Islamabad: Pakistan’s diabetes burden could more than double to 70.2 million adults by 2050 from 34.5 million in 2024, while about 9.3 million people already have the disease without knowing it, International Diabetes Federation (IDF) President Prof Peter Schwarz told the Pakistan Endocrine Society’s PESCON 2026 on Saturday.
PESCON 2026, the 24th annual conference of the Pakistan Endocrine Society, is being held at Serena Hotel in Islamabad from October 9 to 11. Specialists are discussing diabetes, obesity and other endocrine conditions under the theme “Promoting Excellence in Endocrine Care.”
Citing the IDF Diabetes Atlas, Prof Schwarz said Pakistan has the world’s highest age-standardised diabetes prevalence, at 31.4 percent, and recorded an estimated 226,752 diabetes-related deaths among adults aged 20 to 79 in 2024. Globally, 589 million adults live with diabetes, projected to reach 853 million by 2050.
He argued prevention should begin before blood glucose reaches the diagnostic level. Excess abdominal and liver fat, insulin resistance and stress on insulin-producing pancreatic cells can develop years before glucose rises.
He also cited research linking air pollution to about one in five type 2 diabetes cases, alongside diet, inactivity and living environments.
His approach starts with healthier food and activity environments, then early screening and structured support for people at risk. For prediabetes, he cited programmes aiming for 5 to 7 percent weight loss, at least 150 minutes of weekly physical activity and continuing behavioural support. Metformin, or obesity drugs for selected high-risk patients, could supplement lifestyle changes.
Intensive lifestyle programmes, he said, cut diabetes risk by 71 percent over three years, and by 34 percent among those aged 60 and older, with evidence of longer-term delay. Prevention must be built into communities and primary care, not left to hospitals, he added.
He pointed to the Prime Minister’s Diabetes Prevention and Control Programme (2024-2029) as a foundation. Screening has begun in Islamabad, Gilgit-Baltistan and Azad Jammu and Kashmir, and it includes a diabetes registry and frontline health worker training.
He called for routine primary care screening, measurable national targets and sustained funding, and noted the 20 percent federal excise duty on sweetened aerated drinks and diabetes organisations’ June 2026 appeal for a 40 percent duty on all sweetened beverages.
Senior endocrinologist Dr Abbas Raza presented Pakistani findings on diabetes and heart risk. Of 320 participants with usable data, 110 (34.4 percent) had at least one cardiovascular event over 10 years. Coronary heart disease affected 24.3 percent and stroke or mini-stroke 13.8 percent. Many patients remained at high risk, yet statin use was low.
Prof Emerita Tasnim Ahsan examined whether Pakistani diabetes patients fall into distinct subtypes. Groupings varied by classification method; one found the largest group, at 32 percent, had obesity and related metabolic problems. The findings suggest type 2 diabetes in Pakistan is not uniform, and complication risks may differ.
Prof Saeed A. Mahar said prediabetes needs careful assessment because it can have different causes. Insulin resistance and obesity are common, but some cases may involve early autoimmune diabetes or excess cortisol, a stress hormone. He cited evidence losing 7 to 10 percent of body weight can prevent or delay type 2 diabetes, and urged doctors to identify patients needing extra testing or treatment.
Prof Volkan Demirhan Yumuk presented a European Association for the Study of Obesity framework assessing how obesity affects health, not BMI alone, and urged respectful, non-stigmatising language.
Prof Ali Karamat reviewed evidence on tirzepatide beyond blood sugar control, including a 469-participant trial in which it reduced sleep breathing interruptions more than placebo over 52 weeks in adults with obesity and moderate to severe sleep apnoea.
Senior endocrinologists and diabetologists from Pakistan, including Prof Abdul Basit, Pakistan Endocrine Society President Dr Ali Asghar, Prof A.H. Aamir and Prof Yakoob Ahmedani, also spoke at the conference, alongside specialists from several other countries.
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