Prevalence and Determinants of Diabetes among Middle-Aged and Older Adults in India: A Cross-Sectional Analysis of LASI

Background: Diabetes is an increasing public health challenge in India, particularly among middle-aged and older adults. Understanding its prevalence and associated risk factors is essential for informing prevention and management strategies. Objective: This study aimed to estimate the prevalence of diabetes and identify demographic, socioeconomic, behavioural, and health-related factors associated with diabetes among adults aged 45 years and above in India. Methods: A cross-sectional analysis was conducted using nationally representative data from the Longitudinal Ageing Study in India LASI Wave 1 2017 to 18, comprising 72,055 individuals aged 45 years and above. Diabetes status was based on respondents' self-reported diagnosis by a health professional. Descriptive statistics were used to estimate diabetes prevalence, and multivariable binary logistic regression was performed to examine associations between diabetes and selected covariates, including age group, sex, place of residence, caste, religion, physical activity, dietary practices, heart disease, and heart attack risk. Results: Diabetes prevalence was higher among older adults, urban residents, females, and individuals belonging to the Other Backward Classes OBC. After adjustment for potential confounders, age, urban residence, caste, religion, heart disease, and heart attack risk were significantly associated with diabetes, whereas sex was not statistically significant after adjustment. Individuals aged 55 to 64 years and those residing in urban areas exhibited significantly higher odds of diabetes compared with their respective reference groups. Conclusions: Diabetes is highly prevalent among middle-aged and older adults in India and is associated with several demographic, socioeconomic, and health-related factors. These findings highlight population groups that may benefit from targeted prevention, screening, and management strategies. Further longitudinal studies are warranted to clarify temporal relationships and causal pathways.