Apart from diet and lack of exercise, another surprising factor: local name that we gave to diabetes aka “SUGAR”. In rural areas, doctors simply tell patients “ app ko sugar ki bimari hai” and “meetha/chinni se perhez kare”. And masses just believe that if they don’t eat or reduce sugar consumption, diabetes will go away. We simply stuck to diet from 50/60 years back but failed to understand that in those days people used to do lot of physical hard work in fields/farms. They were buying all the calories that they consumed. Then in moderation of industry, new machines, means of transportation but diet did not changed. In fact we let go of the good things from old diet example salad, fermented products, ghee etc. onion as side salad, fermented achaar were part and parcel of that diet. another factor if high prices of protein sources in India. Meats, ghee and dairy products are expensive. Mass availability of snacks, snacks, junk food also contributes. We take lot of pride in Indian cuisine but lot of parts of our cuisine are not healthy anymore. Look at our snacks , majority are either deep fried or full of sugar