11th Edition | 2025

Diabetes Atlas

589
million
people worldwide
have diabetes
IDF Diabetes Atlas
11th edition | 2025
Table of Contents
1 Acknowledgements
2 Forewords
6 Summary

8 Introduction

11 References

12 Chapter 1: What is diabetes

16 1.1 Type 1 diabetes

17 1.2 Type 2 diabetes
18 1.3 Impaired glucose tolerance and impaired fasting glucose
18 1.4 Diagnostic criteria for diabetes
19 1.5 Hyperglycaemia in pregnancy
21 1.6 Other types of diabetes
22 References

26 Chapter 2: Methods

28 2.1 Interpretation of estimates

28 2.2 Gathering and selecting data sources
30 2.3 Estimating diabetes prevalence and projections for the future
30 2.4 Extrapolating data
30 2.5 Estimating confidence intervals
31 2.6 Standardisation of estimates
32 2.7 Estimating undiagnosed diabetes prevalence
33 2.8 Estimating the prevalence of intermediate states of hyperglycaemia
34 2.9 Estimating the prevalence of hyperglycaemia in pregnancy
35 2.10 Estimating diabetes-related mortality
35 2.11 Estimating the economic impact of diabetes
36 2.12 Estimating diabetes prevalence for type 1 diabetes across all age groups
38 References

40 Chapter 3 - The global picture of diabetes

42 3.1 Diabetes prevalence in 2024 and projection to 2050 (20–79 years)

48 3.2 Diabetes prevalence in older adults in 2024 and projection to 2050
50 3.3 Undiagnosed diabetes
53 3.4 Intermediate states of hyperglycaemia
57 3.5 Hyperglycaemia in pregnancy
59 3.6 Diabetes-related mortality
60 3.7 The economic impact of diabetes
68 3.8 Type 1 diabetes estimates in children and adults
71 References

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72 Chapter 4 - Diabetes by region

74 Africa
76 Europe
78 Middle-East and North Africa
80 North America and Caribbean
82 South and Central America
84 South-East Asia
86 Western Pacific

88 Chapter 5 - Diabetes complications

90 5.1 Type 2 diabetes and the risk of cardiovascular diseases

92 5.2 Diabetes and the risk of dementia
95 5.3 Diabetes-related eye disease
98 References

101 Appendices

102 Country summary table: estimates for 2025

118 Abbreviations and acronyms
119 Glossary
124 List of tables, maps and figures

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | V

© International Diabetes Federation, 2025 Unless indicated otherwise, all photographs in this
edition of the IDF Diabetes Atlas are property of the
No part of this publication may be reproduced, International Diabetes Federation.
translated or transmitted in any form or by any
means without the prior written permission of Technical editing and design by
the International Diabetes Federation. Optima: optimadesign.co.uk

Requests can be submitted at: The boundaries and names shown, and the
diabetesatlas.org/copyright-requests/ designations used in this report do not imply the
expression of any opinion whatsoever on the part of
First edition, 2000 the International Diabetes Federation concerning the
Second edition, 2003 legal status of any country, territory, city or area or of
Third edition, 2006 its authorities, or concerning the delimitation of its
frontiers or boundaries. The International Diabetes
Fourth edition, 2009
Federation uses the country and territory official
Fifth edition, 2011 names as listed by the United Nations.
Sixth edition, 2013
This edition of the IDF Diabetes Atlas is dedicated to
Seventh edition, 2015 Professor Akhtar Hussain, who served as President of
Eighth edition, 2017 the International Diabetes Federation from 2022­–2024
Ninth edition, 2019 and untimely passed away on 1 July 2024.
Tenth edition, 2021

Online version of the IDF Diabetes Atlas available

at diabetesatlas.org
Data
The list of studies on which estimates in the
IDF Diabetes Atlas are based can be found
at diabetesatlas.org

ISBN: 978-2-930229-96-6

VI | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Acknowledgements
IDF Diabetes Atlas 11th Edition Committee
Co-Chairs Michael Laxy, Naomi Levitt, Xia Li, Andrea On Yan Luk,
Dianna J Magliano (Co-Chair), Ronald Ma, David M. Maahs Stefania Maggi, Jayanthi
Edward J Boyko (Co-Chair). Maniam, Maja E.Marcus, Jean Claude Mbanya, Natalie
McGlynn, Yoshihisa Miyamoto, Hiliary Monteith,
Special Interest Group (SIG) leads: Jedidiah Morton, Ayesha A. Motala, Ezekiel Musa,
Valentina Naumovski, Katherine Ogurtsova, Richard A.
Mohammed K Ali, Kaarin Anstey, Gillian Booth,
Oram, Bige Ozkan, Emily Papadimos, Odette Pearson,
Bruce B. Duncan, Anthony J. Hanley, William H.
Catherine Pihoker, Justin Porter, R. Guha Pradeepa,
Herman, Elbert Huang, Graham D. Ogle, David R.
Berhe Sahle, Forough Sajjadi, Ambady Ramachandran,
Owens, Meda E Pavkov, Naveed Sattar, Elizabeth
Thomas Robinson, Mary Rooney, Julian Sacre,
Selvin, David Simmons, Alan Sinclair, Matilde
Jithin Sam Varghese, Jacqueline Seiglie, Baiju Shah,
Monteiro-Soares, Rebecca L. Thomas, Sarah Wild.
Jonathan Shaw, Sobha Sivaprasad, Eugene Sobngwi,
Special Interest Group (SIG) members: Jannet Svensson, Robyn Tapp, Felix Teufel, Sathish
Thirunavukkarasu, Brittney Tiffault, Dunya Tomic,
Ahmed H. Abdelhafiz, Ranjit Mohan Anjana,
João Vasco Santos, Madhuri Venigalla, Siddharth
Elizabeth Barr, Abdul Basit, Srikanth Bellary,
Venkatraman, Amelia Wallace, Caroline Wang, Fei
Dominika Bhatia, Theresa Boyer, Isabelle Bourdel-
Wang, Hui Wang, Donald Warne, Mahmoud Werfalli,
Marchasson, Louise Maple Brown, Bertrand Cariou,
Hannah Wesly, Xilin Yang, Lili Yuen, Farhan Zaidi,
Weihan Cao, Carlos Celis-Morales,, Thora Chai, Qinyu
Ping Zhang, Rui Zhang, Wei Zhang, Henry Zhao,
Chen, Benjamin Chidiac, Tawanda Chivese, Faraja
Lidan Zheng, Zhiguang Zhou.
S. Chiwanga, Tali Cukierman-Yaffe, Dana Dabelea,
Natalie Daya Malek, Shutong Du, Daisy Duan, Justin Editorial team
B. Echouffo Tcheugui, Aoife M Egan, Emeka Ejimogu,
Dianna J. Magliano, Edward J. Boyko, Irini Genitsaridi,
Ranmalee Eramudugolla, Michael Fang, Courtney
Lorenzo Piemonte, Phil Riley, Paraskevi Salpea.
Fischer, David Flood, Laercio Joel Franco, Peggy Gao,
Jen Manne-Goehler, Gabriel A Gregory, Zijing Guo,
Supporters
Marion Guerrero-Wyss, Sarega Gurudas, Jessica
Harding, Aveni Haynes, Lucas Crescenti Abdalla Saad The IDF Diabetes Atlas 11th edition has been
Helal, Jiahuan Helen He, Cheri Hotu, Jiaqi Hu, Hamidul produced thanks to unrestricted educational
Huque, Jincy Immanuel, Ayuba Issaka, Steven James, grants from
Alicia J. Jenkins, Tripti Joshi, Emily Okeefe, Dimitrios
Kazantzis, Shihchen Kuo, Rodrigo M. Carillo-Larco,

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 1

Foreword by the IDF President

This edition of the IDF Diabetes Atlas was launched facing significant barriers to diagnosis, treatment,
at our World Diabetes Congress 2025 in Bangkok. and management. Today, despite being a global
The launch coincides with the 75th anniversary of the health crisis and despite the greater attention the
year we were officially founded and 25 years since condition receives, we must acknowledge that for
we introduced the Diabetes Atlas in 2000. In 1950, many, diabetes care remains a privilege rather
diabetes representative organisations from than a right.
16 countries came together to share experiences
and collaborate to create strategies that would Three-quarters of a century after our foundation,
support the response to a condition already identified we must, perhaps more than ever, be united in
as a growing, but at that time much-hidden, threat to our global endeavour to transform access to care
global health. Since then, our federation of national for people affected by diabetes and its complications,
and transnational members has grown to include, at and drive awareness of the serious risk posed to
the time of writing, more than 240 diabetes-focussed individuals, communities and economies. The IDF
organisations in 161 countries and territories. Diabetes Atlas remains a highly valuable tool to
support our advocacy to demand policy change.
From the outset, we looked to embrace the complete I encourage you all to take advantage of the
spectrum of the diabetes community: the researchers resources we have made available online at
pushing the envelope of science to advance diabetes diabetesatlas.org and use the content to support
care, the medical doctors and allied healthcare your efforts and campaigns.
professionals who provide the care, and, of course,
the people with diabetes at the very heart of care. Much has been achieved thanks to the tireless
enthusiasm and commitment of volunteers and
From our genesis, we sought to listen to and voice professionals across the world in service of a common
the concerns of the entire community and improve mission – to improve the lives of people with diabetes
diabetes care worldwide, not just in high-income and prevent diabetes in those at risk. Much, however,
economies but also (indeed, particularly) in those remains to be done to tackle the systemic inequities
countries where resources are limited and health that disproportionately affect communities because
inequities high. Our first President back in 1950 was of socioeconomic status, race, ethnicity, geography,
Dr R D Lawrence, a British diabetologist and one of the gender, disability, and other social determinants of
co-founders of our organisation. He was a researcher health. The Diabetes Atlas helps provide the context
famed for his role in advancing diabetes care and and the evidence to drive change.
advocacy worldwide, and he was a person living
with type 1 diabetes. We are living a defining decade for diabetes.
At the beginning of the decade, the centenary
Lawrence was extremely fortunate to have been one of the discovery of insulin in 2021, was a catalytic
of the first recipients of therapeutic insulin shortly moment that saw the launch of the World Health
after it was first discovered in 1921 at the University of Organization’s Global Diabetes Compact - a unique
Toronto, Canada by Dr. Frederick Banting and Charles global initiative aimed at ensuring access to equitable,
Best, with the assistance of James Collip and under the comprehensive, affordable and quality care for
supervision of Dr. John Macleod. It saved Lawrence’s everyone living with diabetes and addressing risk
life. He would have been keenly aware of the huge factors to reduce the growing cases of type 2 diabetes
inequities in access to diabetes care that existed - and a Resolution on strengthening the prevention
between individuals, countries and regions. and control of diabetes, which places the condition
at the core of the NCD response. In 2022, Member
One wonders what these diabetes luminaries might States agreed on a set of diabetes coverage targets,
think to see that disparities in access to diabetes care aiming to reduce the risk of diabetes and moving
and prevention remain deeply unequal, with many still towards a world where everyone diagnosed with

2 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

diabetes has access to the care they need. We are only
five years away from 2030, the deadline to meet the
targets. Unfortunately, we appear woefully off-track
to achieve them. The time is now to take advantage
of the context, join forces and request governments
to honour their commitments and invest in diabetes
prevention and care.

