An estimated 3.86 crore adults in India are living with undiagnosed diabetes, accounting for 43 per cent of the country's 8.98 crore adults affected by the condition, according to findings released by the International Diabetes Federation (IDF) ahead of World Diabetes Day on November 14.
The findings highlight a significant gap between awareness of diabetes as a health concern and people's understanding of their own vulnerability, with many individuals at increased risk failing to recognise the need for screening.
The research, conducted as part of a six-country study, found that although 84 per cent of Indian respondents believed diabetes screening was worthwhile even when they felt healthy, only 14 per cent considered themselves likely to develop type 2 diabetes.
This was despite nearly every respondent reporting at least two recognised risk factors for the disease.
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The survey covered 502 Indian adults aged between 25 and 64 who had known risk factors for type 2 diabetes but had not been diagnosed with the condition.
It was conducted online by Global Health Strategies between late June and late July 2026 across India, Brazil, Kenya, Saudi Arabia, Spain and the United States.
The findings revealed widespread misconceptions about the early stages of diabetes, particularly pre-diabetes, when blood glucose levels are elevated but have not reached the threshold for a diabetes diagnosis.
Around 75 per cent of Indian respondents incorrectly believed that people with pre-diabetes generally experience noticeable symptoms. This was the highest level of misconception recorded among the six countries surveyed.
Health experts warn that type 2 diabetes can develop gradually, with symptoms remaining mild or unnoticed for several years.
The disease occurs when the body cannot effectively use insulin, resulting in elevated blood glucose levels. Although it can develop at any age, it is more commonly diagnosed among middle-aged and older adults.
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The study also identified emotional and practical barriers preventing people from undergoing diabetes risk assessments.
Nearly 48 per cent of Indian respondents said they would not feel confident arranging a diabetes risk check.
Fear of receiving an unfavourable result emerged as the most frequently cited obstacle, reported by 35 per cent of participants.
Another 25 per cent said they did not believe they were at risk, while 22 per cent cited difficulties in securing appointments at healthcare facilities.
Embarrassment about discussing diabetes screening with a medical professional was reported by 18 per cent, while 12 per cent identified language or communication difficulties as barriers.
Dr Banshi Saboo, chair of the IDF South-East Asia Region, said India needed to make diabetes testing more accessible and less intimidating.
He advocated community awareness campaigns, screening services through local pharmacies, evening and weekend clinics, and information in regional languages to encourage people to seek timely diagnosis.
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According to the IDF's diagnosis scorecard, based on the 11th edition of its Diabetes Atlas, only 57 per cent of adults living with diabetes in India have received a diagnosis.
This remains substantially below the World Health Organization's global target of diagnosing 80 per cent of people with diabetes by 2030.
Achieving that target would require India to identify approximately 2.07 crore additional cases, equivalent to around 13,700 new diagnoses every day until the end of 2030.
The findings underline the scale of the challenge facing India's healthcare system, particularly in expanding early detection and ensuring that individuals diagnosed with diabetes receive appropriate treatment.
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Diabetes-related healthcare expenditure in India reached approximately USD 9.8 billion in 2024, with a substantial share associated with the treatment of serious complications.
These include heart attacks, strokes, kidney failure, vision impairment and lower-limb amputations.
Early detection and appropriate treatment can help reduce the risk of such complications, while screening costs considerably less than managing advanced disease.
IDF president Professor Peter Schwarz said approximately 250 million people worldwide were living with diabetes without knowing it.
He emphasised that general awareness of diabetes did not necessarily translate into recognition of individual risk.
The findings, released ahead of World Diabetes Day, underscore the need for wider screening, better public education and easier access to diagnostic services, particularly among people who may have risk factors but experience no obvious symptoms.