A new study published in the Lancet highlights a worrying trend in India’s healthcare landscape. The report points out that millions of Indians are currently living with diabetes without being diagnosed. This silent spread of the disease is being seen as one of India’s biggest public health challenges, and experts say urgent measures are needed to control the situation before it grows even more severe.

The research shows that while India already carries one of the world’s highest burdens of diabetes, a large section of the population remains ignorant about their condition. Lack of awareness, low testing rates and limited access to primary healthcare are all contributing factors leading to late diagnoses. According to the study’s estimates, nearly half of all adults with diabetes in India do not know that they have the condition.

The Lancet’s findings come as a wake-up call at a time when lifestyle diseases are rising sharply in both cities and villages. Doctors warn that diabetes is not only a long-term illness but also a gateway to other serious health problems like heart disease, kidney failure and blindness. Without timely diagnosis, millions of Indians risk facing these complications without even realising that the root cause is unchecked diabetes.

The Hidden Numbers Behind the Epidemic

India already has one of the largest diabetic populations in the world, second only to China. Current estimates suggest that more than 100 million Indians are living with diabetes, but what is most troubling is that nearly half of these cases remain undiagnosed. This means millions of people may be carrying dangerously high blood sugar levels without treatment or monitoring.

The Lancet study explains that this ‘hidden burden’ comes as a result of several factors. Firstly, unlike infectious diseases which often show immediate symptoms, diabetes develops silently. High blood sugar does not always produce noticeable signs until the disease has advanced. As a result, a person can live with diabetes for years without knowing.

Secondly, the healthcare system has not been able to catch up with the growing non-communicable disease load. In rural areas in particular, diagnostic facilities are limited and people are less likely to go for preventive check-ups. Even in cities, many people do not routinely test for blood sugar unless advised during other medical visits. This neglect results in delayed detection.

Lifestyle Changes Fuel the Rise

Another concerning point raised in the report is how changing diets and sedentary lifestyles are fuelling the rise of diabetes. In the past two decades, economic growth and urbanisation have altered eating habits for millions of Indians. Traditional diets rich in grains, lentils and vegetables are increasingly being replaced with processed food, refined carbohydrates, sugar-sweetened drinks and high-fat options.

Alongside diets, physical activity levels have fallen sharply. Urban jobs often involve long hours of sitting, while children’s daily routines have shifted towards indoor activities, television and mobile phones. With less exercise and increasing obesity rates, the risk factors for diabetes have multiplied across all age groups.

The Lancet researchers emphasise that it is not only the middle-aged or older individuals who are being affected. Early-onset diabetes is emerging among young adults and even among teenagers. This trend is particularly worrying because younger patients face longer exposure to the disease, increasing chances of complications later in life.

A Call for Stronger Policy and Awareness

The report concludes by urging policymakers, healthcare providers and civil society to take stronger action. It calls for mass awareness campaigns that encourage routine blood sugar testing, especially for people above the age of 30. Public health centres should be better equipped with screening services so that even remote villages can have access to testing.

Special focus has also been suggested for integrating diabetes detection into India’s existing health programmes. Doctors point out that campaigns like vaccination drives or maternal health check-ups could be good opportunities to also screen for diabetes, thereby reaching large sections of the population quickly.

Equally important is spreading awareness about lifestyle choices. People need to be informed about the dangers of excess sugar intake, processed foods and lack of physical activity. Small steps like regular exercise, limiting junk food and preferring home-cooked meals can go a long way in prevention.

With India being called the “diabetes capital of the world”, experts say there is little time to lose. Unless urgent action is taken, the number of undiagnosed patients will only grow, bringing with it enormous economic and health costs for families and the country.

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