The number of people with diabetes in the Indian subcontinent has been increasing dramatically: approximately 30-33 million people have diabetes in India and this number could double by 2025. Compared to other ethnic groups, Indians have a high risk of developing diabetes. However, the impact of psycho-social factors related to diabetes care has also contributed to the growing pandemic. Many of the psycho-social problems in the region differ considerably from those encountered in Western society: India has a heterogeneous population with wide differences in language, culture, religion and socio-economic status. Furthermore, the subcontinent is a developing region where the available resources for diabetes care are severely limited. The authors of this article describe the considerable effect of these factors on the psycho-social status of people with diabetes in India, and thus on their ability to manage their condition.