India faces second highest economic burden due to diabetes: Study

India faces the second highest economic burden due to diabetes of $ 11.4 trillion -- the United States bears the highest costs at $ 16.5 trillion, and China the third at $ 11 trillion, a new study has estimated.

Researchers, including those from the International Institute for Applied Systems Analysis and the Vienna University of Economics and Business in Austria, calculated the economic impact of diabetes across 204 countries from 2020 to 2050.

Global costs amount to around $ 10 trillion, excluding informal care provided by family members -- about 0.2 per cent of the world's annual gross domestic product (GDP), findings published in the journal Nature Medicine show.

Factoring in informal care amounts to up to $ 152 trillion, or 1.7 per cent of the world's yearly GDP, the study estimates.

"Caregivers often drop out of the labour market, at least partially, which creates additional economic costs," author Klaus Prettner, professor of macroeconomics and digitalisation at the Vienna University of Economics and Business, said.

The high share of informal caregiving, making up almost 90 per cent of the total economic burden, is explained by the fact that prevalence exceeds mortality by a factor of 30-50, the researchers said.

"The United States faces the largest economic burden of diabetes mellitus at INT$ 2.5 trillion, followed by India at INT$ 1.6 trillion and China at INT$ 1.0 trillion. When considering informal care loss, the largest economic burdens are INT$ 16.5 trillion in the United States, INT$ 11.4 trillion in India and INT$ 11.0 trillion in China," the authors wrote.

An international dollar (INT$) is a hypothetical, statistical unit used to compare economic metrics across countries. It has the same purchasing power as a United States dollar (USD).

For India and China, the high economic costs of diabetes were mainly attributed to a large affected population, while those in the US were primarily due to high treatment costs and physical capital diversion, the researchers said.

They added that a prime distinction between high- and low-income countries is the distribution of the burden across the treatment cost and lost labour channels -- the former makes up 41 per cent of the economic burden for high-income countries as opposed to 14 per cent for low-income countries.

"This is a stark illustration of how medical treatment regimes for chronic diseases such as diabetes are accessible to high income countries only," co-author Michael Kuhn, acting economic frontiers research group leader at the International Institute for Applied Systems Analysis, said.

The economic impact of diabetes is enormous, compared to that due to Alzheimer's disease or cancer, the researchers said.

Promoting healthier lifestyles -- regular physical activity and a balanced diet -- is the most effective way to prevent diabetes and reduce its economic impact, they said.

Early detection through comprehensive diabetes screening programs for the entire population, along with rapid diagnosis and timely treatment, are essential steps toward mitigating both health and economic consequences, the team said.

Over a quarter of the world's diabetics are estimated to be living in India, according to a study published in The Lancet journal in November 2024. 

Why this is happening?

 

"Diabetes crisis isn't just about genetics or changing diets—it's a collision of rapid urbanization with metabolic vulnerability. We've compressed decades of Western lifestyle changes into a single generation: desk jobs replacing physical labor, processed foods displacing traditional meals, and sleep disruption from shift work," says Dr Gagandeep Singh, Diabetes specialist, Metabolic expert and Founder – Redial Clinic. 

 

However, what makes India's burden unique is that our population develops diabetes at lower BMIs and younger ages than Western populations. "We're seeing the 'thin outside, fat inside' phenotype—normal-weight individuals with visceral fat and metabolic dysfunction. The economic burden reflects not just treatment costs, but productive years lost to a disease that's hitting our workforce in their 30s and 40s," he adds. 

 

What India must do now?

 

We need a fundamental shift from diabetes management to diabetes prevention and reversal. "This isn't about better medications—it's about making metabolic health a national priority before diagnosis occurs," notes Dr Singh. 

  Workplace wellness programs should mandate movement breaks and provide access to nutritionists. Primary care physicians need training in reversal protocols, not just medication algorithms. 

 

"We must stop telling newly diagnosed patients this is lifelong—for many, especially those diagnosed early, reversal through structured lifestyle intervention should be the first-line treatment, not an afterthought," he adds. 

 

"The economic burden study shows us the cost of inaction," he says. "But the DiRECT trial showed us nearly half of patients can achieve remission with proper intervention. India needs that urgency translated into policy and clinical practice now."