Thread by @zerodhamarkets

Today, let's talk about a health crisis that’s impacting millions of lives quietly but seriously—diabetes. This problem goes far beyond individual health issues.

It is reshaping economies, adding stress on families, and changing the very structure of our society. In India especially, diabetes is a huge issue affecting our economy, social lives, and productivity, which makes it critical to understand this in detail.

To start, it’s important to know what diabetes really is. Think of it as a condition where the body struggles to manage sugar levels in the blood.

Usually, our body relies on a hormone called insulin to help process sugar from the food we eat. In diabetes, either the body doesn’t produce enough insulin or can’t use it properly.

This results in high blood sugar levels, which can lead to long-term health problems like heart disease, kidney damage, and even blindness.

Globally, diabetes has become a crisis. In 1990, about 63 crore people worldwide were living with diabetes.

By 2022, this number had increased to around 83 crore!

This rapid rise shows just how serious the problem has become, especially in low- and middle-income countries like India, where healthcare systems are often already under pressure.

What’s even more alarming for us in India is that we have the highest number of people with diabetes in the world!

In 2022, roughly 21 crore adults in India were living with diabetes—that’s over 15% of our population.

What’s even more worrying is that diabetes is now affecting younger people at a growing rate.

If you’re a 20-year-old woman living in an Indian city today, you have a 64.6% chance of developing diabetes during your lifetime.

If you’re a young man, your risk is also quite high at 55.5%.

Even for those who reach the age of 40 without diabetes, the chances of getting it remain high—about 59.2% for women and 47.3% for men.

This shows that diabetes is no longer just a disease of older people; it’s impacting young adults too, creating new challenges for the future.

India’s diabetes crisis is even more severe in urban areas. City life often means eating more processed foods, sitting for long hours, and dealing with high stress.

In cities, about 18.5% of people have diabetes compared to 14.9% in rural areas.

The southern states of India, such as Kerala, Tamil Nadu, Andhra Pradesh, and Karnataka, have particularly high rates of diabetes.

This is partly due to diets heavy in carbohydrates and sugar, along with less physical activity. For example, over half the households in Kerala have at least one person with diabetes.

By contrast, only 25.3% of households in Rajasthan deal with this issue. States like Karnataka also report high rates, driven by similar factors.

While southern states often have better healthcare facilities, meaning more cases are diagnosed, it also underscores just how widespread diabetes has become.

A major challenge in India’s diabetes crisis is the cost of healthcare. Less than a quarter of Indians have health insurance, which means most people have to pay for their healthcare out of their own pockets.

On average, diabetes care costs around INR 15,535 per person each year, a heavy burden for many families.

And this estimate might even be on the lower side since healthcare costs are rising fast.

The problem gets even more complicated in states with limited access to healthcare, like Bihar, Uttar Pradesh, and Madhya Pradesh, where insurance coverage is low.

This makes it difficult for many people to get the care they need.

On the other hand, states with better healthcare infrastructure, like Chandigarh, Goa, and Delhi, have higher awareness and better treatment rates.

Socioeconomic factors also play a big role in diabetes care. People with lower incomes are less likely to get proper treatment, especially in rural areas where healthcare is harder to reach.

In urban areas, high stress and lifestyle changes lead to more cases of diabetes.

This creates a complex situation—under-treatment in rural areas and a higher number of cases in cities—showing how challenging the diabetes crisis is in India.

One of the most concerning issues is the lack of awareness about diabetes. Around 27.5% of people with diabetes don’t even know they have it.

This means millions of people are living with a potentially dangerous disease without knowing it.

Only about 21.5% of those with diabetes are receiving treatment, and fewer than 7% manage to keep their blood sugar levels under control.

Without awareness, there can be no treatment, and without treatment, diabetes can lead to serious health problems.

Untreated diabetes can cause heart disease, kidney failure, nerve damage, and even blindness.

The gap in awareness is especially wide in rural areas and among people with lower incomes, who often have less access to information and healthcare resources.

Interestingly, wealthier people are about 10-12% more likely to know about their condition, get treatment, and manage it better.

Gender also plays a role, with women often being underdiagnosed and undertreated due to social and cultural factors.

Diabetes doesn’t just affect people’s health; it has a huge impact on the economy too.

In the United States, diabetes costs an estimated $412.9 billion in 2022, including both direct costs like medical bills and indirect costs such as lost productivity.

In India, even though healthcare costs are lower, the impact is still very serious. The yearly per-person cost of diabetes care is about INR 15,535, which can be a big financial burden for many lower-income families.

But direct costs only tell part of the story. Diabetes also reduces productivity, as people often have to take time off work or aren’t able to work as efficiently.

Back in 2017, the estimated productivity loss due to diabetes was worth INR 176.6 lakh crores, or roughly $2.6 trillion.

This loss came from missed workdays, reduced work efficiency, and early retirement caused by complications from diabetes.

The economic impact is especially concerning in a country where many families are still trying to achieve financial stability.

Unfortunately, a lack of reliable data makes it hard to measure the full scope of the problem, showing the need for more focused research.

To address diabetes, we need a large-scale, systemic approach. Public health campaigns that raise awareness about diabetes and its risk factors are essential.

Expanding insurance coverage and introducing early screening programs could help catch diabetes before complications develop.

Simple lifestyle changes, like adding a few extra minutes of exercise each day or reducing time spent sitting, can make a big difference in blood pressure and overall health.

Even small changes, such as walking or cycling for an extra five minutes a day, can lower the risk of diabetes.

Countries with better awareness and treatment rates, like the U.S., offer valuable lessons. By promoting lifestyle changes and building stronger healthcare systems, we can make significant strides in managing diabetes.

Diabetes affects not just individuals but entire families. When someone in a household has diabetes, everyone feels the strain—financially, emotionally, and socially.

Families often have to prioritize healthcare costs over other basic needs, and the stress of managing a chronic condition can weigh heavily on mental health, impacting both the person with diabetes and their loved ones.

Unhealthy habits within a family can also increase the risk of diabetes for future generations.

This makes diabetes more than just a health issue; it becomes a social issue that affects family life and can even lead to health risks for children down the road.

Simply put, diabetes is a silent crisis with serious consequences. It’s a health challenge that impacts our economy, workforce, and society as a whole.

Those who feel the impact the hardest are often the most vulnerable, like low-income families and people in rural areas.

Without better awareness, improved healthcare access, and proactive policies, this crisis will continue to worsen.

By focusing on education, preventive measures, and better healthcare, we can tackle this epidemic head-on. It’s not just about treating an illness; it’s about protecting the future of our families, our workforce, and our country.

We cover this and one more interesting stories in today's episode of the Daily Brief. You can watch the episode on YouTube, read on Substack, or listen on Spotify, Apple Podcasts, or wherever you get your podcasts. All links here:
thedailybrief.zerodha.com/p/indias-diabe…