Pakistan now has the highest rate of diabetes in the world. The International Diabetes Federation (IDF) estimates that 34.5 million Pakistani adults were living with diabetes in 2024, an age-adjusted prevalence of 31.4 per cent, or close to one adult in three. Only three countries have more adults with diabetes. About 9.3 million of those affected, more than one in four, have not been diagnosed, and more than 10 million other adults have impaired fasting glucose, a stage that often comes before diabetes. Without stronger prevention, the IDF projects that the number of adults with diabetes in Pakistan will double to about 70 million by 2050. Each of these people is at risk of heart attack, stroke, kidney failure, vision loss, nerve damage and amputation. Food is one place where every family can begin to act.

For many Pakistani families, a meal brings together roti or rice, daal, sabzi, salan, dahi and dishes shared across generations. Advice about diabetes should make room for these familiar foods. The aim is to help people enjoy them in portions and combinations that support better health.

What we eat and how much we eat remain central to diabetes care. The order in which we eat may also help.

What we eat and how much we eat remain central to diabetes care. The order in which we eat may also help.

What we eat and how much we eat remain central to diabetes care. The order in which we eat may also help. A practical meal sequence is to begin with vegetables, either alone or with a modest serving of plain dahi or raita, then eat protein foods such as chicken, fish, eggs, lean meat, daal or chana, and finish with a modest portion of roti or rice at the end of the meal. Do not eat the roti or rice first.

During digestion, starch in roti, naan and rice is broken down into glucose. In diabetes, the body has difficulty keeping this glucose within a healthy range. A large portion of carbohydrate can therefore produce a substantial rise in blood sugar.

Small clinical studies have found that eating vegetables and protein before carbohydrate can reduce the immediate rise in blood glucose in people with type 2 diabetes. This is a useful additional strategy, but the evidence is stronger for short-term meal responses than for lasting improvements in diabetes or prevention of its........

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