My sincere hope is that this 11th edition of the IDF

Diabetes Atlas will help the global diabetes community
advocate for intensified action to diagnose diabetes
early and provide access to quality care to delay or
prevent complications, to improve care for all people
living with diabetes and to delay or prevent type 2
diabetes in people at risk.

Every edition of the Diabetes Atlas includes more

quality data from more countries, thereby providing
an increasingly accurate description of the global
diabetes landscape. I give my sincere gratitude to the
many international experts who have contributed to
the production of this edition and to the Co-Chairs,
Professors Dianna J Magliano and Edward J Boyko,
for their leadership.

Regretfully, I must end on a sad note: Had it not been

for his untimely death while on active duty for the
Federation in July 2024, my predecessor, Professor
Aktar Hussain, would have written this foreword. A
friend, inspiration and mentor, Professor Hussain was
a passionate advocate for people living with diabetes,
particularly those in low and middle-income countries.
On behalf of the International Diabetes Federation,
I dedicate this 11th Edition of the IDF Diabetes Atlas
to his memory. We can honour him by using this
publication to drive change.

Professor Peter Schwarz

President 2024–2027
International Diabetes Federation

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 3

Foreword by the IDF Diabetes
Atlas Chairs

It gives us great pleasure to present to you the 11th span for the estimate of numbers of persons globally
Edition of the IDF Diabetes Atlas. with diabetes, ranging from approximately 500 to
800 million in 2021-2024. Along this range, the GBD
The IDF Atlas has now been in production for over two and IDF estimates fall close to 500 million, while the
decades and delivers valuable and realistic summary NCD-RisC estimate is at the upper end of the range.
data on the state of diabetes for each nation and the A critical examination of differing methodologies
world population. Initially designed as a data resource is needed to better inform healthcare planning
for individual countries and to advance the interests of regarding the magnitude of the diabetes problem.
global health, it has since evolved and demonstrated
itself to be a valuable advocacy tool as well. In this edition, 62 out of 215 countries or territories
(29%) lack in-country data. While this is an
Our new data confirm that diabetes prevalence is still improvement on previous editions, it is still grossly
increasing globally and provide strong evidence that inadequate, and data from Africa is still worryingly
should promote action and initiatives to improve the sparse. It should be noted that many older studies
lives of people with diabetes. cannot be used to predict diabetes prevalence given
that the epidemic has continued to rise since the
This is our second edition as co-chairs and this
first edition of the IDF Diabetes Atlas, such that older
experience has instilled in us a deep knowledge
research will almost certainly underestimate current
of the issues and challenges of estimating the
conditions. We have, therefore, elected not to use
impact of diabetes in every country and some
studies conducted before 2005 in the estimations.
populous territories. As with any project intent on
We have also instituted some new aspects of data
utilising available data to make scientific estimates,
inclusion and have elected to exclusively use regular
a methodology must be selected to achieve the
national surveys, like the National Health and
objectives. Choices must be made regarding what
Nutrition Examination Survey (NHANES) and the
type of data to include, for example, clinic-based
Korean National Health and Nutrition Examination
versus community/population-based. The time
Survey (KHANES) in the countries where these were
period over which the data were collected must
conducted. Further, technological advances now
be specified. Another consideration is whether to
allow access to the whole-of-population data of
include all available data meeting eligibility criteria
diabetes prevalence by way of national registries
or only data of the highest quality. An important
and administrative sources. National compulsory
consideration is the definition of diabetes, whether
health insurance organisations also provide excellent
it is based on self-reported diagnosis or laboratory
unbiased estimates. Notably, these sources only
testing, and if by laboratory testing, which test or tests
capture known diabetes, but estimates are corrected
should be used-plasma or capillary fasting glucose,
with recent estimates of undiagnosed diabetes to
Haemoglobin A1c, 1 hour or 2 hour oral glucose
derive a credible unbiased estimate of total diabetes
tolerance tests. Given the many choices, it is not
prevalence for those nations. We can expect that
surprising that the other groups who have published
the future expansion of diabetes registry data will
on global diabetes prevalence – the Global Burden of
enhance national estimates. WHO STEPS studies still
Disease (GBD) and the NCD-RisC Collaboration – have
have a strong place in the Atlas. This year, we have
used different methods, resulting in a considerable
included over 60 WHO STEPS surveys in our estimates.

4 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

It has been the practice for the Atlas team to Lastly, we want to stress the importance of continued
review the methodology for each edition to identify surveillance of diabetes prevalence and encourage
opportunities to reduce bias and increase precision. well-designed and carefully conducted national
In this edition we enlisted statistical experts to diabetes prevalence (and incidence) studies to
scrutinise our methods and assumptions and permit better monitoring of the impact of diabetes
recommend improvements where needed. Therefore, presently and allow a better foundation from which
we caution readers to take care when comparing to make forecasts. We also want to reiterate the
our new estimates to older editions, as differences importance of continued diabetes awareness and
between editions may represent actual changes or an prevention activities to help stem the rising tide of
alteration in methodology. In particular, we have taken diabetes. Controlling diabetes is indeed a team sport.
a new approach to the estimation of deaths attributed Addressing the rising trend will require a concerted
to diabetes by taking into account the lower risk of effort from people with diabetes, governments, non-
dying due to diabetes among those with undiagnosed government organisations focused on diabetes, and
diabetes. We were unable to disentangle mortality in the medical community. We hope this Edition of the
the diagnosed and undiagnosed in the past, but the Atlas will support this endeavour.
availability of new data from our collaborators and
from recently completed larger studies have allowed
us to do this in a more credible and accurate way. We Professor Dianna Magliano
have also used updated urbanisation ratios from WHO
Chair, IDF Diabetes Atlas
and applied a new method to generate confidence
Committee
intervals around our diabetes estimates. We are
excited about these improvements.

As in previous editions, we have presented

forecasts of diabetes prevalence. In this edition,
we present forecasts to the year 2050. Projection
of future diabetes prevalence is always challenging, Professor Edward Boyko
and it is important to note that we only take into Chair, IDF Diabetes Atlas
account changes in age and sex and urban to rural Committee
distribution. We deliberately do not consider any other
changes which would increase or decrease diabetes
incidence because we believe this guesswork would
likely be inaccurate.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 5

Summary
Map 1 Number of people with diabetes worldwide and per IDF Region, in 2024–2050 (20–79 years)

World Africa (AFR)

2050 852.5 Million

45%
increase
2050 59.5 Million
142%
increase
2024 588.7 Million 2024 24.6 Million

Europe (EUR) Middle-East and North Africa (MENA)

2050 72.4 Million

10%
increase
2050 162.6 Million
92%
increase
2024 65.6 Million 2024 84.7 Million

North America and Caribbean (NAC) South and Central America (SACA)

2050 68.1 Million

21%
increase
2050 51.5 Million
45%
increase
2024 56.2 Million 2024 35.4 Million

South-East Asia (SEA) Western Pacific (WP)

2050 184.5 Million

73%
increase
2050 253.8 Million
18%
increase
2024 106.9 Million 2024 215.4 Million

6 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

The IDF Diabetes Atlas is an authoritative source Findings of the current 11th edition confirm that
of evidence and a valuable advocacy tool on diabetes is one of the fastest-growing global health
the prevalence of diabetes, related morbidity challenges of the 21st century (see Map 1). In 2024,
and mortality, as well as diabetes-related health it is estimated that 589 million adults aged 20-79
expenditures at global, regional and national were living with diabetes. Over 9.5 million people
levels. The IDF Diabetes Atlas also introduces had type 1 diabetes in 2024, of whom 1.9 million
readers to the pathophysiology of diabetes, its children and adolescents under the age of 20.
classification and its diagnostic criteria. It presents The total number of people living with diabetes
the global picture of diabetes for different is projected to reach 853 million by 2050.
types of diabetes and populations and provides
There is a large and growing population at high risk
information on specific actions that can be taken,
of developing diabetes. In 2024, 635 million people
such as proven measures to prevent type 2
were estimated to have impaired glucose tolerance
diabetes and the best management of all forms
and 488 million were estimated to have impaired
of diabetes to avoid subsequent complications.
fasting glucose. It was also estimated that over 3.4
The credibility of diabetes estimates relies on the million people aged 20–79 died from diabetes-related
rigorous methods used for the selection and analysis causes in 2024. Direct health expenditures due to
of high-quality data sources. For every edition, diabetes surpassed one trillion USD for the first time
the IDF Diabetes Atlas Committee – composed of and will continue to rise over the coming years.
thematic experts from each of the seven IDF Regions
This IDF Diabetes Atlas 11th edition also
– reviews the methods underlying the IDF Diabetes
shows that hyperglycaemia in pregnancy (HIP)
Atlas estimates and projections and available data
affects approximately one in five pregnancies.
sources. The methods have been explained in detail
Another cause for alarm is the consistently high
by Guariguata et al.1 The majority of the data sources
percentage (43%) of people with undiagnosed
used are population-based studies that have been
diabetes, which is overwhelmingly type 2. This
published in peer-reviewed journals. In this edition,
highlights the urgent need to improve the ability
we have also included data from national diabetes
to diagnose people with diabetes, many of whom
registries. With the establishment of electronic
are unaware they have the condition, and provide
records and national registries becoming more
appropriate and care as early as possible.
common, we anticipate more data like these will be
featured in the future. Furthermore, information
from national health surveys, including some of
the World Health Organization's (WHO) STEPwise
approach to NCD risk factor Surveillance (STEPS),
are used where they meet inclusion criteria.

