With the highest number of children living with Type 1 diabetes, India faces a rising emergency marked by late diagnosis, unaffordable insulin, and a broken support system
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INDIA’S TYPE 1 DIABETES CRISIS
India is witnessing a silent but worrying rise in Type 1 diabetes among children and adolescents. According to diabetologists and paediatricians, cases are increasing steadily, and India now has the highest number of children with Type 1 diabetes worldwide, as per the International Diabetes Federation (IDF). With November marked as National Diabetes Awareness Month, the data underlines the urgent need for research, early detection, affordable insulin, and long-term care for young patients.
WHAT IS TYPE 1 DIABETES?
>> Type 1 diabetes is different from the more common Type 2. It occurs when the immune system destroys the pancreas’ insulin-producing cells, leading to high blood sugar.
>> Patients need lifelong insulin, regular glucose monitoring and dietary planning.
>> “Unlike adult-onset diabetes, children with Type 1 diabetes need wholesome nutrition. The key is calculating carbohydrate content and adjusting insulin for any food. The idea is not to ‘avoid sweets’, but to guide the whole family towards healthy eating,” said Dr Meenakshi Girish, HOD, Paediatrics, AIIMS Nagpur, the only institute with a dedicated non-communicable diseases ward.
>> Early diagnosis and correct treatment prevent life-threatening complications such as diabetic ketoacidosis (DKA).
LIVING WITH TYPE 1 DIABETES
Nupur Lalvani, who has been living with Type 1 diabetes for over 30 years, told mid-day, “It is a difficult disease. It keeps you on the edge throughout your life. But if you have access to the right medication, a knowledgeable doctor who understands type 1 diabetes, and support from family and friends, you can live a wonderful life. If you don’t miss your check-ups, insulin shots and glucose monitoring, the condition can be managed, and life can feel almost normal.
Unfortunately, these are also the reasons why many people with type 1 diabetes die young. With limited access to affordable medication, lack of awareness and tough lifestyle demands, the fatality rate rises. I have to take an insulin shot every single time before I eat — and that is not easy, mentally or financially.”
A: Survey of 898 type 1 diabetes Patients (Nov 2024)
105
deaths reported (11.6%)
Of these 105 deaths
43% in children aged 15 or below
24% within 2 years of diagnosis
53% within 3 years of diagnosis
B: Global numbers (Age 0–19 years)
>> 1.2 million children, adolescents living with type 1 diabetes
>> Highest number reported in India
Source: International Diabetes Federation
CHALLENGES FACED BY PATIENTS
>> Basic treatment using insulin pens and frequent glucose checks costs at least Rs 5000 per month
>> Financial strain makes long-term care difficult for middle-class families
>> Emotional stress at diagnosis; lifelong dependence on injections or pumps
>> Frequent finger-prick tests and rigid daily routines for children
>> Difficulty calculating carbohydrate content in Indian food; lack of free apps
>> Most schools lack facilities for children with Type 1 diabetes
>> Fear of hypoglycemia causes anxiety among parents
>> Stigma and psychological pressure on families
SYMPTOMS OF TYPE 1 DIABETES
>> Sudden return of bedwetting in a toilet-trained child
>> Weight loss despite extreme hunger
>> Excessive thirst and frequent urination
>> Fatigue, lethargy
>> Fruity breath, abdominal pain (possible DKA – medical emergency)
>> Fungal infections in the genital area
Source: Dr Meenakshi Girish
THE COST BURDEN
>> A 10 ml vial of analogue insulin costs around Rs 3000 and may last up to 4 weeks
>> Insulin delivery: syringes (cheapest), pens (moderate), pumps (Rs 6 lakh plus R30,000 monthly maintenance)
>> When life-saving drugs enter the National Essential Medicines List, prices drop — for example, Lantus fell from Rs 1200 to Rs 640 per 3 ml cartridge after inclusion
BlueCircle Foundation survey (2025):
>> 99.2% of Type 1 diabetics cannot afford Libre 1 continuous glucose monitor (CGM) costing around R5500
>> Libre Pro (R2300) has been discontinued, forcing users to buy expensive version
>> CGM sensors last only 14 days, meaning R11,000 monthly out-of-pocket cost
>> Alternative: 10–12 finger-prick tests daily, which is painful and risky for many
TYPE 1 vs TYPE 2 DIABETES
Type 1 Diabetes
>> Age at onset: 6 months and older
>> Family history: less than 10%
>> Insulin secretion: decreased/absent
>> Insulin sensitivity: normal
>> Insulin dependency: permanent
>> Obesity: population prevalence
>> DKA: common
>> Beta cell antibodies: usually, present
>> C-peptide: undetectable/ low
Type 2 Diabetes
>> Age at onset: Usually pubertal
>> Family history: 30–50%
>> Insulin secretion: variable
>> Insulin sensitivity: decreased
>> Insulin dependency: episodic initially
>> Obesity: 90%
>> DKA: rare
>> Beta cell antibodies: usually, negative
>> C-peptide: normal/high
Source: AIIMS Nagpur
WHAT INDIA NEEDS: POLICY GAPS & SOLUTIONS
Representation pic/istock
1 States like West Bengal, Chhattisgarh and Rajasthan provide free insulin and run government clinics for Type 1 diabetes — Maharashtra needs similar support
2 Lack of structured support systems, subsidies, free insulin supply, patient education and mental health services increases long-term risk
3 Integrate Type 1 diabetes care into primary healthcare; expand training for health workers
4 Conduct widespread awareness campaigns for early detection and destigmatisation
5 Provide psychological counselling for children and caregivers
6 Improve access to affordable insulin technologies (CGMs, pumps)
7 Mandate insurance coverage for Type 1 diabetes
November
National Diabetes Awareness Month
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