Peshawar: A silent diabetes epidemic is rapidly expanding across Khyber Pakhtunkhwa’s merged tribal districts, where nearly one in every nine adults is estimated to be living with the disease amid severe shortages of specialist physicians, diagnostic laboratories and screening services.
According to a nationwide Diabetes Prevalence Survey conducted by leading national and international institutions, approximately 17 percent of Pakistani adults have type-2 diabetes, while another 11 percent live with pre-diabetes. Recent systematic reviews place the total number of diabetics in the country at nearly 24 million, with an additional 26 million affected by pre-diabetes.
For Khyber Pakhtunkhwa, the same reviews estimate diabetes prevalence at around 11 percent, though health experts caution that the actual figure could be significantly higher due to limited screening and poor access to healthcare in remote areas.
In the merged tribal districts Kurram, Khyber, Orakzai, North Waziristan and South Waziristan district-level data remain scarce. However, studies conducted by Khyber Medical University and other researchers confirm that non-communicable diseases, including diabetes, are rising sharply across the province.
The crisis is being driven by rapid lifestyle changes. Traditional fibre-rich diets are increasingly replaced by refined flour, sugary beverages, processed snacks and excessive sweetened tea, while physical activity has declined due to mechanisation, unemployment and changing occupations. Obesity, hypertension and family history further compound the risk.
The human and economic toll is severe. Diabetes damages the eyes, kidneys, nerves, heart and blood vessels, and families in tribal districts often spend a substantial portion of their income on medicines, laboratory tests and repeated hospital visits – pushing daily wage earners deeper into poverty. Complications such as vision loss, kidney failure, diabetic foot disease and cardiovascular illnesses steadily erode productivity.
Women face distinct vulnerabilities. Limited mobility, inadequate maternal healthcare and poor awareness frequently delay diagnosis of gestational diabetes, increasing long-term health risks for both mothers and children. Many elderly residents remain undiagnosed until serious complications develop.
Health officials and researchers are calling for a comprehensive public health strategy. Key recommendations include making diabetes screening routine at all Basic Health Units (BHUs), Rural Health Centres (RHCs) and Tehsil Headquarters Hospitals in the merged districts, with regular blood glucose testing for every adult above 35 – particularly those with obesity, hypertension or a family history of diabetes.
They also urge community awareness campaigns through schools, mosques, local media and community health workers; uninterrupted availability of insulin, oral anti-diabetic medicines and glucometers in public facilities; and integration of nutrition education and physical exercise into school routines.
Public health experts emphasise that district-level epidemiological studies in Kurram and other merged districts are urgently needed to generate reliable local data, warning that evidence-based policymaking cannot succeed without accurate information on disease prevalence, risk factors and healthcare access.
