead, India needs a strategic leap rather than incremental improvement. Precision prevention should be built on Indian genetic and metabolic data rather than imported Western models. The “thin-fat” Indian phenotype requires nutrition, exercise, and risk-stratification frameworks tailored specifically to us. Technology will become central—remote monitoring, AI-based prediction models, wearables, and continuous glucose tracking can shift care from episodic visits to continuous, personalised support. Integrating digital tools with public health networks could redefine how India manages chronic disease at scale.
Equally important is adopting a life-course approach. Diabetes must be addressed not just in middle age but across childhood, adolescence, reproductive years, working life, and older age. Policies need to extend beyond hospitals—urban design, food systems, school programmes, corporate wellness, and insurance models all have roles in shaping India’s metabolic future. And because diabetes overlaps so strongly with cardiovascular disease, kidney disease, mental health, and ageing, India must view it as part of a broader chronic-disease ecosystem.
Measurement, Accountability, and the Way Forward
The future of diabetes control in India will depend heavily on what—and how—we measure. Prevalence numbers alone no longer tell the full story. India must invest in metrics like time-in-range, complication rates, workforce productivity, and quality-of-life indicators. High-burden states such as Kerala, Goa and Puducherry need advanced models focused on complication prevention, integrated clinics, and digital monitoring. Lower-burden states like Bihar and Rajasthan, on the other hand, represent enormous prevention opportunities, where early screening and lifestyle interventions can change the trajectory before the crisis peaks.
Conclusion: A Collective Journey, on World Diabetes Day India 2025
On this World Diabetes Day India 2025, India has indeed made progress, but diabetes continues to expand faster than our current systems can manage. The next decade will determine whether we bend the curve or watch the crisis deepen. For me personally, a decade of monitoring my own HbA1c and the process of writing Own Your Health have reinforced one truth: diabetes management is not just medical—it is behavioural, cultural, environmental, and deeply personal. What we do next, as individuals and as a country, will shape the health of generations to come.
