Background: To our knowledge, no estimates of lifetime risk of diabetes have been produced for India, a country with a high propensity to developing diabetes and a low overall body weight compared to high-income countries.

Data: We estimated the lifetime risk of diabetes in metropolitan India, and its variation by sex, age and BMI. We used government mortality statistics, diabetes prevalence from the Indian Council for Medical Research INdia DIABetes study (2008-15) and incidence from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018). We limited estimates Indians aged 20 or more years.

Results: Overall lifetime risk of diabetes in women in metropolitan cities aged 20 was 74.7% (95%CI: 65.4-83.3%), and 69.0% (95%CI: 58.9-78.7%) in men. Remaining risk is highest among the obese (92.9% (95%CI: 88.0-96.0%) in women and 92.4% (95%CI: 86.6-96.1%) in men aged 20) and is lowest among underweight/normal weight people (56.4% (95%CI: 46.9-66.3%) in women and 54.2% (95%CI: 44.5-64.6%) in men). Lifetime risk declines with age (to 67.3% (95%CI: 57.4-77.1%) in women aged 40 to 42.5% (95%CI: 33.8-52.9%) at age 60).

Conclusion: In metropolitan India, 1 in 2 underweight/normal weight, and 9 in 10 obese, people aged 20 are projected to develop diabetes during their life. This portends a serious epidemic and indicates what may develop elsewhere in India in the absence of urgent action.

Table. Lifetime risk of diabetes by sex, age and BMI

Disclosure

S. Luhar: None. S. Kinra: None. V. Mohan: None. D. Kondal: None. R. Anjana: None. S.A. Patel: None. M.K. Ali: Research Support; Self; Merck & Co., Inc. D. Prabhakaran: None. N. Tandon: None. K. Narayan: None.

Funding

Economic and Social Research Council (ES/J500021/1)

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