Beyond the Numbers: Living with Diabetes in Modern India

Chapter 1 · Vihang Rahul Vasa

A Person Living With Diabetes

For years, I saw myself as a “patient”: a word that quietly told me I was different, broken, and in need of fixing. Then one day, a doctor I deeply respect reframed it for me: I am a human being, just like everyone else. I simply live with diabetes.

Think about it this way. If a person wears spectacles, we do not call them a lifelong patient of their ophthalmologist. They are simply someone who wears glasses. In the same way, having diabetes does not make me a patient. It makes me a person with a condition to manage, the same way millions of people manage their eyesight.

I share this because how you see yourself shapes how you handle this condition. If you see yourself as a patient, you will feel like one: dependent, unwell, and waiting to be fixed. If you see yourself as a person living with diabetes, you take charge, you plan, and you live fully. The choice of language matters. It matters to your doctor, to your family, and most of all, to you.

Throughout this book, I use the phrase “person living with diabetes” as often as I can. Not because “patient” is wrong, but because “person living with diabetes” is more true.

You are not alone in this. India is currently one of the global epicentres of Type 2 Diabetes, with approximately 100 million people affected (as per the Indian Council of Medical Research – India Diabetes (ICMR-INDIAB) study), and numbers expected to rise sharply in the coming decades. Diabetes prevalence is higher in urban areas than rural areas, but the gap is rapidly narrowing as rural lifestyles change. Many of them are never told, or never realise it. Many more are told and do not know what to do next. That is the gap this book hopes to fill: one person’s experience, offered to another.

A significant proportion of cases remain undiagnosed, especially in rural India, due to limited screening and low awareness. Among those diagnosed, treatment rates are better in urban populations than rural populations, revealing a clear access gap.

Advanced care, endocrinologists, Continuous Glucose Monitoring (CGM) technology, and specialty clinics, is largely concentrated in cities, while rural areas depend mainly on primary healthcare with limited specialist access. Even where treatment exists, long-term control is inconsistent, due to cost, compliance issues, and fragmented follow-up systems.

Awareness about diabetes is improving in cities but remains low in rural populations, leading to delayed diagnosis and complications. Common behavioural patterns often include late medical consultation, poor diet adherence, and irregular monitoring, especially when symptoms are mild or absent.

Cultural factors contribute to barriers to early diagnosis and treatment, including affordability, access, awareness, and health-seeking behaviour, particularly in lower socioeconomic groups. Overall, India faces a dual challenge: a rapidly rising diabetes burden and unequal healthcare access, making diabetes both a medical and a public health crisis. Given this context raising awareness remains key!

References:

ICMR-INDIAB Study on Diabetes Prevalence in India ( ink.springer.com/article/10.1007/s13300-024-01602-w)

Illustration: Chapter 1 illustrated summary. Person first: a person with diabetes has a condition, not a new identity.

Chapter 1 Person first: a person with diabetes has a condition, not a new identity. Urban specialist care and rural primary care illustrate unequal awareness, access, affordability and follow-up.

Chapter at a glance: an AI-generated illustration to be read with the chapter, not instead of it. The people shown are not real.