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 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 had the world's highest age-standardised diabetes prevalence, at 31.4 per cent, and recorded an estimated 226,752 diabetes-related deaths among adults aged 20 to 79 in 2024.

Globally, 589 million adults live with diabetes, a figure projected to reach 853 million by 2050. He argued that prevention should begin before blood glucose levels reach the diagnostic threshold.

Excess abdominal and liver fat, insulin resistance, and stress on insulin-producing pancreatic cells can develop years before blood glucose levels rise. He also cited research linking air pollution to about one in five cases of Type II Diabetes, alongside factors such as diet, physical inactivity, and living environments.

His approach begins with creating healthier food and physical activity environments, followed by early screening and structured support for people at risk. For those with prediabetes, he cited programmes targeting weight loss of 5 to 7 per cent, at least 150 minutes of physical activity a week, and ongoing behavioural support.

Metformin, or obesity drugs for selected high-risk patients, could supplement lifestyle changes. Intensive lifestyle programmes, he said, reduced the risk of diabetes by 71 per cent over three years and by 34 per cent among people aged 60 and older, with evidence indicating that the benefits included a longer-term delay in the onset of the disease.

Prevention must be built into communities and primary care rather than left to hospitals, he added. He pointed to the Prime Minister's Diabetes Prevention and Control Programme (2024-2029) as a foundation for these efforts.

Screening has begun in Islamabad, Gilgit-Baltistan, and Azad Jammu and Kashmir, while the programme also includes a diabetes registry and training for frontline health workers. He called for routine screening in primary care, measurable national targets, and sustained funding.

He also noted the 20 per cent federal excise duty on sweetened aerated drinks and a June 2026 appeal by diabetes organisations for a 40 per cent duty on all sweetened beverages. Senior endocrinologist Dr. Abbas Raza presented Pakistani findings on diabetes and cardiovascular risk.

Of 320 participants with usable data, 110 (34.4 per cent) had experienced at least one cardiovascular event over 10 years. Coronary heart disease affected 24.3 per cent, while stroke or mini-stroke affected 13.8 per cent.

Prof. Emerita Tasnim Ahsan examined whether Pakistani patients with diabetes fall into distinct subtypes.

The findings suggest that type 2 diabetes in Pakistan is not uniform and that the risk of complications varies.