Diabetes is a major health

issue that has reached
alarming levels. The 11th
edition confirms that
diabetes is one of the
fastest-growing global
health emergencies of
the 21st century.

Tinotenda Dzikiti, Zimbabwe - Living with type 1 diabetes

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 Key messages:

The IDF Diabetes Atlas is a valuable research and advocacy

tool that provides essential information on the estimated
and projected global prevalence of diabetes.

The IDF Diabetes Atlas draws attention to the growing

impact of diabetes in all countries and regions.

The estimates presented in the IDF Diabetes Atlas

are based on the best quality data available at the
time of analysis.

Introduction
Since its first edition, published in 2000, the IDF including a selection of representative studies,
Diabetes Atlas has provided robust estimates of the diabetes case definition, and the means of
the prevalence of diabetes by country, IDF Region generating estimates for countries lacking data. We
and globally. Since its second edition, published in wish to highlight two decisions that may have falsely
2003, it has also projected these estimates into the elevated the WHO/NCD-RisC 2022 estimate. NCD-RisC
future. In doing so, it has served as an advocacy defines diabetes based on fasting plasma glucose
tool, not only for the quantification of the impact (FPG)≥7mmol/l, HbA1c ≥6.5%, or use of medication
of diabetes worldwide, but also for reducing that to help regulate blood glucose. First, IDF does not
impact through measures aimed at improving the widely use HbA1c due to its limited global availability
long-term consequences of all types of diabetes, as and its spuriously high readings with concomitant
well as the primary prevention of type 2 diabetes. iron deficiency,2 common in many lower-income
countries. Second, this elevation in cases may result
In 2014, the WHO/NCD-RisC estimate of 422 million
from another WHO/NCD-RisC estimation method,
people with diabetes3, was very close to the IDF
which scales up diabetes prevalence for countries
estimate of 415 million people with diabetes in 20154.
with FPG but lacking HbA1c in their surveys.7,8
However, the recent WHO/NCD-RisC publication
estimated that 828 million people aged 18 years or The diabetes impact is steadily growing to
older had diabetes in 20225, considerably more than alarming levels. The IDF Diabetes Atlas, under the
estimates provided in this IDF Diabetes Atlas (589 guidance of a committee of experts from all IDF
million) for 2024 and the Global Burden of Diseases regions, remains dedicated to providing the most
Study (GBD) figure of 485 million for ages 20-79 in accurate possible data based on the available
20216. As mentioned above, multiple decisions are epidemiological sources and methods of analysis.
required to estimate worldwide diabetes prevalence,

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Our vision for the IDF Diabetes Atlas 11th edition What’s new in the 11th edition?
The 11th edition of the IDF Diabetes Atlas has A whole chapter is dedicated to up-to-date
interrelated objectives: epidemiological data on the most common
diabetes-related complications (see Chapter 5).
● 
Describe the current diabetes landscape
and deliver the latest diabetes impact data. The impact of diabetes in older adults (>65 years old)
has also been included in this edition (see Chapter 3).
● 
Support global advocacy to improve the lives
of people with diabetes and those at risk. The current Diabetes Atlas presents projections
for 2050 compared to the projections for
● 
Encourage discussions on the latest methodology
2030 and 2045 presented in previous editions.
to monitor the diabetes pandemic.
This change provides a better description of
Multiple changes have been made to the the impact of diabetes by mid-century.
epidemiological methods used in preparing the For the first time, diabetes-related mortality is
11th edition of the IDF Diabetes Atlas. These are presented separately for people with diagnosed
summarised in Chapter 2. New data has been and undiagnosed diabetes (see Chapter 3).
accessed, and some topics have been introduced
for the first time (see ‘What’s new in the 11th Increased recognition of prediabetes has allowed
edition?’ below). However, the basis on which us to report recent data on its prevalence. To better
estimates and projections have been calculated in describe the total impact of the intermediate
this edition remain essentially the same as those states of hyperglycaemia, prediabetes based on
used in the previous edition. Thus, continuity HbA1c-defined American Diabetes Association
has been maintained and, with certain caveats, (ADA) criteria (HbA1c 5.7-6.4%) is included,
conclusions about time trends in the global along with the impaired glucose tolerance and
progress of diabetes can be made with reasonable impaired fasting glucose (see Chapter 3).
confidence except where otherwise indicated. The importance of the advocacy objective of the
IDF Diabetes Atlas and related materials is given
attention. For this purpose, a new user-friendly
data portal has been developed and launched
on the Diabetes Atlas website. This ensures
easy access, downloadable files, and ability to
stratify all the Atlas data per indicator, per region
and per country. The website also provides
downloadable resources such as global and
regional fact sheets and a slide presentation.

Figure 1 Estimates and projections of the global prevalence of diabetes in the 20–79 year age
group in millions (IDF Diabetes Atlas editions 1st to 11th).

Estimates of the global prevalence of diabetes Projections of the global prevalence of diabetes
in the 20–79 year age group (millions) in the 20–79 year age group (millions)
853
2024
783
2021
2050
589

537 643 642 2045

2024 2021 592 2015
463 700
425 2013
415 2021 629 2019
2030 2040
382
366 2017
2019 2035
2017 578
285 2015 380 552
2013 2019
246 2011 2006 2011
438
194
2009 2009
151 2007 2025
2003 333
2000 2003

Projection in millions
Number of people with diabetes in millions
2003 Year projection made

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 9

How to read this edition of the IDF Diabetes Atlas Limitations
Although it might be tempting to focus solely on ● 
The definition of diabetes used in the IDF
the figures for a given country or IDF Region, other Diabetes Atlas is based on an epidemiological
factors should be considered when interpreting the definition which requires abnormal blood
IDF Diabetes Atlas estimates and any differences from glucose levels to be detected in only one test
those given in the previous edition. Possible reasons compared to a clinical diagnosis of diabetes,
to account for significant differences between the which requires abnormal blood glucose levels to
10th edition (2021) and 11th edition (2024) figures are: be detected on two separate tests in someone
with diabetes symptoms such as excessive
● 
The inclusion of new studies for some countries.
thirst (polydipsia) or urination (polyuria).
● 
The inclusion of national diabetes registry
● 
While we attempted to include only population-
data with modification. Data on diagnosed
based representative studies, all studies
diabetes from these sources were
have limitations and biases which require
adjusted to include both diagnosed and
careful interpretation. In some countries and
an estimate of undiagnosed diabetes.
territories where territory-wide or population-
● 
The exclusion of specific WHO STEPS surveys based registers were included, the estimate of
included in the previous edition, as a result of prevalence was adjusted, taking into consideration
concerns about their validity (see Chapter 2). the proportion of people with undiagnosed
diabetes in that country or territory.
● 
While we may include several studies which
all met inclusion criteria for one country, in ● 
When a country lacked any internal data, diabetes
cases where multiple serial surveys were prevalence was extrapolated from a country with
available, only the latest survey was included. similar economy, language and demography. Such
extrapolations may represent a source of error.
● 
The exclusion of studies conducted before
2005. Since older studies probably report ● 
The urban and rural classifications are based on
a lower prevalence, the exclusion of these how the individual data sources defined urban and
studies may result in a higher estimate of rural, rather than defined by the IDF analysis team.
prevalence than in previous editions.
● 
Updating data sources with better quality
studies may result in a lower prevalence than
reports from previous years with less robust
methodology. Any change in prevalence
within individual countries could be due,
in part, to these methodological changes.

10 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

References
1. Guariguata, L., Whiting, D., Weil, C. & Unwin, N.
The International Diabetes Federation diabetes
atlas methodology for estimating global and
national prevalence of diabetes in adults.
Diabetes Res Clin Pract 94, 322–332 (2011).

2. IDF Diabetes Atlas scientific papers and posters.

https://diabetesatlas.org/scientific-papers-
and-posters/

3. NCD Risk Factor Collaboration (NCD-RisC).

Worldwide trends in diabetes since 1980: a pooled
analysis of 751 population-based studies with 4.4
million participants. Lancet 387, 1513–1530 (2016).

4. Ogurtsova, K. et al. IDF Diabetes Atlas: Global

estimates for the prevalence of diabetes for 2015
and 2040. Diabetes Res Clin Pract 128, 40–50 (2017).

5. NCD Risk Factor Collaboration (NCD-RisC).

Worldwide trends in diabetes prevalence and
treatment from 1990 to 2022: a pooled analysis
of 1108 population-representative studies with 141
million participants. Lancet 404, 2077–2093 (2024).

6. GBD 2021 Diabetes Collaborators. Global, regional,

and national burden of diabetes from 1990 to
2021, with projections of prevalence to 2050:
a systematic analysis for the Global Burden of
Disease Study 2021. Lancet 402, 203–234 (2023).

