If you picture diabetes as an iceberg, the part visible above water represents those living with diagnosed diabetes: the people checking their blood sugar, taking medicines, and managing their health. But the much larger, hidden part lies below the surface; millions have diabetes without knowing it, silently facing risks and damage.1
In India, this hidden burden is enormous. Recent data shows that around 90 million adults are living with diabetes in 2024, making India the second highest country globally for diabetes cases.2 Of these, nearly 43% remain undiagnosed, unknowingly carrying risks that can escalate without timely care.3 Compounding this problem, over 100 million more are estimated to have prediabetes — a warning sign that often progresses to full diabetes if left unchecked.2
ET Spotlight
Dr Anusha Handral, MBBS,MD,DM( Diabetes and Endocrinology), Manipal hospital Whitefield , Bengaluru
The slow, silent damage caused by high blood sugar does not just affect blood vessels and organs but hits the heart hardest. Cardiovascular disease is the leading cause of death among people with diabetes in India.4 Studies from 2024 reveal that Indians with diabetes face a significantly higher risk of heart attacks and strokes compared to those without diabetes.5 This connection makes the hidden part of the diabetes iceberg a major contributor to India’s rising heart disease epidemic.
Many people only discover they have diabetes when complications like heart disease or kidney damage bring them to the hospital. The emotional and financial consequences for families and the healthcare system are immense.4
People with Type 2 diabetes (T2D) face higher healthcare costs if they are overweight. Those who are obese (BMI 30–34.9) spend 17% more on direct medical costs compared to people with normal weight (BMI 18.5–24.9).5
If someone has both Type 2 diabetes and heart disease, their annual healthcare costs are four times higher than those with Type 2 diabetes alone.6
This underscores the crucial need for wider awareness and early screening programmes across the country, especially in high-burden states such as Tamil Nadu, Karnataka, and Goa.3
ET Spotlight
But the good news is that much of this burden can be eased. Research and real-world experience show that early action — before symptoms appear — can dramatically improve health outcomes. A balanced diet rich in whole grains, millets, fresh vegetables, whole fruits, and healthy fats, combined with regular physical activity like walking, cycling, or yoga, helps control blood sugar and weight, and also strengthens the heart.4 For those at risk or with a family history, routine screening at local clinics or health camps makes it easier to catch silent cases early. Talking to a doctor early also helps to ease this burden.
Live Events
Community-driven health programmes across India have started showing results: people who receive education, support, and tools to make healthy choices are less likely to develop diabetes and heart diseases. If diagnosed, advances in diabetes care, ranging from modern medicines to digital health monitoring, empower patients to take charge and live full, active lives.4What you see is just the tip. The real cost lies underneath. The visible burden is managing blood sugar, medications, and routine check-ups. The key insight is that diabetes is a major driver of economic and health challenges for India.
ET Spotlight
With early detection, conversations with a doctor about your diabetes journey and healthy habits, the invisible weight of diabetes and heart disease can be lifted, giving millions of Indians a better chance for long-lasting wellness.
References
Hossain MJ, et al. Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Sci Rep. 2024 Mar 22;7(3):e2004.
International Diabetes Federation. India Diabetes Statistics 2024. IDF Diabetes Atlas. 2025 Mar 20.
The rising burden of diabetes and state-wise variations in India: India Journal of Endocrinology and Metabolism. 2025 May 12.
World Health Organization. Diabetes and Cardiovascular Disease in India. 2024 Nov.
Li et al. Pharmacoeconomics 2015 Jul;33(7):735-48
Oberoi et al. Int J Diabetes Dev Cities. 2020
Disclaimer: This content is part of a disease awareness initiative by Novo Nordisk. The opinions and views are that of the Healthcare Professionals. The news and editorial staff of ET had no role in the creation of this article nor vouch for or endorse any of its content. While the content on this site provides general information about health and wellbeing. It is not intended as medical advice, nor is it a substitute for professional medical expertise or treatment. If you need help getting your health under control, we recommend speaking to your doctor.
ET Spotlight
as a Reliable and Trusted News Source