Diabetes in numbers

Diabetes prevalence increases with age. Therefore, the highest estimated prevalence is in people over 65 (Figure 2.1). In 2024, the estimated number of people with diabetes aged 65–99 years was 158.3 million (23.7%). If the current trend continues, the number of people aged 65-99 years with diabetes will be 278 million in 2050 (Table 2.6). These data point to a significant increase in the diabetes population of ageing societies in the next 25 years and the inevitable public health and economic challenges this will bring. It will require all countries to commit to sufficient resources to tackle diabetes.

Regional distribution

There are significant regional differences in the prevalence of diabetes in people over 65. Regions included in the top five places remained the same in 2024 compared with 2019, but the MENA region had the highest prevalence at (32.3%). The lowest prevalence remains in the AFR region (7.8%). This is generally true for 2050 as well (Table 2.7). However, the EUR region will fall to 6th place in the table with the SEA region taking its place. Overall, the projected diabetes prevalence in 2050 in this age group does not forecast significant increases. As an example, in the SACA Region the figures are 23.2% in 2024 and 23.6% in 2050, and in AFR 7.8% in 2024 and 8.3% in 2050.

Country distribution

The countries with the highest number of people over 65 with diabetes are China, India and the USA. India ranked higher than the USA in the number of people over 65 with diabetes for 2024 and 2050. (Map 2.3 and Table 2.8). Projected rises by 2050 are shown and indicate that Germany and the Russian Federation will be replaced by Turkey and Egypt in the top 10 list of countries with for people over 65 with diabetes.

Type 1 diabetes in older adults

The global number of type 1 diabetes in adults is estimated to be 9.15 million, of which 1.1 million are over 60, with a breakdown by age 655,000 (60-69), 325,000 (70-79), and 81,000 (80 and above).

Mortality and health expenditure in older adults

Total global mortality for people with diabetes over 60 is 2.2 million, and 9.2% of all-cause mortality deaths were due to diabetes in this age group. In 2024, 63% of deaths due to diabetes were in people over 60, and total health expenditure for people with diabetes over 60 is a staggering USD501.9 billion.

Undiagnosed diabetes

Estimates of undiagnosed diabetes were generated using 193 data sources from 109 countries. For the remaining 106 countries, which either lacked data sources or data sources did not meet the quality criteria for inclusion, the prevalence of undiagnosed diabetes was extrapolated. In 2024, just over four in ten (42.8%; 251.7 million) adults living with diabetes (20–79 years old) were undiagnosed. High prevalence of undiagnosed diabetes is often the result of insufficient access to healthcare services, as well as a limited capacity of health systems to identify diabetes cases.

Early diagnosis and the timely initiation of treatment are crucial for individuals with diabetes to prevent or delay complications, avoid premature death, and improve quality of life.

Furthermore, the early detection and management of diabetes can help avoid substantial costs related to diabetes complications.

Scaling-up cost-effective diabetes screening and diagnostic capacity is a crucial first step towards improving care for people with diabetes.

Global and regional disparities in undiagnosed diabetes

Across low-income, middle-income, and high-income countries, 58.7%, 45.5%, and 28.9% of adults living with diabetes are undiagnosed (Table 2.9). Globally, 86.9% of all people with undiagnosed diabetes live in low- and middle-income countries, home to four-fifths of the world’s population.

There are large differences in the proportion of undiagnosed diabetes across IDF regions. The highest proportion of undiagnosed diabetes is found in Africa (72.6%), followed by the Western Pacific (50.0%), and South-East Asia (42.7%) (Table 2.10). The lowest proportion of undiagnosed diabetes is found in North America and Caribbean (29.1%). Variation in undiagnosed diabetes across regions and countries is often linked to several factors, including social and economic conditions, health system performance, and awareness about diabetes among health professionals and the public.

The proportion of people living with undiagnosed diabetes varies by country (Map 2.4). Colombia (16.2%), Hungary (16.7%), and the Czech Republic (16.7%) have the lowest proportions of undiagnosed diabetes, whereas Burkina Faso (90.4%), Benin (89.8%), and Mozambique (88.6%) have the highest. In absolute terms, 50.5% of all people with undiagnosed diabetes globally live in just three countries, namely China, India, and Indonesia (Table 2.11). These three countries are among the four most populous countries in the world and among the top five countries in terms of number of people with diabetes (Table 2.4).

To improve estimates of undiagnosed diabetes and guide health-system responses, investments in surveillance and monitoring systems for diabetes are urgently needed. Crucially, data quality depends on the collection of diabetes biomarkers in population-based studies. For reliable estimates, a combination of both HbA1c and FPG is recommended. However, diabetes monitoring efforts, particularly in low-resource settings, will need to balance diagnostic accuracy of different diabetes tests with their feasibility and the cost of implementation. Globally, more than four in ten adults with diabetes in 2024 were unaware that they have the condition. This translates to 252 million people living with undiagnosed – and therefore untreated – diabetes, placing them at increased risk of complications and premature death. Thus, there is a clear need to scale up screening programmes and high-quality, personcentred health services, especially in low- and middleincome countries, where over 85% of people with undiagnosed diabetes live.