Epidemiology and determinants of diabetes in Pakistan have peculiar combination of risk factors. Strong gene and environment interplay along with in-utero programming in context of low birth weight and gestational diabetes are the main contributors of a high prevalence of type 2 diabetes in Pakistan. The real burden of diabetes is due to its chronic complications leading to increased morbidity and mortality. The unique combination of various risk factors necessitates research studies to make appropriate risk assessment tools to control this diabetes pandemic. Better understanding of aetio-pathological genetic and environmental factors are suggesting prevention should begin much before the start of disease process and interventions in high-risk subjects alone will not be sufficient. It is necessary to initiate population based programmes for primary prevention of diabetes including a range of activities targeted at different age groups from fetal life to old age. Synchronized and coordinated efforts from public and private sectors are needed to combat this mammoth health and economic issue. Key words: Diabetes, Pakistan, Introduction: Escalation in rates of diabetes, especially type 2 diabetes in Pakistan is posing threats to the economy and quality of life of people due to poor glycemic control and very high rates of complications (1-6). Cost of care is estimated to be very high. Resource constraints society, lack of medical reimbursement and insufficient allocation of health budget are barriers to quality care. Most often the patient is unable to afford the high cost of treatment (7-9). This review was conducted to study research evidence
