NEW DELHI: India has released its first-ever national guidelines for screening, diagnosis, treatment and long-term management of childhood diabetes.
This positions India among a select group of countries that have integrated childhood diabetes care into the public health system.
The guideline aims to ensure universal screening of all children from birth to 18 years, with early identification through community and school-based platforms.
Suspected cases will undergo immediate blood glucose testing, followed by timely referral to district-level health facilities for confirmatory diagnosis and treatment.
A key feature of the framework is the provision of a comprehensive, free-of-cost care package at public health facilities.
This includes screening, diagnostic services, lifelong insulin therapy, monitoring devices such as glucometers and test strips, and regular follow-up care.
The approach is designed to reduce financial burden and ensure uninterrupted treatment for children diagnosed with diabetes.
The guidance document on diabetes will be covered under the Rashtriya Bal Swasthya Karyakram programme, which aims at early identification and early intervention for children from birth to 18 years of age for four defects: defects at birth, deficiencies, diseases, and development delays, including disability, thus spanning 32 common health conditions for early detection and free treatment and management, including surgeries at tertiary level.
The guideline also introduces an integrated continuum of care, linking community-level screening with district hospital-based management and advanced care at medical colleges. "This convergence ensures that no child is lost in the system and that care continues seamlessly from detection to long-term follow-up," the guideline said.
To support early diabetes detection, the initiative promotes the “4Ts” awareness framework – toilet, thirsty, tired and thinner – enabling parents, teachers and caregivers to recognize early warning signs of Type 1 Diabetes.
As India is dubbed as the “diabetes capital” of the world, the structured and standardized national framework is expected to deliver significant public health benefits, including reduced mortality due to early detection, prevention of complications, and improved quality of life for affected children.
Over the long term, it will contribute to lowering healthcare costs and strengthening health system capacity for managing non-communicable diseases among children, health ministry officials said.
The Union Health Ministry, which released the 144-page ‘guidance document on diabetes mellitus in children’ at the recently concluded National Summit on Best Practices in Public Healthcare Service Delivery, with the aim to strengthen child health services.
In addition to clinical protocols, the document emphasises family and caregiver empowerment, providing structured training on insulin administration, blood glucose monitoring, emergency response and daily disease management.
It also outlines evidence-based treatment guidelines, regular monitoring schedules, and protocols for preventing complications.
“The release of the document underscores the government’s commitment to ensuring accessible, affordable, equitable and quality healthcare for all children, with a focus on early intervention, continuity of care and improved health outcomes,” ministry officials added.
The document said while Type 1 diabetes (T1DM) is more common in childhood, epidemiological trends indicate that the prevalence of type T2 diabetes is rising in children and adolescents, largely driven by increasing rates of obesity and sedentary lifestyles.
The risk factors for T2DM and pre-diabetes in children and adolescents are: Obesity or being overweight; sedentary lifestyle including lack of physical activity; unhealthy diet which is high intake of processed foods, sugary drinks, and fats, and low intake of whole foods, fruits and vegetables; family history of T2DM; maternal history of gestational diabetes during pregnancy; presence of conditions such as Polycystic Ovarian Syndrome (PCOS), hypertension, or fatty liver disease.