A new review highlights how rising temperatures and air pollution could exacerbate India’s growing diabetes epidemic, urging climate-sensitive healthcare strategies to prevent future health crises.
A new review in Current Diabetes Reports argues that India’s diabetes crisis may be deepened by another force: climate stress. The paper says rising heat, worsening air pollution and more frequent extreme weather can disturb the body’s glucose control, insulin signalling and broader metabolic function, adding to familiar drivers such as diet, obesity and inactivity. It comes against a backdrop of a large and growing burden. One estimate cited in the review puts the number of Indians living with diabetes at 101 million in 2023, while other recent analyses have placed prevalence at about 11% and projected further growth over the coming years.
The authors, drawn from Harvard T.H. Chan School of Public Health, the Madras Diabetes Research Foundation, Dr Mohan’s Diabetes Specialities Centre in Chennai, Kuwait University and Dasman Diabetes Institute, use India and Kuwait as case studies for climate-vulnerable regions. They argue that India faces a particularly sharp combination of exposures: some of the world’s highest levels of fine particulate pollution, repeated hot weather and limited access to cooling in many homes. The Global Economy’s data for India show prevalence rising from 9% in 2011 to 10.5% in 2024, while a separate nationwide survey reported by The Lancet Diabetes & Endocrinology found diabetes in 11.4% of Indians, alongside high rates of hypertension and prediabetes.
Air pollution appears to be the clearest route by which climate-linked exposure may feed into diabetes risk. The review cites a prospective cohort study in Chennai and Delhi finding that every 10 microgram-per-cubic-metre increase in PM2.5 was linked with higher fasting glucose and HbA1c, the long-term blood sugar measure, as well as an estimated 22% higher risk of type 2 diabetes. The paper says tiny particles can enter the bloodstream, trigger oxidative stress and inflammation, and interfere with insulin signalling in muscle, liver and fat tissue. It also notes that nitrogen dioxide and wildfire smoke have been associated with worse glycaemic control and more diabetes hospitalisations in studies outside India.
Heat, the review says, creates a different but equally troubling metabolic burden. High temperatures can raise dehydration risk, strain the cardiovascular system and disturb the hormonal responses that regulate blood sugar. In people already living with diabetes, that can make hyperglycaemia harder to control and, in severe cases, increase the risk of diabetic ketoacidosis or hyperosmolar hyperglycaemic state. Heat may also affect insulin absorption and storage, creating further uncertainty for day-to-day management. The risk is compounded when heat exposure coincides with poor air quality, a pattern that Indian mortality studies have already linked with worse health outcomes.
The review also stresses that climate change affects diabetes care indirectly. Floods and storms can shut clinics, disrupt laboratory testing, damage records and interrupt insulin supplies and routine monitoring, leaving patients exposed long after the immediate disaster has passed. The authors say the evidence is still incomplete on how these pressures interact in India over time, and call for long-term studies that track combined exposure to heat and pollution across rural and urban areas. Their policy message is clear: diabetes should increasingly be treated as a climate-sensitive condition, with prevention, early-warning systems and care pathways designed for hotter, dirtier and more volatile conditions.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
