As per WHO, Non-Communicable Diseases (NCDs) are collectively responsible for more than 74% of all deaths worldwide including heart disease, stroke, cancer, chronic respiratory diseases and diabetes. NCDs cause significant morbidity and mortality, both in urban and rural population and across all socio-economic strata with considerable loss in potentially productive years of life including maximum out of pocket expenditure on health. SDG 3 (Target 3.4) aims to reduce premature mortality from NCDs by one third by 2030 in the world. The National Health Policy 2017 also emphasises the need to halt and reverse incidence of NCDs and seeks focus on common NCDs. Among NCDs the top four killers that together account for more than 80% of all premature NCD deaths annually include cardiovascular diseases (17.9 million), cancer (9.3 million), chronic respiratory diseases (4.1 million) and diabetes (2.0 million).
The Ministry of Health and Family Welfare (MoHFW) Government of India has set a target to screen 75 million people for diabetes and hypertension and put them on standard care and halt the rise in diabetes and prevent premature deaths from NCDs by 25% by 2025.
Understanding diabetes and its risks
Diabetes is a chronic metabolic disorder characterized by elevated blood sugar levels due to the body’s inability to produce or use insulin effectively. Insulin is a hormone that helps regulate blood glucose by converting sugar, starch and other foods into energy, and when it is insufficient or not used properly, blood sugar levels can rise to dangerous levels. There are two main types of diabetes: type 1, an autoimmune condition that typically begins in childhood results from the failure of the pancreas to enough produce insulin, and type 2, which is strongly linked to lifestyle factors and often develops in adulthood is due to failure of the body to respond to insulin properly and hence also referred to as NIDDM (Non-insulin dependent DM). Type 2 diabetes is far more common, accounting for around 90% of all cases globally. Gestational DM resembles Type 2 DM and occurs in 2-10% of all pregnancies.
In 2019 Diabetes had a prevalence of 9% among adults above 18 years in India. Diabetes Mellitus if not detected early and managed promptly it can damage the heart blood vessels, eyes, kidneys and nerves leading to cardiovascular diseases, kidney failure, nerve damage, and even blindness. Simple lifestyle measures have shown to be effective in prevention ore delaying of diabetes.
For this reason, diabetes places a tremendous burden on individuals, families, and healthcare systems. Identifying at-risk individuals through early screening and encouraging preventive measures can greatly reduce the occurrence and impact of diabetes.
The role of early screening in diabetes prevention
Early screening is essential because it helps detect prediabetes—a condition where blood sugar levels are higher than normal but not high enough to be diagnosed as diabetes. People with prediabetes have a significantly higher risk of developing type 2 diabetes but often show no symptoms. While the American Diabetes Association (ADA) recommends screening for people over 45, the MoHFW recommends screening people above 30 years for DM, Hypertension and cancer. Younger individuals who are overweight and have other risk factors, such as a family history of diabetes, hypertension, or high cholesterol should be screened earlier.
Through screening, individuals can learn their risk level and understand if they are already in the prediabetic stage. Detecting diabetes risk early enables them to take preventive actions, which can prevent or delay the onset of diabetes. Studies show that nearly 70% of people with prediabetes will develop diabetes if they do not make changes in their lifestyle. However, early screening followed by lifestyle changes has been shown to reduce this risk by up to 58%. These screenings are usually simple blood tests, which measure fasting blood sugar levels or glycated haemoglobin (HbA1c) to assess average blood sugar levels over a few months.
Biochemical parameters to detect Diabetes
| Category | Fasting Plasma Glucose | Post Prandial Plasma Glucose | HBA1C | Random Plasma Glucose |
| Diabetes | >126 mg/dl | >200 mg/dl | >6.5% | >200 mg/dl + diabetes symptoms |
| Pre Diabetes | 110-125 mg/dl (Impaired fasting glucose) | 140-199 mg/dl (Impaired glucose tolerance) | 5.7-6.4% |
Lifestyle changes as a key preventive strategy
Lifestyle changes, particularly in diet, physical activity, and weight management, are critical in preventing diabetes. A healthy diet that limits refined carbohydrates and sugars, while emphasizing whole grains, fruits, vegetables, and lean proteins, can help maintain stable blood sugar levels. Adopting a balanced diet also helps prevent obesity, which is one of the main risk factors for type 2 diabetes. Furthermore, studies suggest that even a modest weight loss of 5-7% of body weight can make a significant difference in reducing diabetes risk for overweight or obese individuals.
Regular physical activity also plays a major role in diabetes prevention. Exercise helps the body use insulin more efficiently, which lowers blood sugar levels. It is recommended that adults engage in at least 150 minutes of moderate-intensity aerobic activity, such as brisk walking or cycling, per week. Physical activity also contributes to weight loss and improved cardiovascular health, making it a powerful tool in diabetes prevention.
In addition to diet and exercise, quitting smoking and limiting alcohol intake are also beneficial. Smoking has been linked to a higher risk of diabetes, as well as its complications, due to the damage it causes to blood vessels and its impact on insulin resistance. Excessive alcohol intake can similarly affect blood sugar control, so moderating alcohol consumption is advised.
Community and governmental support in Diabetes prevention
While individual efforts are essential, the role of community programs and government support cannot be overlooked. Public health campaigns which promote the importance of early screening, especially in high-risk populations is being done under the NCD program driven through the Ayushman Bharat Health and Wellness Centres across India. Effective linkages are being built between primary secondary and tertiary care facilities. There is a need to additionally, implement awareness programs in schools, colleges and workplaces that encourage healthy eating, exercise, and education about diabetes can help reinforce lifestyle changes on a broader scale.
Preventing diabetes requires a proactive approach that emphasizes early screening and significant lifestyle adjustments. Screening for diabetes risk factors, especially in adults over 30 or those with predisposing health conditions, can reveal prediabetes early, enabling timely intervention. By making healthier lifestyle choices—such as improving diet, engaging in regular physical activity, managing weight, and avoiding smoking—individuals can reduce their risk of developing type 2 diabetes and the associated complications.
As diabetes continues to rise globally, preventing it through early screening and lifestyle changes is more critical than ever. By raising awareness, supporting early detection, and encouraging healthy lifestyles, we can curb the diabetes epidemic and create a healthier future for individuals and communities.
(Author: Dr Smita Hiras Sudke, Regional Chief of the lab (Pune & ROM), Metropolis Healthcare Ltd)
