THIRUVANANTHAPURAM: Diabetes-related deaths in the state are rising at an alarming rate, with the disease responsible for nearly one in six (16.36%) medically certified deaths in 2024, compared to one in ten a decade ago.
Often described as a “silent killer”, diabetes is increasingly linked to fatal complications such as kidney failure, heart disease, and stroke, according to the Medical Certification of Cause of Death (MCCD) 2024 report published recently.
Nearly 45% of all diabetes deaths occur among those aged 70 and above, with men disproportionately affected, accounting for 57% of fatalities. The report describes the trend in diabetes-related fatalities over the past decade as “upward and significant”, signalling a shift in the disease’s role from a manageable metabolic condition to a leading contributor to mortality in the state.
The findings underline that diabetes rarely acts alone. It dominates the endocrine, nutritional and metabolic diseases category, accounting for 89.18% of deaths in this group, while also triggering serious secondary complications. It is closely linked to the state’s leading cause of death: diseases of the circulatory system that account for 27.56% of total deaths, particularly ischaemic heart disease and stroke.
‘Findings highlight need for structured policy intervention’
Although diabetes deaths dipped briefly in 2021 amid the surge in Covid fatalities, the sharp rise recorded in 2023 and 2024 indicates that the metabolic health crisis has persisted beyond the pandemic.
Health experts caution that diabetes is not merely about elevated blood sugar levels. It significantly increases the risk of complications such as renal failure, cardiovascular disease, and vision loss, placing a growing burden on specialised healthcare services.
An analysis of long-term trends from 2012 to 2024 shows a fluctuating but overall upward pattern in diabetes-related mortality. The proportion remained between 9% and 11% during 2012-2015 before dipping to 7.85% in 2016. It then rose steadily to 13.31% in 2019 and 14.25% in 2020.
While there was a temporary decline in 2021, the proportion climbed again to 12.61% in 2022 and peaked sharply at 19.09% in 2023, before slightly declining to 16.36% in 2024.
Despite short-term variations, the overall trajectory points to a growing burden of non-communicable diseases in the state. The state’s ageing population -- among the highest proportions of elderly in India -- makes it particularly vulnerable to chronic illnesses like diabetes. The report notes that most diabetes-related deaths occur after the age of 35, reflecting a progressive transition of health risks across the lifespan.
However, health experts caution that the report likely underestimates the true scale of the crisis. The MCCD system currently captures only 10.71% of total registered deaths in the state and is limited to 150 selected hospitals across five urban local bodies. As a result, mortality patterns in more than 1,000 largely rural local bodies remain uncertified, limiting the ability of policymakers to design targeted interventions.
Public health expert K Rajasekharan Nayar, emeritus professor at the Global Institute of Public Health, said the findings highlight the need for structured policy intervention beginning at the primary healthcare level. He stressed that lifestyle disease programmes must shift their approach from blaming individuals to addressing broader structural issues within the public health system.