Is Diabetes Only An Old Age Disease? What Young Indians Must Know

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A 2025 cross-sectional study of Indians aged 18 to 40 found that 17.2 per cent, nearly one in six, already had Type 2 diabetes. Of those, more than a third had no idea. No prior diagnosis. No warning. Just a blood test that changed everything.

Photo Credit: Canva (Edited by BoldSky)

Diabetes in India has long lived in a particular corner of the imagination, something that arrives with retirement, grey hair, and a fondness for mithai. But the onset of Type 2 diabetes in India is now, on average, two decades earlier than in Western populations. The disease has moved. The awareness has not.

In partnership with BoldSky, Sun Pharma has launched India Win Over Diabetes, a national initiative to drive awareness, encourage early screening, and empower Indians to understand their metabolic health beyond the mirror.

As part of this initiative, we spoke to Dr Ankita Tiwari, Consultant - Diabetologist and Endocrinologist, Manipal Hospital, Bhubaneswar, who explained why diabetes is no longer a disease of old age, and what every young Indian needs to know today.

India's Numbers Are No Longer Deniable

Photo Credit: Canva (Edited by BoldSky)

According to the International Diabetes Federation (IDF) Diabetes Atlas 11th Edition, released in April 2025, an estimated 89.8 million Indian adults were living with diabetes in 2024, making India the second-most affected country in the world after China, with a prevalence rate of 10.5 per cent. The figure is projected to cross 134 million by 2045 if current trends continue. What that headline number obscures, however, is who is now getting sick, and how young.

"Correspondingly, heart attacks and sudden cardiac death also occur two decades earlier in Indians than in Caucasians. This is not a marginal difference. It is a generation-level shift in when the disease begins to damage the body," said Dr Tiwari.

The Biology Behind Early Onset: The "Thin-Fat" Indian

"Part of the explanation lies not in lifestyle alone but in biology. Research has shown that Indian newborns, despite lower birth weights, carry higher levels of insulin and leptin, indicating higher body fat from birth. This has been described as the "thin-fat Indian" phenotype: a body that appears lean but stores excess fat internally, particularly around the abdomen, creating insulin resistance from an early age," explained Dr Tiwari.

A 2024 study published in Nature Medicine, analysing over 50,000 South Asian individuals, identified genetic susceptibility to insulin deficiency and unfavourable fat distribution as key drivers of young-onset Type 2 diabetes, explaining why South Asians develop the disease at a younger age, at a lower BMI, and progress to complications faster than other ethnic groups.

In plain terms, a young Indian does not need to be overweight to be at metabolic risk. The rules are different here.

When Modern Life Makes It Worse

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Genetics load the gun; lifestyle pulls the trigger. The 2025 study found that the majority of young adults with diabetes were physically inactive, with the most common barriers being lack of time, lack of willpower, and lack of energy. These are not excuses, they are the architecture of urban Indian life: long commutes, sedentary desk jobs, late dinners, and chronic sleep debt.

"Children and young adults are now developing diabetes much earlier due to sedentary lifestyles and poor diets. Modern living has brought metabolic diseases a decade earlier than before," added Dr Tiwari.

The Signs That Are Easy To Miss

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"Young-onset diabetes is frequently silent. There is no dramatic moment of collapse, just a slow accumulation of symptoms that most people attribute to stress or a busy week: persistent fatigue, unusual thirst, blurred vision, wounds that take longer to heal. Alarmingly, 43 per cent of Indian adults living with diabetes, nearly 38.6 million people, are unaware of their condition," said Dr Tiwari.

That ignorance has consequences. The longer blood sugar stays elevated without management, the greater the damage to the heart, kidneys, eyes, and nerves - all of which begin silently, years before any obvious symptom appears.

What Young Indians Should Actually Do

Researchers studying young-onset diabetes in India have recommended that screening begin by the age of 25, particularly for those with a family history, sedentary habits, or abdominal weight gain, regardless of overall BMI.

The Indian Diabetes Risk Score (IDRS), a simple questionnaire covering age, waist circumference, physical activity, and family history, is a practical starting point. A fasting blood sugar test or HbA1c test can follow.

Research from the Chennai Urban Rural Epidemiology Study (CURES) suggests that with a healthy diet and increased physical activity, up to 50 per cent of new cases of Type 2 diabetes could be prevented. That is not a small number. That is half an epidemic, preventable.

Bottomline

Dr Tiwari concluded, "Diabetes does not wait for retirement anymore. It is arriving quietly in the bodies of young working Indians, people who eat takeout at their desks, skip morning walks, and check their phones before they sleep. The disease has changed its face, but the response to it has not quite caught up. Knowing your numbers, fasting glucose, HbA1c, and waist circumference, before you turn 30, is no longer overcautious. For young Indians, it may be the most important health decision of the decade."