'India Urgently Needs A Strong National Diabetes Prevention Program': Top Diabetologist Dr. Sanjay Reddy

The global burden of diabetes is rising rapidly. As per International Diabetes Federation 2025 estimates, about 583 million people worldwide are living with diabetes, with over 101 million in India alone and a prevalence of around 11.7%. This rise is not limited to developed countries; it is even more pronounced in developing and lower-income nations.

“A key concern is under-diagnosis. For every known case, another may remain undetected. Additionally, nearly 120 million people in India are prediabetic, placing them at high risk. South Asians are particularly vulnerable, and modern lifestyles have further amplified this risk. By 2050, the global prevalence of diabetes is expected to increase by around 45%, while India may see a rise of nearly 75%,” said Dr. Sanjay Reddy, eminent endocrinologist and one of India's top diabetologists, presently with Fortis Hospital, Cunningham Road in Bengaluru.

Dr. Reddy was the Program Chair at the Diabetes India Annual Conference held in February 2026 in Hyderabad, where experts from over 25 countries discussed diabetes care, prevention, and education. In an exclusive interview with Anubha Jain for ETV Bharat's diabetes campaign, he highlighted key discussions, including early diagnosis, improved access to care, advances in Type 2 management, and the role of AI in screening complications like diabetic retinopathy.

Q 1. India is often referred to as the diabetes capital of the world. What are the key factors driving this sharp rise in cases?

Diabetes often remains asymptomatic in its early stages, delaying diagnosis. Its rise is driven by genetic predisposition and lifestyle factors, including sedentary habits, urbanisation, high carbohydrate intake, and rising obesity. In India, diets are largely carbohydrate-based, and reduced physical activity, especially among children due to limited open spaces, further increases future risk.

Diabetes is multifactorial and significantly impacts quality of life due to complications like heart, kidney, and nerve damage. The rise in diabetes is driven by a complex interplay of genetic, biological, psychological, social, cultural, and economic factors. In essence, it results from the combined effects of genetic predisposition, environmental influences, and lifestyle changes.

Continuous glucose monitoring device (Getty Images)

Q 2. Over the past decade, how have you seen diabetes patterns evolve in India, particularly among young populations?

This is a concerning trend. Early-onset diabetes is rising rapidly and needs urgent attention. Traditionally, Type 2 diabetes was seen after the age of 40, while Type 1 diabetes was more commonly seen in younger individuals. However, we are now increasingly diagnosing Type 2 diabetes in the 20-40 age group.

The main drivers are sedentary lifestyles, obesity, poor diet, and lack of physical activity, making this “screen-age” generation highly vulnerable. The impact is significant. A diagnosis at 25 means decades of disease and higher risk of complications compared to someone diagnosed later in life. Our goal is not just control, but ensuring a long, complication-free life.

Q 3. What are the early symptoms or warning signs people often ignore before being diagnosed with diabetes?

Diabetes is often asymptomatic and diagnosed incidentally. When symptoms like thirst, frequent urination, weight loss, fatigue, blurred vision, or tingling or numbness in the feet appear, they usually indicate high blood sugar. However, such symptoms are seen in less than 10% of patients.

The risk of diabetes also increases with age. In fact, in many parts of India, nearly 1 in 2 individuals above 50 years old may have diabetes or prediabetes. Early screening (especially after 30 or in individuals with risk factors such as family history, obesity, a sedentary lifestyle, thyroid disorders, PCOD, gestational diabetes, or hypertension) is essential. The message is simple: don’t wait for symptoms. Treat blood sugar as a vital health parameter just like blood pressure or heart rate.

GLP-1 analogues support weight loss, improve insulin sensitivity, and aid glycaemic control in diabetics (Getty Images)

Q 4. Type 2 diabetes accounts for the majority of cases in India. What are the most effective early interventions to prevent or delay its onset?

Diabetes prevention begins with lifestyle changes. Eat balanced meals, control portions, and maintain a healthy weight. Exercise regularly (150-170 minutes/week). Reduce excess carbohydrate intake while maintaining adequate protein, healthy fats, and fibre in your diet. Monitor blood sugar and blood pressure regularly. Ensure 6-7 hours of good sleep and limit screen time. Avoid smoking and limit alcohol.

Q 5. Can high or fluctuating blood sugar levels impact a person’s mood, leading to irritability, anger, or even aggression?

Behavioural changes are often seen in people on anti-diabetic medications, especially when blood sugar drops too low. Low sugar can cause sweating, palpitations, headache, confusion, and abnormal behaviour. Also, persistently high blood sugar may impact brain health or neuro behavioural changes, with possible links to conditions like dementia and Alzheimer’s disease while good glycaemic control may help delay the onset of these conditions.

Q 6. Is diabetes reversal or remission truly possible, especially in Type 2 diabetes?