7. Anjana, R. M. et al. Metabolic non-communicable

disease health report of India: the ICMR-INDIAB
national cross-sectional study (ICMR-INDIAB-17).
Lancet Diabetes Endocrinol 11, 474–489 (2023).

8. Madhu, S. V., Raj, A., Gupta, S., Giri, S. & Rusia,

U. Effect of iron deficiency anemia and iron
supplementation on HbA1c levels - Implications for
diagnosis of prediabetes and diabetes mellitus in
Asian Indians. Clin Chim Acta 468, 225–229 (2017).

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 11

1
Robin Fein, USA - Living with type 2 diabetes

What is diabetes?
16 1.1 Type 1 diabetes
17 1.2 Type 2 diabetes
18 1.3 Impaired glucose tolerance and impaired fasting glucose
18 1.4 Diagnostic criteria for diabetes
19 1.5 Hyperglycaemia in pregnancy
21 1.6 Other types of diabetes
22 References

12 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Key messages:

Diabetes is a serious, chronic condition that occurs

when the body cannot produce enough insulin or
cannot effectively use the insulin it does produce,
leading to high levels of glucose (hyperglycaemia).

Type 1 diabetes is the major type of diabetes in

children and young adults but can occur at any age.
People with type 1 diabetes require insulin to survive.

Type 2 diabetes accounts for the vast majority

(over 90%) of diabetes cases worldwide.

Type 2 diabetes can be prevented or delayed, and

there is accumulating evidence that remission of
type 2 diabetes may be possible in the early
stages of the condition.

‘Prediabetes’ or ‘Intermediate Hyperglycaemia’ are

terms used to describe impaired glucose tolerance
and/or impaired fasting glucose. People with
prediabetes are at higher risk of developing type
2 diabetes, cardiovascular disease and stroke.

Women with gestational diabetes (GDM) are at

increased risk of birth complications. Regular
prenatal care is essential to monitor and address
potential complications promptly.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 13

Diabetes is a serious, long-term (or ‘chronic”) condition that occurs when glucose levels in a person’s blood
rise because the body cannot produce enough or any insulin or cannot effectively use the insulin it produces.

Insulin allows glucose from the bloodstream to enter A high blood glucose if left untreated over the long
the body’s cells, where it is converted into energy or term, can cause damage to many of the body’s
stored. Insulin is also essential for the metabolism of organs, leading to disabling and life-threatening
protein and fat. A lack of insulin, or the inability of cells health complications such as cardiovascular diseases
to respond to it, leads to high levels of blood glucose (CVD), nerve damage (neuropathy), kidney damage
(hyperglycaemia), which is the clinical indicator of (nephropathy), lower-limb amputation, and eye
diabetes. Another important measurement of blood disease mainly affecting the retina (retinopathy),
glucose (glycaemia) is Haemoglobin A1c (HbA1c), resulting in loss of vision and even blindness. There
which gives an indication of glucose concentration is also increased recognition of other complications
in the blood over a period of 90 days prior to the associated with diabetes such as cognitive decline,
blood test. Both direct measurement of glucose liver disease, cancer and frailty. If near-normal levels
concentration in plasma or HbA1c may be used to of blood glucose can be maintained, these serious
diagnose diabetes. The threshold glycaemia levels for complications can be delayed or prevented.
the diagnosis of diabetes can be found in Figure 1.1.

14 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Figure 1.1 Diagnostic criteria for diabetes.1

Impaired Glucose Impaired Fasting

Diabetes
Tolerance Glucose (IFG)
Should be diagnosed Should be diagnosed if Should be diagnosed if
if ONE OR MORE of the BOTH of the following THE FIRST OR BOTH of
following criteria are met criteria are met the following are met

7.0 < 7.0 6.1–6.9

mmol/L mmol/L mmol/L
Fasting plasma
glucose (126 mg/dL) (126 mg/dL) (110 - 125 mg/dL)

or and and if measured

Two-hour
plasma glucose 11.1 7.8 and < 11.1 < 7.8
mmol/L mmol/L mmol/L
after a 75g oral glucose
load (oral glucose
tolerance test (OGTT)) (200 mg/dL) (140-199 mg/dL) (140 mg/dL)

or

48
mmol/L

HbA1c
(equivalent to 6.5%)

or

Random plasma
glucose
11.1
mmol/L
in the presence of symptoms
of hyperglycaemia
(200 mg/dL)

Note: Fasting is defined as no caloric intake for at least eight hours.

The HbA1c test should be performed in a laboratory using a method that is National Glycohaemoglobin Certification
Program (NGSP) certified and standardised to the Diabetes Control and Complications Trial assay.

The two-hour postprandial plasma glucose test should be performed using a glucose load containing the equivalent
of 75-g anhydrous glucose dissolved in water.

In the absence of symptoms of hyperglycaemia, two abnormal tests are required for the diagnosis of diabetes.

The American Diabetes Association (ADA) (2) recommends diagnosing “prediabetes” with a fasting plasma glucose
between 5.6 and 6.9 mmol/L (100mg/dL to 125mg/dL: impaired fasting glucose), a 2-h plasma glucose ≥7.8 and
<11.1 mmol/L (140–200 mg/dl: impaired glucose tolerance) or HbA1c values between 39 and 47 mmol/mol (5.7–6.4%).2

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 15

1.1 Type 1 diabetes
Type 1 diabetes is caused by an autoimmune process The typical symptoms of type 1 diabetes are listed
in which the body’s immune system attacks the in Figure 1.2. The classic clinical picture of excessive
insulin-producing beta-cells of the pancreas, resulting thirst (polydipsia), frequent urination (polyuria) and
in insulin deficiency.3 Although the cause(s) of type weight loss may, however, not be present and the
1 diabetes remains unknown, it is thought to be diagnosis delayed or even missed entirely.
the result of a complex interplay between multiple
Even in countries with universal health coverage
genetic and environmental factors.2 Stages are now
(UHC), diagnosis of type 1 diabetes may be delayed
recognised in the onset of type 1 diabetes: Stage 1
until the first hospital admission for diabetic
represents autoimmunity with normoglycaemia, stage
ketoacidosis (DKA), sometimes with fatal results.
2 reflects progression to asymptomatic dysglycaemia,
and stage 3 is a clinically overt disease requiring A recent study of DKA rates at diagnosis of type 1
initiation of insulin treatment.4 The condition can diabetes in 13 high-income countries showed a pooled
develop at any age, although the onset of stage 3 is rate for 2006–2016 of 29.9%.11 Prevalence of DKA at
most frequent in children and young adults. Type 1 diagnosis of type 1 diabetes, ranged from 19.5% to
diabetes is one of the most common chronic diseases 43.8%, and increased over time in three countries
in childhood but can happen at any age. and decreased in one. This situation has prompted
campaigns to increase awareness of type 1 diabetes
The incidence of type 1 diabetes varies around
among parents, school teachers and healthcare
the world, with some regions having much higher
professionals.12 The latter includes advocacy of ‘on-the-
incidences than others.5–8 Incidence has been
spot’ blood glucose measurement in an unwell child
increasing in the great majority of countries studied,
with no obvious diagnosis. In less-resourced countries,
although there is evidence that this increase is stable
the frequency of misdiagnosis and consequent death
or tailing off in some high-income countries. The
from DKA at the onset of type 1 diabetes is not known,
reasons for this are unclear but the rapid increase over
but is likely to be very substantial.13
time is most likely due to environmental changes.5–8
Following clinical diagnosis, people with type 1
Clinical (stage 3) type 1 diabetes is diagnosed by an
diabetes need daily insulin injections to keep their
elevated blood glucose concentration (Figure 1.1) in
blood glucose level within an appropriate range.
the presence of some or, rarely, all the symptoms
Without insulin replacement therapy, they would
listed in Figure 1.2. However, diagnosing the type of
not survive. However, with daily insulin treatment,
diabetes is sometimes difficult, and additional testing
regular blood or interstitial fluid glucose monitoring,
may be required to distinguish between type 1, type 2,
education and support, they can live healthy lives and
and rarer forms of monogenic diabetes.9,10
delay or prevent many of the complications associated
with diabetes.

Figure 1.2 The typical symptoms of type 1 diabetes

Excessive thirst Frequent urination Lack of energy Constant hunger

or bedwetting or fatigue

Sudden weight Loss Blurred vision Diabetic

ketoacidosis

16 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Living with type 1 diabetes remains a challenge for Type 2 diabetes may have symptoms similar to those
a child and the whole family, even in countries with of type 1 diabetes, but the onset is typically much less
access to multiple daily injections or an insulin pump, dramatic and often completely asymptomatic. The
glucose monitoring, structured diabetes education lack of symptoms makes the exact time of the onset
(including insulin adjustments, physical activity and of type 2 diabetes difficult or impossible to determine.
a healthy diet) and expert medical care. Besides the As a result, there is often a long period before the
acute complications of hypoglycaemia (abnormally diabetes is diagnosed. At any given time, as many as
low blood glucose) and DKA, suboptimal glycaemic one-third to one-half of people with type 2 diabetes in
control may lead to poor growth and the early onset the population may be undiagnosed. If the diagnosis
of circulatory (or ‘vascular’) complications.14 Optimal is delayed for a prolonged time, complications may
care is now recognised to be the use of an automated develop.19,20 Many are diagnosed because they already
insulin delivery system that combines an insulin have one or more of the complications associated with
pump and a continuous glucose monitor, but this is the condition.
an expensive approach which, as yet, is only widely
The causes of type 2 diabetes are not completely
available in some high-income countries.
understood, but there is a strong link with excess
In many countries, especially in economically body weight, higher age, ethnicity and a family history
disadvantaged families, access to insulin and self-care of diabetes. Contributors to type 2 diabetes risk are
tools, including structured diabetes education, can thought to include multi-gene predisposition and
be limited.15 This may lead to serious acute and environmental triggers.
chronic complications which can result in early
The cornerstone of type 2 diabetes management
death or severe disability.16
is promoting a lifestyle that includes a healthy diet,
regular physical activity, smoking cessation and
1.2 Type 2 diabetes maintenance of healthy body weight. If changes to
lifestyle are not sufficient to control blood glucose
Type 2 diabetes is the most common type of diabetes, levels, oral medication is usually initiated, with
accounting for over 90% of all diabetes worldwide. It metformin as the first-line medication.
is currently the 8th leading cause of disease burden17
globally and estimated to become the second leading If treatment with a single medication is not sufficient,
cause by 2050.18 In type 2 diabetes, the inability of a range of combination therapy options are also
the body’s cells to respond fully to insulin is termed available. These include sulphonylureas, alpha
insulin resistance. The presence of insulin resistance glucosidase inhibitors, thiazolidinediones, dipeptidyl
prompts an increase in insulin production, which, over peptidase 4 (DPP-4) inhibitors, glucagon-like peptide
time, may result in inadequate insulin production as 1 receptor (GLP-1R) gastric inhibitory peptide
pancreatic beta cells fail to keep up with demand. (GIP) agonists, and sodium-glucose co-transporter
2 inhibitors.

