CHENNAI: Drawing on insights from a nationwide lipid profile study, new data on the Indian population highlights how subtle lipid imbalances often precede the onset of diabetes. A deeper analysis shows that nearly one in three Indians exhibits lipid abnormalities — a key marker of early metabolic dysfunction and insulin resistance, both precursors to Type 2 diabetes.
The latest findings by Metropolis Healthcare, India’s second-largest pathology network, reveal an alarming trend: early metabolic disruptions may be quietly driving India’s growing diabetes burden. The insights are based on Metropolis’ large-scale analysis of more than 3.9 lakh individuals, reinterpreted to emphasise the strong link between lipid abnormalities, metabolic imbalance and diabetes risk.
The report notes that disturbances in cholesterol and triglyceride levels often appear years before blood sugar begins to rise, underscoring the need for health evaluations that extend beyond glucose checks. About 35 percent of individuals were found to be at elevated risk due to low HDL (“good cholesterol”), while 33 percent recorded high triglyceride levels — both strong indicators of impaired fat metabolism and early insulin resistance.
Lipid imbalance — such as elevated LDL cholesterol, high triglycerides or low HDL — disrupts the body’s normal energy and fat-processing systems, says a noted endocrinologist.
Dr Abhilash K Chandran explains; "When excess lipids circulate in the blood, cells become less responsive to insulin, forcing the pancreas to produce more of the hormone to maintain normal glucose levels. Over time, this strain contributes to insulin resistance, a core feature of metabolic disorders. The imbalance also promotes inflammation and fat accumulation in the liver and around abdominal organs, further weakening metabolic control. Together, these changes set the stage for conditions like prediabetes, type 2 diabetes, and cardiovascular disease."
An emerging concern is the rising prevalence of metabolic irregularities among younger adults. Increasing numbers of people in their 30s and 40s are showing low HDL or high triglycerides, often without obvious symptoms. This points to a silent metabolic shift taking shape, particularly across urban and semi-urban regions.
“This data clearly indicates that metabolic risks are building silently in younger adults, and that greater awareness and early testing can alter this trajectory,” said Surendran Chemmenkotil, Managing Director, Metropolis Healthcare.
Key national findings
Men appear to face a higher risk, with 37.5 percent showing elevated triglycerides and 46.5 percent recording low HDL, compared with 28.9 percent and 24.3 percent among women. These abnormalities were observed across all age groups, including non-obese individuals, suggesting that metabolic imbalance is becoming less dependent on weight and more influenced by lifestyle factors such as stress, inadequate sleep and increased intake of processed foods.
The study reinforces the importance of routine lipid and glucose screening for adults over 30, enabling timely lifestyle and medical interventions. Metropolis’ TruHealth packages offer comprehensive metabolic and cardiovascular assessments designed to detect risks early and support preventive care.
Metabolic syndrome (MetS) is diagnosed when an individual presents three or more of the following indicators: abdominal obesity, elevated triglycerides, low HDL cholesterol, high blood pressure or elevated fasting glucose. Together, these significantly increase the risk of diabetes, heart disease and fatty liver. The study’s findings are consistent with global literature that pegs MetS prevalence between 12.5 percent and 31.4 percent, underscoring the growing public-health challenge of non-communicable diseases.
“Metabolic imbalance is the body’s earliest warning signal, often appearing years before diabetes is diagnosed. Low HDL and high triglycerides are among the first markers of insulin resistance. Regular lipid and glucose testing helps identify these patterns early, giving people a chance to make meaningful lifestyle adjustments and delay or prevent diabetes,” explained Dr. Kirti Chadha, Chief Scientific and Innovation Officer at Metropolis Healthcare.
She added that with the rising use of weight-loss and metabolic therapies, consistent laboratory monitoring remains essential to track progress and ensure safe, effective outcomes.
India now has one of the highest diabetes burdens in the world. Recent estimates suggest that nearly 90 million adults in the country are living with diabetes, and many remain undiagnosed or untreated. What is even more worrying is the growing number of young Indians developing the disease. A nationwide screening found that almost 18 percent of people under 35 already have diabetes, with the highest rates seen among those in their early 30s.
Experts warn that more young adults in their 20s, 30s and 40s are being diagnosed today than ever before, which means they will live with the condition for a longer period and face higher risks of complications later in life. Rising stress, sedentary lifestyles, poor diets and lack of early health checks are major reasons behind this early onset trend.