“Reversal” of diabetes is not the correct term; remission is possible. Evidence from the DiRECT trial in the UK and anti-obesity interventions like bariatric surgery shows that significant weight loss (around 15% of body weight in individuals with obesity) can lead to remission of Type 2 diabetes and may allow temporary discontinuation of medications.

Very low-cal diets (around 800 kcal/day) and newer drugs like GLP-1 analogues (e.g., semaglutide) support weight loss, improve insulin sensitivity, and aid glycaemic control, with added benefits for the heart, liver, and kidneys. However, sustaining such strict regimens is challenging, and diabetes is a progressive disease. Remission may last for years, but ongoing lifestyle management is essential. Early intervention, especially in prediabetes can even help restore normal glucose levels.

Q 7. What are the biggest challenges in Type-1 diabetes diagnosis and long-term management, especially among children?

Type 1 diabetes primarily affects individuals under 20 and involves a complete loss of insulin production due to destruction of pancreatic beta cells (Beta cells are cells that produce insulin in the body). Children often show symptoms such as weight loss, frequent urination, or serious complications like diabetic ketoacidosis. Treatment requires lifelong insulin therapy, either through multiple daily injections or insulin pumps, along with regular glucose monitoring. Management extends beyond medication, involving psychological, social, and financial challenges. Early diagnosis and continuous support are essential for better outcomes.

Q 8. How important is family history in diabetes, and what should high-risk individuals do differently?

Family history is a strong risk factor, if both parents have Type 2 diabetes, the lifetime risk for children can be as high as 80-90%, though early lifestyle changes can delay onset.

Q 9. How is technology such as continuous glucose monitoring, digital health platforms, stem cell therapy transforming diabetes care in India?

Diabetes care has evolved significantly. Newer drugs such as SGLT2 inhibitors and GLP-1 analogues not only improve blood sugar control but also provide benefits for the heart, kidneys, liver, and weight management. The focus today extends beyond glucose control to preventing complications through targets like HbA1c below 7, optimal BMI, controlled blood pressure, and regular screening for eye and foot health.

Technology is transforming diabetes care. Continuous glucose monitoring (CGM), insulin pumps, and closed-loop systems enable more precise, real-time glucose management. While stem cell therapy remains experimental and limited to select cases, ongoing research offers hope for the future. Overall, early intervention, patient education, and integrated care are essential for achieving better outcomes.

Q 10. How can patients and families recognise the behavioural changes and manage the patient effectively?

Low blood sugar (hypoglycaemia) can cause sweating, palpitations, confusion, and unusual behaviour, often due to an imbalance between medication, food, and activity. Hypoglycaemia is a common risk in people on insulin and certain drugs like sulfonylureas. Early recognition and timely intake of glucose are essential to prevent complications. If the person is unconscious, do not give anything orally; seek urgent medical care for intravenous glucose.

Q 11. Are there any recent research developments or clinical advancements that give hope for better diabetes control or even a potential cure? What more should the government do to tackle diabetes?

The future of diabetes care is promising. Over the past two decades, newer drugs such as GLP-1 analogues and SGLT2 inhibitors have gone beyond glucose control, offering benefits for weight loss, heart failure, and kidney health, and even enabling remission in some patients. The next decade looks even more encouraging, with advanced therapies on the horizon.

However, India urgently needs a strong national diabetes prevention program. While earlier public health efforts focused on infectious diseases, rising life expectancy (now around 70 years) has led to a growing burden of chronic conditions like diabetes, which contribute significantly to mortality. The priority must shift to prevention through mass awareness, early screening, lifestyle modification, and public education. Just as vaccination programs have succeeded, similar nationwide initiatives can improve diabetes awareness and early detection.

Affordability remains a major challenge, as most care is still out-of-pocket despite some government support. Bridging this gap is essential. Most importantly, prevention should begin early through school-based education that promotes healthy lifestyles, physical activity, and sustained behavioural change. A coordinated effort involving government, healthcare systems, and all stakeholders is crucial to reduce the burden of diabetes and its complications.

Q 12. What is your key message to better prevent and manage diabetes?

Maintain a healthy lifestyle: eat right, stay active, and sleep well. Get regular screening after 30, and ensure consistent follow-ups to prevent complications. Take medications consistently and keep your targets under control. Dedicate at least one hour a day to your physical and mental well-being. For every person diagnosed with diabetes, at least one more is unaware. From children to adults, diabetes affects everyone. Early screening, awareness, and action are the keys to turning the tide.

Also read:

1. ETV Bharat Has Launched A Nationwide Campaign On Diabetes, Featuring Leading Doctors, Data Stories And Real-Life Journeys, Here's What To Expect
2. Exclusive Interview | Dr. V. Mohan: '30% People Aged 20 And Above Suffer From Diabetes'
3. Diabetes Is No Longer A Disease Of The Elderly Or Urban Elite, It's Spreading Fast Across Villages: Diabetologist Dr Rakesh Parikh
4. Can Diabetes Really Be Reversed? Top Doctors Say The Reality Is More Complicated