Pakistan is facing a health crisis that is growing quietly in almost every home. Specialists at the Aga Khan University Hospital have warned that the number of adults living with diabetes could reach 70.2 million by 2050 if present trends continue, roughly double the number affected today. The warning came at a media roundtable in Karachi, where doctors called for earlier screening, simpler food habits and regular check-ups.
The scale of the problem is startling. Around 34.5 million adults in Pakistan are living with diabetes, according to the International Diabetes Federation’s Diabetes Atlas, and nearly 9.3 million of them, more than one in four, do not even know they have the condition. Because diabetes often develops without clear symptoms, many people discover it only after it has begun to damage their heart, kidneys, eyes or nerves.
Pakistan’s position in the global picture is especially worrying. The Federation’s latest Atlas gives the country an age-standardised prevalence of 31.4 per cent, the highest rate of any large country in the world. By total numbers, Pakistan ranks fourth in the world, behind only China, India and the United States, and it accounts for more than 40 per cent of all diabetes cases in the Eastern Mediterranean region.
The human cost is visible. Diabetes was linked to an estimated 226,752 deaths in Pakistan during 2024, while the annual bill for treating the disease has reached about 2.7 billion dollars. Yet spending per patient remains strikingly low, at roughly 79 dollars a year, one of the smallest amounts anywhere in the world.
The picture is not confined to Pakistan. Across the world, about 589 million adults are living with diabetes, roughly one person in nine, and an estimated 252 million of them remain undiagnosed. The World Health Organisation has recorded a steep rise over three decades, with the global total climbing from 200 million in 1990 to 830 million in 2022.
More than 10 million Pakistanis are also thought to have impaired fasting glucose, often called prediabetes, in which blood sugar is higher than normal but not yet high enough to count as diabetes. A national prevention and control programme, running from 2024 to 2029, is promoting free screening and healthier daily habits.
Younger Adults Are No Longer Safe From Diabetes
One of the strongest warnings from the Karachi roundtable was that diabetes is no longer a disease of old age. Specialists explained that the condition gradually harms blood vessels and nerves, raising the risk of serious problems in the heart, kidneys, eyes and limbs. Younger adults are increasingly caught up in this, particularly those with a family history of diabetes, extra weight around the waist, or a daily routine built around sitting.
Dr Asma Ahmed, a consultant endocrinologist at the hospital, said type 2 diabetes does not affect older people alone, and she urged younger people with a family history or other warning signs to get tested before symptoms appear. For those already diagnosed, she advised taking medicines exactly as prescribed and keeping follow-up appointments.
Small Lifestyle Changes Are Already Paying Off
There is encouraging evidence that early action works in Pakistani homes. The hospital’s community-based Pakistan Diabetes Prevention Trial followed people with prediabetes who adopted modest changes suited to their own food and daily life. After one year, 61 per cent of those in the lifestyle group had returned to normal blood sugar levels, a striking result without expensive treatment or drastic diets.
Simple Foot Checks Can Stop Serious Damage
The roundtable also drew attention to a complication that receives far too little notice: damage to the feet. Dr Fareed Ahmed Shaikh, assistant professor and section head of vascular surgery at the hospital, explained that diabetes affects both circulation and the nerves, and the legs and feet suffer most. When feeling in the feet fades, a small cut can go unnoticed, and poor blood flow makes it slow to heal.
The remedy is straightforward. Regular foot checks and prompt medical attention can catch trouble early, when it is still easy to treat. Doctors advise people with diabetes to inspect their feet daily, wear shoes that fit well, and seek help quickly for any sore that does not heal.
Food also plays a central role, though specialists warned against turning eating into punishment. Farah Syed, a senior dietitian at the hospital, said managing diabetes does not mean giving up favourite dishes or following a harsh diet that nobody can keep up. Instead, she advised balanced choices and careful portion sizes, with more vegetables, pulses and whole grains and fewer sugary drinks. The specialists also called for coordinated care combining medical treatment, foot checks and personalised food advice.
The numbers make the case for action hard to ignore. If the present course holds, Pakistan will have twice as many people with diabetes within a generation, at a cost its health system can ill afford. Yet most of the tools needed are known, affordable and within reach: screening, modest changes in food and activity, and a daily glance at the feet.
