Why prediabetes is so common in India

136 million Indians have prediabetes, more people than the population of most countries. It isn't one cause. It's a diet, an activity level, and a body that stores risk differently, compounding for years before a blood test says anything.

If you've been told your blood sugar is "borderline" or your doctor has mentioned prediabetes almost in passing, you're not an outlier. You're one of an estimated 136 million people in India carrying the same result, most of whom found out the same way: a routine test, a number just past the line, and not much explanation of what it actually means or why it happened.

The numbers behind the headline

• An estimated 101 million people in India have type 2 diabetes, and 136 million have prediabetes (ICMR–INDIAB national study, The Lancet Diabetes & Endocrinology, 2023).
• 35.5% of adults, roughly 315 million people, have high blood pressure in the same study.
• 28.6% have generalised obesity and 39.5% have abdominal obesity, both strongly linked to insulin resistance.
• Physical inactivity among Indian adults has been rising sharply, from an estimated 22.4% in 2020 toward 45% and higher by 2022 (WHO India physical activity factsheet, 2024).

Why diet and inactivity do most of the work

Prediabetes isn't usually one bad year. It's insulin resistance building quietly, meal by meal, over several years: refined carbohydrates and sugar spiking blood glucose faster than the body can clear it, less muscle mass to absorb that glucose because activity has dropped, and visceral fat around the organs making the whole system less responsive to insulin in the first place. None of this shows up as a symptom. It shows up as a number.

“A result can sit inside the normal range twice in a row and still be heading somewhere. The direction is the story, and a single test can't show it.”

What actually catches it in time

The reassuring part of this research is also the useful part: prediabetes is one of the most responsive conditions there is to diet and activity, especially caught early. That means the two most ordinary things, what you eat and how much you move, are also the two biggest levers. The harder part is knowing where your own numbers are actually trending, not just whether the last one technically passed, and having a plan built around your specific labs rather than a generic "eat better, move more."