About 1 in 4 adults in Pakistan had diabetes when the country's national survey tested them, and many had not been diagnosed. In the second National Diabetes Survey of Pakistan, 26.3% of adults had diabetes, and 7.1 in every 100 adults found out only because the survey tested their blood.
Quick answer: diabetes in Pakistan is very common. The national survey of 10,834 adults, run in all four provinces in 2016 and 2017, found that 26.3% had diabetes and another 14.4% had prediabetes. Of the 26.3%, 19.2% already knew and 7.1% were newly found by the survey's blood test, so about 1 in 4 people with diabetes didn't know they had it. Diabetes was linked to being 43 or older, family history, high blood pressure and extra weight.
This breakdown explains what counts as diabetes and prediabetes, how the survey worked, what it found, how Pakistan compares, what the survey can't tell us, and what WHO advises.
What counts as diabetes and prediabetes?
The survey used a glucose tolerance test. People came in after an overnight fast of at least 8 hours, had their blood sugar measured, then drank 75 g of glucose and were measured again 2 hours later. It followed WHO's criteria:
| Result | Fasting blood sugar | 2 hours after the glucose drink |
|---|---|---|
| Normal | Below 110 mg/dL | 140 mg/dL or below |
| Prediabetes | 110 to 125 mg/dL | 141 to 199 mg/dL |
| Diabetes | 126 mg/dL or more | 200 mg/dL or more |
Source: Basit et al., BMJ Open, 2018, diagnostic criteria (WHO). Either result was enough. People already diagnosed by a doctor counted as known diabetes.
Prediabetes means blood sugar is above normal but not yet high enough to be diabetes. The survey also measured HbA1c, a second kind of blood test, where 6.5% or more counted as diabetes.
The study: Pakistan's second National Diabetes Survey
The survey was run by Pakistan's health ministry, the Pakistan Health Research Council, the Diabetic Association of Pakistan and the Baqai Institute of Diabetology and Endocrinology, and published in BMJ Open in 2018.
| Detail | What the survey did |
|---|---|
| Who | 10,834 adults aged 20 or older. Pregnant women were not included. 87% of the people approached took part |
| Where | Urban and rural areas of Punjab, Sindh, Khyber Pakhtunkhwa and Balochistan |
| When | February 2016 to August 2017 |
| How people were picked | Teams went lane by lane, picking every 10th house after a random start |
| Tests | Glucose tolerance test and HbA1c, plus height, weight, waist, blood pressure and cholesterol |
Source: Basit et al., BMJ Open, 2018. Results were weighted to Pakistan's population and adjusted for age.
What it found: diabetes in Pakistan by the numbers
| Measure | Share of adults |
|---|---|
| Diabetes, total | 26.3% |
| Already knew they had diabetes | 19.2% |
| Newly found by the survey's test | 7.1% |
| Prediabetes | 14.4% |
| Diabetes in urban areas | 28.3% |
| Diabetes in rural areas | 25.3% |
Source: Basit et al., BMJ Open, 2018, glucose tolerance test results
Put another way, 7.1 out of 26.3 means about 1 in 4 people with diabetes found out only from this survey. Diabetes and prediabetes together came to 43.8% in urban areas and 39.2% in rural areas, which the authors describe as about double the first national survey in 1994 to 1998. Sindh had the highest rate of diabetes, followed by Punjab.
The method changes the number. With HbA1c instead of the glucose test, 30.1% had diabetes and 5.9% had prediabetes. The authors still treat the glucose test as the more reliable one for a survey like this, partly because HbA1c can be thrown off by anaemia.
Who was more likely to have diabetes?
A survey taken at one point in time can show what diabetes went with, not what caused it. After adjusting for other factors, diabetes was linked to:
| Factor | Odds of diabetes, compared with people without it |
|---|---|
| Age 43 or older | 3.3 times (95% CI 2.9 to 3.8) |
| High blood pressure | 2.2 times (95% CI 1.9 to 2.5) |
| Diabetes in the family | 1.9 times (95% CI 1.7 to 2.2) |
| Unhealthy cholesterol levels | 1.8 times (95% CI 1.3 to 2.4) |
| Obesity (BMI 25 or more, the Asian cut-off) | 1.4 times (95% CI 1.3 to 1.6) |
Source: Basit et al., BMJ Open, 2018, Table 3, adjusted odds ratios. 43 is the cut-off the survey used, not a medical threshold.
