NEW DELHI - It's festival season in India, with the celebrations providing a perfect opportunity for family outings, late-night parties and customary feasting on sweets.
But health experts warn that the festivities, coupled with genetic predisposition and lifestyle changes brought about by the increasing prosperity of the middle class, is contributing to the country being called the world's "diabetes capital," with the highest number of diabetics in any nation.
The string of festivals, starting with Durga Puja and Dussehra and ending with Diwali, take place in accordance with the Hindu calendar and the dates change every year. The first two were on Oct 6 and Diwali falls on Oct 26 this year.
"For the next one month or so, it is all either festivals or outings," says Anoop Misra, chairman at New Delhi's Fortis-C-DOC, Center of Excellence for Diabetes, Metabolic Diseases and Endocrinology.
"During this time, the rate of obesity goes up, sugar control of established diabetics goes down and those who are predisposed to develop diabetes also show diabetes."
Festivals in India are synonymous with eating and gifting sweets, and most food and confectionery shops are decked with an assortment of goodies in colorful wrappings meant for traditional presents.
Two all-time favorites are rasgullas, a soft, spongy ball made from cottage cheese, and the conch-shaped samdesh, made from jaggery. A popular holiday treat is milk-based kaju barfi.
But experts warn the festival fun -- and, not least, the culture of sweet-eating that peaks then -- can help trigger long-term health problems, with diabetes only the start.
The disease is characterized by high levels of sugar in the blood and can lead to more serious complications such as heart disease and stroke, damage to the kidneys or nerves, and blindness.
But the culture of consuming sweets is hard to shake off, especially during festivals.
"Everybody (in India) has a sweet tooth, including me," said Ramachandran, a man in his 50s polishing off a plate of sweets at a New Delhi restaurant.
"(Diabetes) is not because of sweets. It's because people are too lazy (to exercise)," he added.
MIDDLE CLASS DISEASE?
The majority of those with diabetes have Type 2, which is linked to obesity and lack of exercise. India, with 62.4 million cases, has the world's highest number of diabetics.
Misra said numbers are rising at an alarming rate because of a newly rich middle class that increasingly consumes junk food while adopting more sedentary lifestyles.
"Their awareness about healthy eating is very low," he said.
Recent studies have shown the numbers of diabetics is also rising fast in villages, where people are traditionally more active and have not previously been exposed to fast food restaurants and refined snacks.
Nutritionist Uma Gupta attributes it to increasing stress and people adopting city culture, among other causes.
A recent study commissioned by the Indian Council for Medical Research found that in the last one year, the number of diabetics in India increased by 11.6 million, while another 77.2 million are pre-diabetics -- a precursor to Type 2 diabetes where a person's blood sugar levels are higher than normal.
Experts warn that the country's health infrastructure could soon be unable to deal with the burden.
"(Diabetes) is a forerunner of multiple diseases including heart disease and cancer ... I don't think our present health system can counter this pressure," Misra said.
The situation is made worse by a tendency for people to wait until they have a real health problem before doing anything, said Gupta.
"Take measures now, improve your lifestyle. Otherwise, hospitals will not have space for you, doctors will not have time to treat you," she added.
"Treatment should start from your plate itself."