Why India is facing a diabetes explosion: Stanford's top 2% scientist reveals the hidden reasons Indians develop it younger than the rest of the world

Diabetes has become so common in India that almost every family knows someone living with the condition. Parents worry about it. Young adults are being diagnosed with it. Even people who appear healthy sometimes discover they have high blood sugar during a routine health check.So, why does diabetes seem to affect Indians more often and at a younger age than many other populations?That question was addressed by one of India's best-known diabetologists, Dr V Mohan, Chairman of Dr Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, during a conversation on Raj Shamani's podcast. Dr Mohan, whose research has earned him a place among Stanford University's list of the world's top 2% scientists, explained that there is no single answer. Instead, India's diabetes epidemic is the result of genetics, early-life nutrition, changing lifestyles, and everyday habits coming together over decades.Dr Mohan said one of the biggest reasons is genetics. According to him, generations of inherited genes have made many Indians naturally more susceptible to diabetes. He also pointed out that in some communities where marriages between close relatives have traditionally occurred over generations, certain diabetes-prone genes may become more common within families.However, genetics alone do not decide a person's future.A person may inherit a higher risk, but lifestyle often determines whether that risk eventually turns into diabetes. That is why two siblings with similar genes may have very different health outcomes depending on their diet, activity levels, weight, and overall health.Experts across the world have long described diabetes as a condition influenced by both inherited risk and environmental factors. The World Health Organization (WHO) also notes that genetics, unhealthy diet, physical inactivity, and obesity all contribute to the development of type 2 diabetes.One of the most interesting points Dr Mohan discussed was that diabetes risk may start much earlier than adulthood.He explained that if a mother is undernourished during pregnancy, the baby may be born with a lower birth weight and a smaller pancreas. Since the pancreas contains beta cells that produce insulin, having fewer of these cells could reduce the body's ability to regulate blood sugar later in life.In simple words, some people may begin life with a lower reserve for insulin production, making them more vulnerable as they grow older, especially if unhealthy lifestyle habits are added to the equation.Scientists have studied this concept for years under what is often called the "developmental origins of health and disease," which suggests that nutrition during pregnancy can influence future health.If genetics load the gun, lifestyle often pulls the trigger.Dr Mohan said today's eating habits and reduced physical activity have become a dangerous combination.Many Indian meals are naturally rich in carbohydrates. Rice, wheat, potatoes, sweets, and sugary drinks are widely consumed. While carbohydrates are an important source of energy, regularly eating more than the body needs, especially when physical activity is low, can increase blood sugar levels and contribute to insulin resistance over time.Office jobs, long hours in front of screens, lack of regular exercise, poor sleep, and increasing stress only add to the problem.The result is that diabetes is no longer considered a disease of old age. Increasingly, doctors are diagnosing it in people in their 30s and 40s, and sometimes even earlier.The warning signs often appear long before diabetesOne of the biggest challenges with type 2 diabetes is that it often develops quietly.Dr Mohan highlighted a few clues that people should not ignore.A family history of diabetes is an important warning sign. Being overweight also increases risk, but waist size matters even more for Indians.He explained that men with a waist circumference above 90 centimetres and women above 80 centimetres should pay attention because abdominal fat is closely linked to insulin resistance.Prediabetes usually causes few or no symptoms. That is why regular health screenings become especially important for people with these risk factors.Managing diabetes is about much more than simply avoiding sugar.Dr Mohan explained a practical framework called ABCD, which helps patients focus on overall health.A1c below 7%: This blood test reflects average blood sugar over the past two to three months. Keeping it below the target recommended by a doctor can reduce long-term complications.Blood pressure below 140/90 mmHg: Diabetes and high blood pressure together significantly increase the risk of heart disease, kidney disease, and stroke.LDL cholesterol below 100 mg/dL: Controlling cholesterol helps protect blood vessels and lowers cardiovascular risk.Discipline: Healthy eating, regular exercise, good sleep, avoiding smoking, and following prescribed treatment consistently are just as important as medication."The diabetic who knows the most lives the longest."The quote remains relevant today because diabetes management depends heavily on understanding the condition and making informed daily choices.India's diabetes epidemic did not appear overnight, and there is no single solution. Some people inherit a higher risk. Others are affected by modern lifestyles. For many, it is a combination of both.The encouraging part is that diabetes is not always unavoidable. Healthy eating, regular physical activity, maintaining a healthy waistline, routine health check-ups, and recognising prediabetes early can delay, or sometimes even prevent, the disease from developing.This article is for informational purposes only and should not be considered medical advice. The discussion is based on statements made by Dr V Mohan in a podcast, along with information from government and global public health sources. Diabetes risk and treatment vary from person to person. Always consult a qualified healthcare professional before making decisions related to diagnosis, medication, diet, or lifestyle changes.