The Growing Burden of Diabetes Mellitus in Pakistan: Epidemiology, Risk Factors, Challenges, and Public Health Interventions

Abstract

Background: Diabetes mellitus has emerged as a major public health challenge in Pakistan, with prevalence rates among the highest worldwide and a substantial proportion of undiagnosed cases. Despite increasing incidence, integrated data on epidemiology, risk factors, and health system barriers remain limited, creating a gap in effective prevention and management strategies. Objective: This review aims to synthesize the epidemiological burden, key risk factors, diagnostic and management challenges, and public health responses to diabetes mellitus in Pakistan, with a focus on quantifying prevalence, analyzing risk associations, and identifying actionable intervention points. Methods: A narrative review was conducted at Baqai Medical University, Karachi, using structured searches of Google Scholar and PubMed for literature published between 2000 and 2025. Studies were included if they addressed diabetes prevalence, risk factors, management, or public health interventions in Pakistan; non-English, duplicate, or irrelevant articles were excluded. Data extraction focused on prevalence, demographic risk profiles, system-level barriers, and outcomes. Descriptive and comparative statistics were calculated using Microsoft Excel, with significance assessed at p < 0.05 and 95% confidence intervals. The review adhered to ethical standards consistent with the Helsinki Declaration. Results: National prevalence of diabetes in adults was 30.8% (95% CI: 29.7–31.9), with urban areas showing higher rates than rural (28.3% vs 25.3%, p < 0.05) and 26.9% of cases undiagnosed. Central obesity, low physical activity, hypertension, and family history were major risk factors (OR range: 1.33–2.41, all p < 0.01). Poor glycemic control affected up to 86.4% of patients and was associated with a twofold increase in complications (OR 2.34, 95% CI: 1.62–3.38). Conclusion: Diabetes mellitus in Pakistan constitutes an urgent clinical and public health threat driven by interlinked genetic, behavioral, and systemic factors. Comprehensive, context-specific interventions in early detection, risk factor modification, and health system strengthening are essential to reduce disease burden and improve patient outcomes.