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A large number of people are living with severe health risks in the country as they carry undiagnosed diabetes for years, while the number of confirmed patients continues to climb, experts have warned.

More than half of the adults with diabetes in the country do not seek diagnosis until serious symptoms appear by which time complications take serious turns, narrowing treatment options and mounting pressure on the patients’ financial capacities.

‘Diabetes often shows no symptoms in the beginning, so people ignore it. They come for treatment only when it begins affecting other organs,’ said National Professor and Diabetic Association of Bangladesh president AK Azad Khan.

He stressed routine screening for all adults with early tests for those with a family history of diabetes.

The Diabetic Association of Bangladesh, country’s largest specialised diabetes care provider, operates more than 135 centres and served around 65 lakh patients in 2024–25 financial year—nearly 12 lakh up from 52.76 lakh in 2019–20.

In 2015–16, the number was 35.10 lakh.

Experts say that all the DAB data present large caseloads, but even then they represent just fractions of the national burden.

The 2021 Bangladesh Demographic and Health Survey found that 61.5 per cent of adults living with diabetes were unaware of their condition, indicating that millions remained undiagnosed.

While experts believe that the actual figure is far higher, they underscore the urgency of a nationwide diabetes screening programme. 

Globally, one in every nine adults is living with diabetes, according to the International Diabetes Federation.

The IDF Diabetes Atlas 2024 estimated that Bangladesh had 1.39 crore adult diabetes patients at the time—a number projected to reach 2.31 crore by 2050, one of the fastest increases in the region.

Bangladesh Endocrine Society president-elect and Bangladesh Medical University associate professor Shahjada Selim puts the figure of adult diabetes patients in the country at nearly two crores.

The disease is fast spreading driven by rapid urbanisation, unhealthy diets and declining physical activity, he says.

‘Since most adults spend the majority of the day at work, workplaces are critical settings for prevention, early detection and management,’ he said.

On Friday, Bangladesh observed World Diabetes Day centring the theme ‘Creating awareness about diabetes in the workplace.’

Noting that globally 70 per cent of people with diabetes are of working age, experts underscore that workers in Bangladesh face higher risks due to long hours of sedentary work, limited access to healthy food and scanty space for physical activity.

They have also criticised authorities for failing to ensure safe food environment or urban infrastructure supporting active living.

Physicians warn that diabetes drives 80 per cent of heart attacks, 44 per cent of kidney failure, and more than 30 per cent of retinopathy cases, yet the disease often remains unnoticed until complications appear at its later stage.

‘Diabetes affects all parts of the body, from head to toe,’ said Azad Khan.

The International Diabetes Federation also reports that three in four diabetics experience mental health distress or anxiety related to their condition.

Experts also said that widespread and affordable screening could reduce deaths and catastrophic health spending.

Currently, screening at public hospitals costs around Tk 600, while private facilities charge around Tk 1,200 in Bangladesh.

Diabetes is one of the costliest chronic diseases in the country, with expenses varying based on medication, complications and treatment facilities.

A 2021 analysis by ICDDR,B and the Diabetic Association of Bangladesh found that a typical diabetes patient spent up to Tk 8,000 monthly, while those with complications spent around Tk 30,000.

Azad Khan urged employers to facilitate prevention by allowing 15–30 minutes of daily exercise time and ensuring healthy food options at canteens.

‘Such steps would also increase national productivity,’ he stressed.

Diabetic association secretary general Md Sayef Uddin said that 70–75 per cent of diabetes cases were preventable through lifestyle changes, but enabling these changes required supportive environment.

Urban planners argue that cities in the country are structurally unfit for healthy living.

Bangladesh Institute of Planners president Adil Mohammad Khan blames the severe lack of adequate open spaces or walkable footpaths in Dhaka city.

‘Policymakers do not think about the health structure of the city—they have simply made it a commodity,’ he said.

While the United Nations Environment Programme recommends 25 per cent open space in sustainable cities, Dhaka has only around 8 per cent, with planners warning that the actual usable space is even lower.

Bangladesh now has the second-highest diabetes prevalence among the seven countries in the International Diabetes Federation’s South-East Asia region.

Experts warn that without urgent action, including widespread screening, improved food safety and urban planning promoting active living, the country’s diabetes burden will continue to grow quietly but catastrophically.