Nearly half of those with diabetes may be unaware they have the disease

A large portion of the global population with diabetes remains undiagnosed or is not receiving optimal care, according to a new study published in The Lancet Diabetes & Endocrinology.

The Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine and a global network of collaborators conducted the analysis of the diabetes care cascade for all ages, both sexes, and 204 countries and territories from 2000 to 2023.

In 2023, an estimated 44% of people aged 15 and older with diabetes are unaware of their condition. Underdiagnosis was greatest among young adults—despite facing higher risks for long-term complications.

Among those who were diagnosed, 91% were on some form of pharmacological treatment. However, of those receiving treatment, only 42% had their blood sugar levels managed optimally. This translates to just 21% of all people with diabetes globally having their condition under optimal management.

Despite improvements over two decades, the research also found substantial regional diagnosis and treatment disparities, particularly in low- and middle-income countries. High-income North America had the highest rates of diagnosis, while high-income Asia Pacific showed the highest rates of treatment among diagnosed individuals.

Southern Latin America had the highest rates of optimal blood sugar management among those treated. In contrast, Central sub-Saharan Africa faced the largest gaps in diagnosis, with less than 20% of people with diabetes being aware of their condition.

“By 2050, 1.3 billion people are expected to be living with diabetes, and if nearly half don’t know they have a serious and potentially deadly health condition, it could easily become a silent epidemic,” said Lauryn Stafford, first author and researcher at IHME.

Given the pace at which cases are rapidly rising, the research underscores the urgent need for investment in screening programs for younger populations and access to medications and glucose-monitoring tools, especially in underserved regions.

In 2022, the WHO set a target to have 80% of people with diabetes clinically diagnosed by 2030.