Rising trends of diabetes in South Asia: A systematic review and meta-analysis

Abstract

Background: South Asians are known for their increased predisposition for type 2 diabetes (T2D). We describe the most recent prevalence and trends of diabetes, prediabetes, and undiagnosed diabetes in South Asia based on surveys conducted from 2000 to 2024.

Methods: A comprehensive search was conducted in PubMed, Web of Science and Scopus databases for population-based studies describing diabetes/prediabetes prevalence. Including STEPS surveys, 7261 records were screened for eligibility, of which 89 were included in this analysis. Prevalences and trends of diabetes, undiagnosed diabetes and prediabetes were analysed by country, making male/female and urban/rural comparisons.

Results: Prevalence of diabetes in South Asia has increased from 11.29 % in 2000-2004 to 22.30 % in 2020-2024. Sri Lanka and Pakistan have demonstrated a steep rise in diabetes over the two decades. India and Bangladesh, have also shown a rise in prevalence from 2.5 % (2015-16) to 8.1 % (2019-21) and 5.5 % (2006) to 8.3 % (2018), respectively. Diabetes prevalence among males was higher. Urban prevalence was higher than rural throughout the region, with both sectors showing a rising trend. Prediabetes followed a similar pattern. Despite the high burden, a large proportion remained undiagnosed, being as high as 17.5 % in Delhi, India (2010-11).

Conclusion: Pooled prevalences show a rising burden of diabetes over the past decade, with a considerable proportion being undiagnosed, in South Asia. Urban prevalence is higher than rural prevalence throughout the region. Prediabetes also shows a similar rising trend, with a notable proportion o being undiagnosed, alerting the need for coordinated efforts for early diagnosis, and prevention.

Keywords: Diabetes; Prevalence; South Asia; Trends.