Imagine discovering that nearly a quarter of your city's adults over 30 are living with diabetes—a staggering three times the national average. This isn’t a hypothetical scenario; it’s the alarming reality in Kathmandu, Nepal, where a recent health screening uncovered a silent epidemic. But here’s where it gets even more concerning: diabetes is no longer just a disease of the elderly. It’s creeping into the lives of young people, often without them even realizing it. And this is the part most people miss—a new form of diabetes, linked to chronic undernutrition, is emerging in low- and middle-income countries, adding another layer to this complex crisis.
Between December 2024 and January 2025, Kathmandu Metropolitan City conducted a massive health screening of over 26,000 residents, checking for blood sugar levels, hypertension, behavioral risk factors, and renal function. A seemingly random blood sugar test of 19,660 individuals revealed a shocking truth: 22% of Kathmanduites over 30 had high blood sugar levels. This preliminary report highlights a crisis that’s far worse than the national average of 8%. Globally, the numbers are equally daunting. The World Health Organization (WHO) reports that diabetes cases skyrocketed from 200 million in 1990 to 830 million in 2022, with low- and middle-income countries bearing the brunt. What’s more, diabetes is now affecting younger populations, including children, yet many still believe it’s an ‘old person’s disease.’
Here’s the controversial part: while unhealthy lifestyles are often blamed, systemic failures in early detection and state intervention play a massive role. Nepal’s healthcare system, for instance, has seen declining government investment in public health, even as non-communicable diseases (NCDs) like diabetes account for 73% of the country’s total deaths. The previous government allocated a mere Rs21.1 million to NCDs—a drop in the ocean compared to the soaring costs of diabetes care. This raises a critical question: Are governments doing enough to tackle this growing crisis, or are they turning a blind eye to a problem that could cripple healthcare systems?
Diabetes is manageable with proper diet, regular physical activity, timely diagnosis, and medication. Yet, many remain unaware of their condition or avoid seeking treatment. In Nepal, experts link the rise in youth diabetes to processed food consumption, physical inactivity, and increasing stress levels. But the lack of nationwide screening programs and public awareness exacerbates the issue. For instance, the new type-5 diabetes, associated with chronic undernutrition, remains largely unknown, leaving many vulnerable.
Kathmandu’s screening initiative is a step in the right direction, but it’s just the beginning. Regular screenings and proactive interventions are essential, not just in the capital but across the country. If left unchecked, diabetes could overwhelm Nepal’s healthcare system, burdened by the continuous and exorbitant costs of treatment. So, here’s a thought-provoking question for you: Is diabetes a personal responsibility, or should governments take the lead in prevention and early detection? Share your thoughts in the comments—let’s spark a conversation that could shape the future of public health.