Type 2 diabetes is the most

common type of diabetes,
accounting for over 90%
of all diabetes worldwide.

Heather Koga, Zimbabwe - Living with type 2 diabetes

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 17

Insulin injections may be necessary to control and cardiovascular disease.30,32–35 The detection of
hyperglycaemia to recommended levels if non-insulin intermediate hyperglycaemia provides a target
medications do not help people with type 2 diabetes population for interventions.36,37
to achieve glycaemic control.
Progression from IGT or IFG to type 2 diabetes
Beyond controlling blood glucose levels, it is critically depends on the degree of hyperglycaemia and
important to manage blood pressure (BP) and other risk factors, particularly age and excess body
blood cholesterol (LDL-c) levels and assess control weight.37,38 The absolute risk for this progression
of these risk factors on a regular basis (at least depends dramatically on individual characteristics
annually). Regular screening for the development such as age and BMI.
of early diabetes-related complications, such as
kidney disease, retinopathy, neuropathy, peripheral
artery disease and foot ulceration, helps prevent the
1.4 Diagnostic criteria for diabetes
development and progression of these complications. Most guidelines use the standard diagnostic criteria
With regular check-ups and effective lifestyle proposed by IDF and the World Health Organization
management – along with medication as needed and (WHO) Figure 1.1. The footnote in Figure 1.1 mentions
support in the form of diabetes education – people the American Diabetes Association (ADA) inclusion of
with type 2 diabetes can lead long and healthy lives. HbA1c as part of the diagnostic criteria of diabetes
Globally, the prevalence of type 2 diabetes is high and prediabetes. WHO supports the use of HbA1c
and rising across all regions. This rise is driven ≥6.5% for diabetes diagnosis but not for intermediate
by population ageing, economic development hyperglycaemia, partly on the grounds that quality-
and increasing urbanisation – leading to greater assured HbA1c measurement is not available on a
exposure to type 2 diabetes risk factors including global scale.27
more sedentary lifestyles, greater consumption of Currently, IDF and WHO recommend the use of the
sugar-sweetened beverages, processed and red meat, 75-gram oral glucose tolerance test (OGTT) with
unrefined grains, and other unhealthy foods linked measurement of both fasting and two-hour plasma
to obesity, and greater exposure to air pollution.21 glucose to detect IGT, IFG and diabetes. However,
However, the beneficial results of early detection and there is literature favouring the use of the one-hour
more effective treatment are helping people with type 75-gram OGTT, which may be a more sensitive method
2 diabetes to live longer, which also contributes to the of identifying intermediate hyperglycaemia.39
rise in prevalence.
For type 2 diabetes, if a single random plasma glucose
The prevalence of type 2 diabetes has increased concentration is ≥ 11.1 mmol/l in the presence of
notably in adults under 4022 and has also become symptoms such as polyuria, polydipsia, and
a concern in children and young people due to unexplained weight loss, the diagnosis can
the increasing prevalence of obesity in childhood be made without a second abnormal measurement.
and adolescence.23
The prevalence of type 2 diabetes varies by race and
ethnicity, as reported by the IDF Diabetes Atlas.24–26

1.3 Impaired glucose tolerance and

impaired fasting glucose
Impaired glucose tolerance (IGT) and impaired
fasting glucose (IFG) are conditions of blood
glucose levels above the normal range and below
the threshold recommended for diagnosis of
diabetes (see Figure 1.1). The terms ‘prediabetes’,
‘dysglycaemia’, ‘borderline diabetes’ and ‘intermediate
hyperglycaemia’ are often used interchangeably.27
IGT and IFG are associated with a heightened risk
of the future development of type 2 diabetes28–31

18 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Table 1.1 Diagnostic criteria in studies used for estimating hyperglycaemia in pregnancy.55

Fasting 1-hour 2-hour 3-hour

Criteria
mg/dL mmol/L mg/dL mmol/L mg/dL mmol/L mg/dL mmol/L

NDDG (USA)* 105 5.9 190 10.6 165 9.2 145 8.1

Carpenter Coustan 95 5.3 180 10.0 155 8.6 140 7.8

(USA)*

CDA 95 5.3 191 10.6 160 9.0 - -

WHO 1985 140 7.8 - - 140 7.8 - -

WHO 1999 126 7.0 - - 140 7.8 - -

IADPSG/ 92 5.1 180 10 153 8.5 - -

ADA WHO/FIGO

(DIPSI non-fasting) - - - - - 7.8 - -

NICE (UK) - 5.6 - - - 7.8 - -

Note: ADA = American Diabetes Association; NDDG = National Diabetes Data Group; ADIPS = Australasian Diabetes in Pregnancy Society;
CDA = Canadian Diabetes Association; DIPSI = Diabetes in Pregnancy Society of India; WHO = World Health Organization;
IADPSG = International Association of the Diabetes and Pregnancy Study Groups; NICE = National Institute for Clinical Excellence
* after 50g glucose challenge test-if positive, uses 100g glucose load, at least two need to be positive

1.5 Hyperglycaemia in pregnancy Screening and diagnosis of GDM

Classification Overt symptoms of hyperglycaemia during pregnancy

are rare and may be difficult to distinguish from
According to WHO and the International Federation of normal pregnancy symptoms. As a result, an OGTT is
Gynaecology and Obstetrics (FIGO), hyperglycaemia recommended for screening for GDM for all women
in pregnancy (HIP) can be classified as either pre- between the 24th and 28th week of pregnancy, but
gestational diabetes, gestational diabetes (GDM) should be conducted earlier in pregnancy for women
or diabetes in pregnancy (DIP).40,41 Pre-gestational at high-risk.49
diabetes includes women with known type 1, type 2 or
rarer forms of diabetes before pregnancy. GDM may The diagnostic criteria for GDM vary and remain
occur at any time during the antenatal period and is controversial, complicating the comparison of
not expected to persist after the child is born.42 DIP research data. There has been a move towards the
applies to pregnant women with hyperglycaemia who diagnostic criteria advocated by the International
were first diagnosed during pregnancy and meet WHO Association of the Diabetes and Pregnancy Study
criteria of diabetes in women who are not pregnant. Groups (IADPSG)/WHO50,51 which has resulted in a
DIP is best detected during the first trimester.43 While general increase in the overall prevalence of GDM.52
screening for DIP, other women with lesser degrees of Typically, an OGTT is performed by measuring the
hyperglycaemia are often detected early in pregnancy plasma glucose concentration while fasting and
and there is now randomised control trial evidence one and two hours after ingesting 75 grams of
that such women and their babies can benefit from glucose. For diagnosing GDM, the criteria currently
early treatment.44–46 It has been estimated that most recommended across the world are summarised in
(75%–90%) cases of HIP are GDM.47 Table 1.1. These criteria are under review with some
countries starting to move to the Canadian Diabetes
Pre-existing type 2 diabetes in pregnancy is a growing Association (CDA) criteria, alongside early screening
challenge48 and the management of type 1 diabetes in for GDM (e.g., Belgium).53 Consideration of the use
pregnancy is increasingly supported by the use of new of an early HbA1c to rule out GDM is also under
technology (e.g. continuous glucose monitoring and active investigation.54
assisted insulin delivery).

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 19

Erum Ghafoor, Pakistan - Living with type 2 diabetes

Besides those women with hyperglycaemia early in GDM: a life course condition
pregnancy, GDM arises in women with insufficient
GDM is increasingly seen as a reflection of an
insulin secretory capacity to overcome the diminished
underlying metabolic state predisposing to both type
action of insulin (insulin resistance) due to hormone
2 diabetes and cardiovascular disease (CVD), although
production by the placenta as the pregnancy
postpartum testing may initially be normal.56 As a
progresses40 Risk factors for GDM include older age,
consequence, pregnant women with hyperglycaemia
overweight and obesity, previous GDM, excessive
are at higher risk of developing GDM in subsequent
weight gain during pregnancy, a family history of
pregnancies. In addition, the relative risk of developing
diabetes, polycystic ovary syndrome, habitual smoking
type 2 diabetes is particularly high at 3–6 years after
and a history of stillbirth or giving birth to an infant
GDM and can occur under 40 years of age. The risks
with a congenital abnormality. GDM is more common
remain markedly elevated thereafter.52 Considering
in some ethnic groups.
the high risk of early-onset type 2 diabetes and the
fact that prior GDM increases the risk of CVD, with
or without type 2 diabetes, a lifestyle intervention to
reduce risk should be started within three years after
the pregnancy to achieve the maximum benefit for
the prevention of diabetes.52,57 Babies born to mothers
with GDM also have a higher lifetime risk of obesity
and developing type 2 diabetes.58

20 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Management of hyperglycaemia in pregnancy All women who have HIP – be it GDM, previously
undiagnosed DIP or existing and known diabetes
Women with hyperglycaemia detected during
– require optimal antenatal care and appropriate
pregnancy are at greater risk of adverse pregnancy
assistance with postnatal management. Women
outcomes. These include high blood pressure
with hyperglycaemia during pregnancy may be
(including pre-eclampsia) and a large baby for
able to control their blood glucose levels through
gestational age (termed ‘macrosomia’), which can
a healthy diet, weight management, moderate
make a normal birth difficult and hazardous, with
exercise and blood glucose monitoring. Interaction
the baby more prone to fractures and nerve damage.
with healthcare professionals is important to support
Identification of hyperglycaemia in pregnancy,
self-management and to identify when medical
combined with optimal management of blood
(e.g. prescription of insulin and/or oral medications)
glucose during pregnancy can reduce these risks.
or obstetric intervention is needed.
Women of childbearing age who are known to have
diabetes prior to pregnancy should receive advice
before conception, higher dose folic acid treatment,
a medication review, intensive diabetes management
and a planned approach to pregnancy.

