On World Diabetes Day, doctors say a third of cases go undiagnosed and slim adults should not assume they are safe.
KARACHI: Type 2 diabetes is increasingly appearing in younger Pakistani adults, specialists at the Aga Khan University Hospital (AKUH) said, urging people with a family history or sedentary jobs to get screened before symptoms appear rather than after complications set in.
The warning, delivered at a media roundtable ahead of World Diabetes Day on Nov. 14, comes as Pakistan holds the highest diabetes prevalence in the world.
The scale of the problem
An estimated 34.5 million Pakistani adults live with diabetes, and 9.3 million of them, or 26.9%, do not know they have it, according to the International Diabetes Federation’s latest atlas. On current trends the number will reach 70.2 million by 2050.
The federation puts Pakistan’s age-standardised adult prevalence at 31.4%, the highest of any country. The World Health Organization said this week that Pakistan accounts for more than 40% of estimated diabetes cases in its Eastern Mediterranean region.
Minister of State for Health Dr Mukhtar Ahmad Malik called the disease an economic and development challenge as well as a medical one at a separate event in Islamabad on Thursday.
Not just an older person’s disease
“Type 2 diabetes is not limited to older adults,” said Dr Asma Ahmed, a consultant endocrinologist at AKUH. “Younger people, particularly those with a family history or other risk factors, should not wait for symptoms to appear before seeking screening.”
The panel singled out excess abdominal weight as a risk factor and said people who appear to be a healthy weight should not assume they are safe. A family history of the disease and a lack of physical activity were singled out as warning signs.
Feet, nerves and amputations
Diabetes damages blood vessels and nerves over time, raising the risk of heart, kidney, eye and limb complications. Dr Fareed Ahmed Shaikh, head of vascular surgery at AKUH, said reduced sensation in the feet meant a small cut could go unnoticed and turn into a serious wound that may ultimately cost a patient a limb. Regular foot checks, he said, could catch problems early.
Prevention works
The hospital’s community-based Pakistan Diabetes Prevention Trial offered evidence that early action pays. After a year of culturally tailored lifestyle changes, 61% of participants with prediabetes in the intervention group had returned to normal blood sugar levels.
Diet need not mean deprivation, said senior dietitian Farah Syed, who recommended watching portion sizes, adding vegetables, pulses and whole grains and cutting back on sugary drinks. “The key is to adopt practical changes that can be sustained over time,” she said.
The specialists called for integrated care that combines medication, vascular and foot assessments and personalised nutrition, rather than treating blood sugar in isolation.
For Punjab, where the provincial health department is expanding hospital capacity, including a new cardiology hospital with a heart transplant centre, the numbers point to a growing load of diabetes-related heart and kidney disease that primary screening could reduce.
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