World Diabetes Day 2025: Why the disease remains India’s silent killer

More than 77 million Indians above the age of 18 are currently living with type 2 diabetes while another 25 million are prediabetic according to the World Health Organization Alarmingly nearly half of all diabetics in India are unaware of their conditionmdashmaking diabetes one of the countryrsquos most pervasive yet underdiagnosed health threatsOn World Diabetes Day observed annually on November 14 midday spoke to Dr Pranav Ghody Consultant Endocrinologist amp Diabetologist at Wockhardt Hospitals Mumbai Central and Dr Vijay Negalur HoD ndash Diabetology at KIMS Hospitals Thane They explain why diabetes is known as a ldquosilent killerrdquo and what India must do to prevent and manage it more effectivelyWhat is the difference between Type 1 Type 2 and gestational diabetesDr GhodyldquoType 1 diabetes is an autoimmune condition where the body destroys insulinproducing cells It usually starts young but adults can develop it too Type 2 diabetes is mostly lifestyledriven mdash the body makes insulin but doesnrsquot use it effectively Gestational diabetes develops during pregnancy and usually resolves after delivery but it significantly increases the risk of Type 2 diabetes later for both mother and childrdquoDr NegalurldquoThink of it this wayType 1 the body stops making insulin mostly in childhoodType 2 the body resists insulin mdash the most common form todayGestational develops due to hormonal shifts in pregnancy and needs careful monitoring because of future risksrdquoWhy is India called the lsquodiabetes capital of the worldrsquoDr GhodyldquoIndia earns that title because over 100 million people live with diabetes Genetics urban diets chronic stress lack of exercise and poor sleep are major contributors We need widespread awareness early screening and timely interventionrdquoDr NegalurldquoItrsquos a perfect storm mdash genetic susceptibility rapid urbanisation dietary changes and low physical activity Indians develop diabetes at younger ages and even at lower body weight We must move from reactive care to preventive carerdquoHow do urban vs rural lifestyles affect diabetes riskDr GhodyldquoSedentary work processed food and constant stress put urban populations at higher risk But diabetes is no longer an lsquourbanrsquo disease mdash rural India is catching up as traditional diets and physical activity declinerdquoDr NegalurldquoUrban life means long work hours processed meals and minimal movement With mechanisation and packaged foods entering villages rural India is now facing the same risksrdquoAre younger Indians increasingly being diagnosed with diabetesDr GhodyldquoYes mdash Type 2 diabetes is now showing up in people in their early 20s Sedentary habits junk food screen addiction and disrupted sleep are the main triggersrdquoDr NegalurldquoAbsolutely Obesity poor diets and lack of activity mean children and young adults are developing diabetes a decade earlier than beforerdquoHow effective are alternative or herbal remedies promoted onlineDr GhodyldquoMost lack solid scientific evidence Natural foods can support health but replacing prescribed medicines with unverified remedies can be dangerous Always consult a qualified specialistrdquoDr NegalurldquoSome herbs may help but none replace evidencebased medical care The real danger is when people stop their prescribed treatment Integrative care mdash diet exercise and medication together mdash works bestrdquoHas the nature of diabetes changed over timeDr GhodyldquoYes Wersquore seeing earlier onset more obesitylinked cases and faster progression to complications Diabetes today behaves more aggressively than it did two decades agordquoDr NegalurldquoWersquore seeing more cases of lsquodouble diabetesrsquo mdash where Type 2 patients develop autoimmune tendencies Heart kidney and nerve complications are also appearing much earlierrdquoWhat improvements are needed in Indiarsquos healthcare system to tackle diabetesDr GhodyldquoWe need robust screening programs at the primary care level stronger patient education and better access to diabetes care beyond metros Prevention must be part of national health campaignsrdquoDr NegalurldquoOrganised diabetes education at the community level screening at schools and workplaces and access to affordable insulin and diagnostics are critical Diabetes needs to be treated as a national priorityrdquo