Figure 1.3. Other specific types of diabetes.59

Diabetes caused by diseases of Infection-related diabetes that is

the pancreas, such as pancreatitis, caused by viral infection associated
trauma, infection, pancreatic cancer with beta cell destruction
and pancreatectomy

Diabetes due to endocrine disorders Uncommon specific forms of

that cause excess secretion of immune-mediated diabetes (e.g.
hormones that antagonise insulin immunological disorders other than
(e.g. Cushing’s syndrome) those that cause type 1 diabetes)

Other genetic syndromes sometime

Drug and chemical-induced diabetes
associated with diabetes (i.e. Prader-
from drugs that disrupt insulin secretion
Willi syndrome, Down’s syndrome,
or insulin action
Friedreich’s ataxia)

1.6 Other types of diabetes diseases.61 Although rare, these can help provide
insight into diabetes pathogenesis.62
The recently published WHO report on the classification
of diabetes59 lists a number of ‘other specific types’ of From a clinical perspective, the exact diagnosis of the
diabetes, including monogenic diabetes and what was monogenic forms of diabetes is important because,
once termed ‘secondary diabetes’. in some instances, therapy can be tailored to the
specific genetic defect.60 Further distinction between
Monogenic diabetes, as the name implies, results from the 14 different sub-types of MODY leads not only
a single gene rather than the contribution of multiple to differences in clinical management but different
genes and environmental factors, as seen in type 1 predictions of complication risk. In recent years, with
and type 2 diabetes. Monogenic diabetes is much less the accumulation of genome-wide association studies,
common and represents 1.5–2% of all cases, though an increasing number of monogenic forms of diabetes
this may well be an underestimate as it is often are being discovered.10,61,62 Thus the true prevalence of
misdiagnosed as either type 1 or type 2 diabetes.60 these types may be underestimated.
These monogenic forms present a broad spectrum, Diabetes can also arise as a consequence of other
from neonatal diabetes (sometimes called ‘monogenic conditions. These other specific types of diabetes
diabetes of infancy’), maturity onset diabetes of the are listed below, according to the most recent WHO
young (MODY) and rare diabetes associated syndromic diabetes classification.59

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 21

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28. Richter, B., Hemmingsen, B., Metzendorf, 798–810 (2023).
M.-I. & Takwoingi, Y. Development of type 2
diabetes mellitus in people with intermediate 38. Howells, L., Musaddaq, B., McKay, A. J. & Majeed,
hyperglycaemia. Cochrane Database Syst Rev 10, A. Clinical impact of lifestyle interventions for the
CD012661 (2018). prevention of diabetes: an overview of systematic
reviews. BMJ Open 6, e013806 (2016).
29. Tabák, A. G., Herder, C., Rathmann, W., Brunner, E.
J. & Kivimäki, M. Prediabetes: a high-risk state for 39. Bergman, M. et al. International Diabetes
diabetes development. Lancet 379, Federation Position Statement on the 1-hour
2279–2290 (2012). post-load plasma glucose for the diagnosis of
intermediate hyperglycaemia and type 2 diabetes.
30. Twigg, S. M. et al. Prediabetes: a position Diabetes Res Clin Pract 209, 111589 (2024).
statement from the Australian Diabetes Society
and Australian Diabetes Educators Association. 40. WHO. World Health Organization. Diagnostic
Med J Aust 186, 461–465 (2007). Criteria and Classification of Hyperglycaemia First
Detected in Pregnancy. Preprint at http://apps.
31. Schmidt, M. I. et al. Intermediate hyperglycaemia who.int/iris/bitstream/10665/85975/1/WHO_
to predict progression to type 2 diabetes NMH_MND_13.2_eng.pdf (2013).
(ELSA-Brasil): an occupational cohort study
in Brazil. Lancet Diabetes Endocrinol 7, 41. Hod, M. et al. The International Federation of
267–277 (2019). Gynecology and Obstetrics (FIGO) Initiative
on gestational diabetes mellitus: A pragmatic
32. Huang, Y., Cai, X., Mai, W., Li, M. & Hu, Y. guide for diagnosis, management, and care. Int J
Association between prediabetes and risk of Gynaecol Obstet 131 Suppl 3, S173-211 (2015).
cardiovascular disease and all cause mortality:
systematic review and meta-analysis. BMJ 355, 42. Immanuel, J. & Simmons, D. Screening and
i5953 (2016). Treatment for Early-Onset Gestational Diabetes
Mellitus: a Systematic Review and Meta-analysis.
33. Yeboah, J., Bertoni, A. G., Herrington, D. M., Post, Curr. Diab. Rep. 17, 115 (2017).
W. S. & Burke, G. L. Impaired fasting glucose
and the risk of incident diabetes mellitus and 43. Guariguata, L., Linnenkamp, U., Beagley, J.,
cardiovascular events in an adult population: Whiting, D. R. & Cho, N. H. Global estimates of
MESA (Multi-Ethnic Study of Atherosclerosis). the prevalence of hyperglycaemia in pregnancy.
J Am Coll Cardiol 58, 140–146 (2011). Diabetes Res Clin Pract 103, 176–185 (2014).

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44. Simmons, D. et al. Treatment of Gestational 54. Saravanan, P. et al. Early pregnancy HbA1c as
Diabetes Mellitus Diagnosed Early in Pregnancy. the first screening test for gestational diabetes:
N Engl J Med 388, 2132–2144 (2023). results from three prospective cohorts. Lancet
Diabetes Endocrinol 12, 535–544 (2024).
45. Seifu, C. N. et al. Association Between Immediate
Treatment of Early Gestational Diabetes Mellitus 55. Guariguata, L., Linnenkamp, U., Beagley, J.,
and Breastfeeding Outcomes: Findings From the Whiting, D. R. & Cho, N. H. Global estimates of
TOBOGM Study. Diabetes Care dc231635 (2024) the prevalence of hyperglycaemia in pregnancy.
doi:10.2337/dc23-1635. Diabetes Res. Clin. Pract. 103, 176–185 (2014).

46. Haque, M. M. et al. Cost-effectiveness of 56. Hivert, M.-F. et al. Pathophysiology from
diagnosis and treatment of early gestational preconception, during pregnancy, and beyond.
diabetes mellitus: economic evaluation of the Lancet 404, 158–174 (2024).
TOBOGM study, an international multicenter
randomized controlled trial. EClinicalMedicine 57. Bellamy, L., Casas, J.-P., Hingorani, A. D. & Williams,
71, 102610 (2024). D. Type 2 diabetes mellitus after gestational
diabetes: a systematic review and meta-analysis.
47. American Diabetes Association. Diagnosis and Lancet 373, 1773–1779 (2009).
classification of diabetes mellitus. Diabetes Care
37 Suppl 1, S81-90 (2014). 58. Fetita, L.-S., Sobngwi, E., Serradas, P., Calvo, F. &
Gautier, J.-F. Consequences of fetal exposure to
48. Chivese, T. et al. IDF Diabetes Atlas: The maternal diabetes in offspring. J. Clin. Endocrinol.
prevalence of pre-existing diabetes in pregnancy Metab. 91, 3718–3724 (2006).
- A systematic reviewand meta-analysis of studies
published during 2010-2020. Diabetes Res Clin 59. World Health Organization. Classification of
Pract 183, 109049 (2022). diabetes mellitus [Internet]. World Health
Organization; 2019 [cited 2019 Jul 16].
49. Diagnostic criteria and classification of Available from: https://apps.who.int/iris/
hyperglycaemia first detected in pregnancy: a handle/10665/325182.
World Health Organization Guideline. Diabetes
Res. Clin. Pract. 103, 341–363 (2014). 60. Hattersley, A. T. et al. ISPAD Clinical Practice
Consensus Guidelines 2018: The diagnosis and
50. International Association of Diabetes and management of monogenic diabetes in children
Pregnancy Study Groups Consensus Panel et and adolescents. Pediatr Diabetes 19 Suppl 27,
al. International association of diabetes and 47–63 (2018).
pregnancy study groups recommendations on
the diagnosis and classification of hyperglycaemia 61. Vaxillaire, M., Bonnefond, A. & Froguel, P. The
in pregnancy. Diabetes Care 33, 676–682 (2010). lessons of early-onset monogenic diabetes for
the understanding of diabetes pathogenesis.
51. Saeedi, M., Cao, Y., Fadl, H., Gustafson, H. & Best Pract Res Clin Endocrinol Metab 26,
Simmons, D. Increasing prevalence of gestational 171–187 (2012).
diabetes mellitus when implementing the IADPSG
criteria: A systematic review and meta-analysis. 62. Cnop, M., Toivonen, S., Igoillo-Esteve, M. &
Diabetes Res Clin Pract 172, 108642 (2021). Salpea, P. Endoplasmic reticulum stress and eIF2α
phosphorylation: The Achilles heel of pancreatic β
52. Song, C. et al. Long-term risk of diabetes in cells. Mol Metab 6, 1024–1039 (2017).
women at varying durations after gestational
diabetes: a systematic review and meta-analysis
with more than 2 million women. Obes Rev 19,
421–429 (2018).

