India’s silent epidemic deserves more than a trend

My mother lived with diabetes for twenty-four years.

She was very conscious and action oriented about it  – the way she was action oriented about everything. Medicines. Diet. Walks. A kitchen reorganised around what her sugar could tolerate. Medications managed with a discipline that put the rest of us to shame. Daily blood sugar measurement , meticulously recorded. She navigated through therapies as they evolved, always doing what her doctors advised, always hoping the numbers would cooperate.

They didn’t.

Not enough.

In 2017, her heart gave out – a cardiac condition that her doctors attributed directly to the long years of metabolic damage that diabetes quietly, silently inflicts.

She was on every therapy available to her.

She did everything right.

What she didn’t have access to was what we now know changes outcomes in patients exactly like her: Glucagon-like-peptide-1, or GLP-1 receptor agonists, for short. These are a class of therapy that address not just blood sugar, but the underlying metabolic dysfunction, the cardiovascular risk, the interconnected crisis that diabetes really is.

The science existed, somewhere in research pipelines.

It just hadn’t reached my mother. It hadn’t reached India.

Not at a price, or a scale, that would have mattered.

As I write this in 2026, having spent many years working on GLP-1s, I think about my mother  every time I hear this conversation reduced to celebrity weight-loss jabs, or Instagram reels of people looking slimmer and more insta-worthy.

The truth is that we Are the Diabetes Capital of the World.

India is the diabetes capital of the world.

Let That Land.

India has over 100 million people living with diabetes. One hundred million. More than the population of every single country in Europe. If Indian diabetics were a country, they would be the 16^th most populated country in the world.

This population is living with a condition that, left inadequately managed, impacts kidneys, hearts, nerves, and vision with quiet, methodical cruelty.

The challenge isn’t only the disease. It is that in spite of the better tools than ever to fight it, most patients still cannot access them.

GLP-1 receptor agonists like Semaglutide represent a genuine leap in diabetes care. They don’t merely manage blood sugar – they intervene in the metabolic dysfunction driving the disease, reduce cardiovascular risk substantially, and do so through a once-weekly regimen that patients actually sustain.

The global clinical evidence is robust.

The outcomes are real.

My mother’s generation of diabetics didn’t have this option.

Millions of Indians today still don’t – not because the science doesn’t exist, but because the price makes it inaccessible. That is the gap that needs closing.

And Then There Is Obesity. A condition we are only beginning to reckon with.

Diabetes has been visible in India – in family histories, in neighbourhood camps checking blood sugar, in the glucometer quietly occupying a corner of every middle-class kitchen.

Obesity, somehow, was never treated with the same medical seriousness. It was lifestyle. It was willpower. It was something to deflect with a joke. It was something representing a well fed household.

We got that wrong.

Obesity in India is now a clinical emergency, rising fastest among younger demographics – people in their 30s and 40s, increasingly in smaller cities and rural areas, not just urban metros. More importantly, diabetes and obesity are not two separate problems. They are one interconnected metabolic continuum. Obesity drives insulin resistance. Insulin resistance accelerates diabetes. The two feed each other in a cycle that traditional therapies manage but rarely break.

Semaglutide addresses both – not as a cosmetic solution, but as a serious intervention in a serious disease.

Having lived through this situation seeing my mother grapple with it, I see the global conversation muddied by weight-loss hype: this is a prescription medicine for clinically diagnosed patients, to be used under physician supervision. It is not an answer to wanting to look pretty at a party or in wedding photos.

Reducing it to that is medically irresponsible – and an insult to patients who genuinely need it.

I have deep respect for the researchers and companies whose decades of work produced this molecule. That investment changed the global standard of care. But breakthrough science has a second chapter. That chapter is access. Innovation that doesn’t reach the patient is incomplete.

This is why the entry of generic GLP-1s such as Semaglutide matters. Not because it introduces a new molecule, but because it challenges an old model that says cutting edge therapies must remain limited to a few.

India built its reputation by making essential medicines affordable for the world. The next frontier is doing that for complex, advanced therapies. Quality is non-negotiable – many manufacturers in India make products with world class quality, with global standards. There is no compromise there.

Affordability is equally non-negotiable when patients pay out of pocket and healthcare remains a personal financial burden for the majority.

The next phase for us in India is more ambitious: becoming the world’s access engine-taking complex, high-value therapies and making them available to far more people, to every part of the world. There are millions of patients all over the world waiting for them.

While I say that, I also believe that a disease like diabetes has to be managed through the right balance between medicine, nutrition, exercise and lifestyle. It has to be managed holistically, in an integrated manner. A non-integrated approach might not give the desired outcomes.

This shift is not just commercial, not just in the thinking. It is deeply human.

Because behind every statistic that is thrown out is a story like my mother’s. Of patients who spend years of managing a disease, doing everything right, and still facing outcomes that might have been different with better therapies.

The patient sitting in a Tier 2 clinic, or a government hospital, or a modest home managing diabetes on a modest income – that patient deserves the best available standard of care, delivered holistically.

Not a lesser version.

Not some day in the future.

Right here.

Today.

Now.