Abstract The world epidemiology of diabetes mellitus is experiencing a sharp shift, and there is an increasing number of diabetes cases among children, adolescents, and young adults. India represents a major example of the growing burden of early-onset diabetes driven by genetic predisposition, rapid urbanization, lifestyle transitions, and limitations within the health system. Diabetes occurring in early adulthood is linked with a more severe progression of the disease, the development of complications at an earlier age, and higher lifetime medical and social expenditures than late-onset diabetes. This narrative review is a synthesis of the available evidence on the data on national screening, international epidemiological surveillance, community-based intervention research, health systems literature and mental health literature to investigate the number of early-onset diabetes in India and the world. As pointed out in the review, existing screening approaches have gaps, rural-urban disparities in healthcare provision, the efficacy of lifestyle measures in the high-risk population, and the importance of psychosocial elements in diabetes management are critical. T
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