53. Benhalima, K. et al. The 2024 Flemish consensus

on screening for gestational diabetes mellitus
early and later in pregnancy. Acta Clin
Belg 79, 217–224 (2024).

24 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

2 Tinotenda Dzikiti, Zimbabwe - Living with type 1 diabetes

Methods
28 2.1 Interpretation of estimates
28 2.2 Gathering and selecting data sources
30 2.3 Estimating diabetes prevalence and projections for the future
30 2.4 Extrapolating data
30 2.5 Estimating confidence intervals
31 2.6 Standardisation of estimates
32 2.7 Estimating undiagnosed diabetes prevalence
33 2.8 Estimating the prevalence of intermediate states of hyperglycaemia
34 2.9 Estimating the prevalence of hyperglycaemia in pregnancy
35 2.10 Estimating diabetes-related mortality
35 2.11 Estimating the economic impact of diabetes
36 2.12 Estimating diabetes prevalence for type 1 diabetes across all age groups
38 References

26 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Key messages:

246 data sources from 153 countries were selected

to estimate diabetes prevalence for the current IDF
Diabetes Atlas.

Data sources come from countries which comprise

over 93% of the global population.

Other sources, such as registries, have also been

included, but only after rigorous scrutiny of their
quality, just as for the peer-reviewed publications.

Future projections have been calculated using the

United Nations population predictions and degree
of urbanisation. These predictions only take into
account changes in the distribution of age, sex
and urban/rural residence ratio.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 27

2.1 Interpretation of estimates
Monitoring prevalence, the number of people Furthermore, locations with population of less than
with diabetes at any one time divided by the total 50,000 were excluded. As a result, this edition presents
population, is an important indicator of disease data for 215 countries and territories.
impact and is valuable for monitoring the impact
In addition to data sources used in the previous 10th
of preventive interventions.
edition of the Atlas, new sources were sought. The
In each edition of the IDF Diabetes Atlas, we estimate Atlas systematically reviewed the literature published
diabetes prevalence based on the best quality data between September 2020 and March 2024, adding
available at the time of analysis as judged by the 63 data sources from 31 countries to the existing
international diabetes experts who comprise the database (Map 2.1).
IDF Diabetes Atlas Committee.
As in previous IDF Diabetes Atlas editions, each source
Depending on study design, sample size, type of was scored to evaluate the quality of available data,
measurements performed, definitions, and methods using an analytical hierarchy process3 that considers
of analysis, these estimates can vary markedly the criteria mentioned in Figure 2.1. Each criterion’s
between studies and countries as well as over time. classification possibilities are presented from the
Therefore, changes in the magnitude of prevalence highest to the lowest degree of preference in the
of individual countries from edition to edition and figure. Preference was thus given to data sources
comparisons between countries should be treated based on the objective measurement of diabetes
with caution. Large differences are usually the result status (rather than self-reported), with a sample
of new studies, which may have been performed size >5000, nationally representative, conducted in
several years after those previously available. the past five years, and published in peer-reviewed
Additionally, future estimates are based only on journals or derived from national health surveys.†
projected changes in age, sex, and rural-urban The final score of a data source is the sum of scores
residence as defined by the United Nations (UN). on the five criteria mentioned in Figure 2.1. Among
studies meeting this cut off for a given country, the
one with the highest score and others with a score
2.2 Gathering and selecting within 0.1 of this highest score were included in
data sources prevalence calculations.
The data used for the estimation of diabetes In total, 241 out of 991 identified data sources (24.3%)
prevalence in this edition of the IDF Diabetes were used to generate estimates and projections.
Atlas were obtained from a variety of sources. The The identified data sources received a score above
vast majority were extracted from peer-reviewed threshold and agreed in consensus with members of
publications and national health surveys. The latter the IDF Diabetes Atlas Committee. An additional five
included selected WHO STEPwise approach to NCD studies, with quality below the Atlas threshold, were
risk factor surveillance (WHO STEPS) studies.1 In total, included by expert consensus for this 11th edition,
59 WHO STEPS were included as data sources, and usually given the alternative of having no study to
18 were excluded, having been recently shown to estimate a given country’s prevalence.
overestimate diabetes prevalence.2 Data from other
official sources, such as registries and reports from
health regulatory bodies, were also used, provided
† Data sources used in this edition can be
there was sufficient information to assess their quality.
found on the IDF Diabetes Atlas website:
Data sources required sufficient methodological
diabetesatlas.org
details on key areas of interest such as the method
of diagnosis and representativeness of the sample to
be included. Given the importance of age as a major
determinant for diabetes prevalence, only studies with
at least three age-specific estimates across their age
range were included. Data sources published before
2005 were excluded.

28 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Map 2.1 Countries and territories with in-country data sources on diabetes.

Countries with
in-country data
sources

Figure 2.1 Classification of diabetes data sources

Method of diabetes diagnosis Age of the data source

(i.e. time since study conducted)
●  Oral glucose tolerance test (OGTT)
●  Less than 5 years
●  Fasting blood glucose (FBG)
●  5 to 9 years
●  Haemoglobin A1c (HbA1c)
●  10 to 19 years
●  Self-reported diabetes
●  20 or more years
●  Medical record or clinical diagnosis

Sample size Type of publication

●  Equal to or greater than ●  Peer-reviewed publication

5,000 people ●  National health survey
●  1,500 to 4,999 people ●  Other official report or publication
●  700 to 1,499 people by a health regulatory body
●  Less than 700 people ●  Unpublished study

Representativeness of study sample

●  Nationally representative
●  Regionally representative
●  Locally representative
●  Ethnic (or other) specific
group representative

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 29

2.3 Estimating diabetes prevalence 2.4 Extrapolating data
and projections for the future One-third of countries or territories with more than
Smoothed age- and sex-specific prevalence estimates 50,000 habitants (62 countries out of 215 countries or
for each selected data source were produced using territories, 29%) do not have in-country data sources
a logistic regression model. on diabetes prevalence that fulfil the IDF Diabetes
Atlas inclusion criteria. Under such circumstances,
If more than one data source was available for estimates were generated by extrapolation using
an individual country, the country-level diabetes diabetes prevalence data from countries that are
estimates were derived as the average prevalence similar in ethnicity,8 language,9 World Bank income
estimated from the various data sources, each classification,10 and geographic location.
weighted by the analytical hierarchy process quality
score. This permitted the higher-quality studies to Extrapolated estimates are less reliable than
contribute more to the final country estimate. The estimates based on national data sources and
details of the logistic regression model have been should be interpreted with caution. Countries with
described in a previous publication,4. extrapolated estimates are designated in the country
summary table (Appendices) and Map 2.1. The use
For each country, age- sex- and urban/rural-specific of extrapolation emphasises the importance of
diabetes estimates were generated. When a study conducting high-quality studies worldwide that help
was not nationally representative, the national to address gaps in diabetes prevalence information.
prevalence was estimated, taking into account the
urban/rural ratio of the study in relation to that of
the country. The ratio of urban to rural disease 2.5 Estimating confidence intervals
prevalence was estimated for studies that did not
Confidence intervals are provided to indicate the
present results stratified by urban and rural residence
degree of uncertainty around each of the estimates.
in countries. Atlas data from countries judged to be
Heterogenous data sources provide diabetes
similar and the United Nations Population Division
prevalence estimates that are not harmonized for
(UNPD)6 approximation of the country’s urban/rural
analysis. Polynomial regression models are thus used
population ratio were used to distribute the results
to harmonize the data from heterogenous studies.
by urban and rural prevalence.
Predicted estimates from models for specific country
Country prevalence estimates were then aggregated population subgroups (regarding female or male
to produce estimates for the seven IDF Regions gender, urban or rural location type and 5-year age
and for countries in the four World Bank income groups in the range 20 to 79 years) are weighted
classification categories. and combined (weighted average formula) taking
into account the quality of the data sources and
The UNPD World Population Prospects (2022 Revision)
also the population size of the analysed subgroups.
estimates were used to transform prevalence
The predicted estimates are combined in order
estimates into the number of people with diabetes
to derive country-level and regional-level average
for each nation. To project diabetes estimates forward
estimates. The standard error is also computed for
to the year 2050, the population projection for 2050
each predicted estimate from the models. Error
from the UNPD for each country was used. The 2050
propagation using the weighted variances of the
diabetes projection assumes that diabetes prevalence
estimates was used to derive the variance of the
does not change for each age group but considers the
combined estimates. Correlation between the
changes in population age structure and degree of
errors of the estimates was accounted in the error
urbanisation.7 This approach is likely to underestimate
propagation process, in the case of extrapolated
future diabetes prevalence as it does not take into
countries that were missing data sources and data
account an increasing prevalence of obesity and other
sources from similar countries were used. Confidence
risk factors, independent of age and urbanisation,
intervals were constructed using the propagated error
known to result in a higher diabetes incidence.
in the national, regional and global level.5,11

30 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

2.6 Standardisation of estimates
It is important to appreciate that the IDF Diabetes These were produced by standardising 2024
Atlas presents two sets of prevalence estimates prevalence estimates from each country to the age
for diabetes, impaired glucose tolerance (IGT), structure of the UN Population Division’s estimated
and impaired fasting glucose (IFG) for each country world population (2022 Revision). They are referred
in 2024. to as age-standardised and indicated with a footnote:
‘standardised to world population’. This latter
The first set is calculated by applying the computed
standardisation approach removes the effect of
age-, sex- and urbanisation-specific prevalence rates
differences in the age structure between countries.
from the literature to the country’s 2024 age-, sex- and
The age-standardised diabetes prevalence in 2050 was
urban/rural setting distribution as estimated by the
calculated using the UN projected global age structure
UN Population Division, World Population Prospects
for 2050.6
(2024 Revision).6,12
This provides a prevalence estimate per country, as
indicated in the table and figure footnotes: ‘national
prevalence’. However, to permit comparison of
diabetes prevalence between countries, additional
‘age-standardised’ estimates were also calculated.