How Pakistan compares with the rest of the world
The International Diabetes Federation's Diabetes Atlas, 11th edition (2025) gives Pakistan an age-standardised diabetes prevalence of 31.4% in adults aged 20 to 79 (2024), the highest of any country. That figure comes from a different method, a different age range and a later year, so it isn't directly comparable with the survey's 26.3%. Both put diabetes in Pakistan among the most common in the world.
What the survey can't tell us
- Whether every result would hold up. WHO advises repeating a blood test to confirm diabetes, and the survey couldn't do a second test, so some single results may not have been confirmed.
- Type 1 or type 2. The survey couldn't tell them apart, though it was designed mainly to find type 2.
- Cause. The risk factors are links found at one point in time, not proof that they cause diabetes.
- Today's picture. The data are from 2016 and 2017, adults 20 and over, with pregnant women not included.
Diabetes symptoms and how to prevent type 2: what WHO advises
WHO lists the common symptoms of diabetes as feeling very thirsty, needing to urinate more often than usual, blurred vision, feeling tired and losing weight without trying. For type 2, the most common kind, symptoms can be mild and take several years to notice.
WHO says lifestyle changes are the best way to prevent or delay type 2 diabetes:
- Reach and keep a healthy body weight.
- Stay active, with at least 150 minutes of moderate exercise a week.
- Eat a healthy diet, and avoid sugar and saturated fat.
- Don't smoke.
When to get tested: if you have any of the symptoms above, see a doctor. WHO says the best way to detect diabetes early is regular check-ups and blood tests with a health-care provider, and that over time diabetes can damage the blood vessels in the heart, eyes, kidneys and nerves.
The bottom line
When Pakistan's national survey tested nearly 11,000 adults, about 1 in 4 had diabetes and about 1 in 7 had prediabetes. For many of them, the survey's test was the first time they found out.
FAQs
How common is diabetes in Pakistan?
In the second National Diabetes Survey of Pakistan, 26.3% of adults aged 20 and over had diabetes, about 1 in 4. The IDF Diabetes Atlas 2025 gives an age-standardised 31.4% for adults aged 20 to 79 (2024), the highest of any country, using a different method.
What is a normal fasting blood sugar level?
By the WHO criteria the survey used, a fasting blood sugar below 110 mg/dL is normal, 110 to 125 is prediabetes, and 126 or more is diabetes. WHO advises repeating the test to confirm, which the survey couldn't do.
What is prediabetes?
Prediabetes means blood sugar is above normal but not high enough to be diabetes. In the survey, 14.4% of adults in Pakistan had prediabetes.
What are the symptoms of diabetes?
WHO lists feeling very thirsty, urinating more than usual, blurred vision, tiredness and losing weight without trying. Type 2 symptoms can be mild for years. WHO says the best way to detect diabetes early is regular check-ups and blood tests.
Can type 2 diabetes be prevented?
WHO says lifestyle changes are the best way to prevent or delay type 2 diabetes: keep a healthy weight, get at least 150 minutes of moderate exercise a week, eat a healthy diet low in sugar and saturated fat, and don't smoke.
Sources
- Basit A, Fawwad A, Qureshi H, Shera AS; NDSP Members. Prevalence of diabetes, pre-diabetes and associated risk factors: second National Diabetes Survey of Pakistan (NDSP), 2016-2017. BMJ Open, 2018;8:e020961. Read the study or the free full text
- WHO. Diabetes fact sheet
- International Diabetes Federation. IDF Diabetes Atlas, 11th edition, 2025: Pakistan
Disclaimer: Control Group is an initiative by Vitalis Living. This breakdown is for educational purposes only and does not constitute medical advice. If you think you may have diabetes, speak to your doctor.