Trends in Diabetes Screening and Care in Jharkhand, India (2021-2025)

Introduction: Diabetes mellitus poses a major public health challenge in India, with Jharkhand reflecting both rising prevalence and unique challenges due to its rural and tribal population. Early detection and sustained management are critical, yet gaps in follow-up and control persist. This study analyzes state-level program data from 2021-2025 to assess the diabetes care cascade. Materials and Methods: A retrospective descriptive analysis was conducted using aggregated data from the Jharkhand State Health Department, covering the duration from 2021 to 2025. Indicators included enrollment, screening, diagnosis, initiation of treatment, follow-up adherence, and glycemic control. Percentages were calculated to reflect progression through the care cascade, and linear regression was applied to assess trends and forecast future coverage. Results: Enrollment expanded from 353,955 in 2021-2022 to 5.58 million in 2024-2025, with the screening coverage improving from 73.7% to 91.3%. Newly diagnosed diabetes cases increased from 3862 to 84,860. Treatment initiation improved markedly, with 90% of diagnosed patients started on therapy in 2024-2025 compared to negligible numbers in 2021-2022. However, follow-up adherence remained low, increasing only from 0.0008% to 20.2%. Among those retained in care, nearly half achieved glycemic control, but overall control rates were limited to less than 10% of all diagnosed cases. Forecasting suggests that full program coverage of the estimated diabetic population may take decades without strategic improvements. Discussion: Jharkhand has achieved large-scale screening and improved treatment initiation, but suboptimal follow-up and control rates highlight the areas of improvement in chronic disease management. Strengthening patient retention, culturally sensitive counseling, and community-based follow-up are essential to improve long-term outcomes.