Map 2.2 Countries and territories with data sources on the proportion of adults (20–79 years)
with previously undiagnosed diabetes.

Countries with
in-country data
sources

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 31

Map 2.3 Countries and territories with selected data sources on impaired glucose tolerance adults
(20–79 years).

Countries with
in-country data
sources

2.7 Estimating undiagnosed diabetes prevalence

The early detection of diabetes and initiation of It is important to keep in mind that diagnostic tests
treatment is extremely important in the management are based on different biochemical processes and
of diabetes and prevention of complications. The longer often yield different results.13 Common diabetes
a person has diabetes but remains undiagnosed, the biomarkers, such as fasting plasma glucose (FPG) or
greater the risk of developing complications. People haemoglobin A1c (HbA1c), detect different subgroups
are defined as having undiagnosed diabetes when of people with diabetes and those groups only
their blood glucose levels would satisfy the diagnostic partially overlap. Studies using different combinations
criteria for diabetes, but the diagnosis has not been of diabetes biomarkers may thus report different
confirmed by a health professional. diabetes prevalence estimates. Furthermore, this
affects the number of undiagnosed people. That said,
Population-based scientific studies allow us to
the limited availability of data means that reports of
estimate the prevalence of undiagnosed diabetes
this nature must make decisions on which diagnostic
worldwide. A sample of the population is surveyed
methods for diabetes are prioritised.
to assess how many people have diabetes by testing
blood glucose levels. Additionally, all participants are For this edition of the IDF Diabetes Atlas, we
asked whether they were previously diagnosed with have assembled all published studies reporting
diabetes by a health professional. This helps establish undiagnosed diabetes that met defined selection
the proportion of people with diabetes-level blood criteria (see Chapter 2, “Gathering and selecting
glucose who remain undiagnosed. data sources”), regardless of the diabetes biomarker
used. The average of the estimates was calculated
The proportion of undiagnosed diabetes may differ
for countries that reported data on estimates of
greatly across countries, for example, depending on
undiagnosed diabetes. However, in countries without
access to healthcare services, disease awareness,
in-country data sources, the undiagnosed proportion
and socioeconomic context. In a final step, prevalence
was approximated by the average of the estimates
estimates and proportions undiagnosed are multiplied
from countries with data sources within the same IDF
with population size numbers to calculate the total
Region (e.g., Europe IDF Region) or IDF Region and
number of people with undiagnosed diabetes in
World Bank Income Group. Estimates of undiagnosed
a respective country.
diabetes were generated using 193 data sources
representing 109 countries (Map 2.2).

32 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Map 2.4 Countries and territories with selected data sources on impaired fasting glucose in adults
(20–79 years).

Countries with
in-country data
sources

2.8 Estimating the prevalence of intermediate states of hyperglycaemia

Data sources for IGT and IFG prevalence were identified New to this edition, we identified studies with
and selected according to previously described criteria national estimates of HbA1c-defined intermediate
(See Chapter 1). There were 51 high-quality studies hyperglycaemia, based on the American Diabetes
(from 46 countries) for IGT and 63 high-quality studies Association (ADA) criteria (HbA1c 5.7-6.4%). There were
(from 60 countries) for IFG that satisfied the selection 21 countries with published data of HbA1c-defined
criteria (Map 2.3 and Map 2.4). A logistic regression intermediate hyperglycaemia. As there were fewer
model was used to estimate smoothed prevalence of countries with published data, we did not extrapolate
IGT and IFG by country. The prevalence estimates for prevalence estimates for HbA1c-defined intermediate
the remaining countries were extrapolated from similar hyperglycaemia in countries that were missing data.
countries (see Chapter 2, “Extrapolating data” and
www.diabetesatlas.org under Resources).

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 33

Anita Sabidi, Indonesia - Living with type 1 diabetes

2.9 Estimating the prevalence of hyperglycaemia in pregnancy

Data sources reporting age-specific prevalence of It should be noted that the method for selecting
gestational diabetes (GDM) and diabetes first detected data sources was updated in the 9th edition of the
in pregnancy were searched14 and selected according IDF Diabetes Atlas. Thus, any comparison of the
to the criteria described previously.15 UN fertility prevalence estimates from the 9th, 10th and 11th
projections16 and IDF estimates of diabetes were used editions with those of previous editions must be
to calculate the total percentage of live births affected viewed with caution. The changes in the selection
by hyperglycaemia in pregnancy (HIP). of data sources include:
All studies were scored according to the diagnostic ● 
International Association of Diabetes and
criteria used, the year the study was carried out, study Pregnancy Study Group (IADPSG) diagnostic
design, the representativeness of the sample and the criteria have been given more weight in this
screening approach. Studies which met our predefined edition compared to previous editions.
threshold were then selected to calculate country-level
● 
A new criterion, termed “screening approach”,
estimates. For this edition of the IDF Diabetes Atlas,
has been added that includes the following
65 studies from 52 countries were used to estimate
options: universal one step, selective, two or
country-level, age-specific prevalence of HIP using a
more steps, and selective two or more steps.
generalised linear regression model (Map 2.5). The
detailed methods for estimation of prevalence of
HIP have been described previously.15

34 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Map 2.5 Countries and territories with selected data sources on hyperglycaemia in pregnancy in
adults (20–49 years).

Countries with
in-country data
sources

2.10 Estimating diabetes-related 2.11 Estimating the economic

mortality impact of diabetes
The total number of deaths attributable to diabetes The direct cost estimates in this edition of the IDF
by country was calculated by combining information Diabetes Atlas were calculated using an attributable
on the number of annual deaths from all-causes fraction method, which relies on the following inputs:  
stratified by age and sex,17 age- and sex-specific ● 
IDF Diabetes Atlas estimates of diagnosed and
mortality relative risks separately for people with undiagnosed diabetes prevalence for each
diagnosed and undiagnosed diabetes compared country and for each age and sex sub-group,
to those without diabetes, and country-specific stratified by rural and urban setting.  
diagnosed and undiagnosed diabetes prevalence
by age and sex for the year 2024. Relative risks ● 
UN population estimates for 2024 and
attributable to diabetes are derived from cohort UN population projections for 2050.
studies comparing death rates in those with ● 
WHO global health expenditures per capita
diabetes (diagnosed and undiagnosed) and no for 2022 (latest available data).
diabetes.18–25 This method of estimating
diabetes-related mortality (regardless of diagnosis ● 
The ratios of health expenditures for people with
status) is described in more detail elsewhere.26–28 diabetes compared to people without diabetes,
stratified by age, sex, rural versus urban setting,
diagnosed and undiagnosed diabetes, and
income per IDF Region.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 35

The WHO definition of health expenditure includes 2.12 Estimating diabetes prevalence
provision of health services (preventive and curative), for type 1 diabetes across all
family planning activities, nutrition activities, and
emergency aid designated for health, but does not
age groups
include provision of water and sanitation services. The 11th Edition IDF Diabetes Atlas for the type 1
The definition includes health expenditures from both diabetes estimates, uses outputs from Version 3.0
public and private sources.29 The same method was of the T1D Index (t1dindex.org). The Index utilises
used as in the previous editions to distribute the total a Markov Model and machine learning methods to
health expenditure in a given country into expenditure estimate individual country and thereby global T1D
by age and sex.30 numbers.32 It combines published and available
unpublished population-based data on T1D incidence
Another critical component of the analyses is the
and prevalence, as well as mortality among those with
ratio of health expenditures for people with diabetes
and without T1D, to estimate prevalence, incidence
(diagnosed or undiagnosed) compared to those
and life expectancy for those with T1D in all countries.
without diabetes. Since the publication of the 8th
edition of the IDF Diabetes Atlas, these ratios have Childhood and adolescent T1D incidence
been refined by the work of Bommer et al. (2017),31 data were sourced from recently published
providing estimates for this ratio with much more literature,publications cited in all previous editions of
specificity in relation to age, sex, rural versus urban the Atlas with study dates from 2000 onwards, and
setting, whether diabetes is diagnosed, region, and also unpublished registry and study data provided
income levels of countries. by in-country researchers. In the T1D Index Version
3.0, incidence data were available for 83 countries,
The diabetes-related health expenditure estimates
and extrapolated for the 119 (of 202) other countries/
are presented in US dollars (USD), and in international
territories using previously-described
dollars (ID), as well as a percentage of total health
Atlas methodology.33
expenditures and of gross domestic product
(GDP). IDs account for local purchasing power and Adult incidence data were derived from 30 studies
facilitate direct cross-country comparisons of health from 21 countries and used to estimate incidence as a
expenditures. Health expenditures for diabetes as a function of age, assuming a similar pattern of age of
percentage of total health expenditures and of GDP onset across countries. Estimates for countries in
reflect the direct economic burden of diabetes to Sub-Saharan Africa were produced separately due
a national economy. to the later peak age of onset in that region.32,34

36 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Changes in incidence over time were then estimated
for the period between 1985 and 2019, using the most
representative data for each country, either from local
data or extrapolated from regional or global averages.
Data from the COVID-19 pandemic years 2020-22 were
excluded from the incidence over time model as a
number of studies showed marked temporal variation
in incidence during this period,35 and very limited
data have been published as yet for 2023 onwards.
Incidence was assumed to be constant prior to 1985,
unless there were earlier historical data, and assumed
to be increasing/decreasing into the future at the same
rate as occurred in the final year of available data.
Actual prevalence data for single or multiple years
were used when available (26 countries), and otherwise
were modelled. Age-standardised mortality over
time was modelled using random forest regression
of mortality data from 39 countries, as well as infant
mortality and under five year mortality rates, percent
of population living in cities, doctors per capita, gross
domestic product, and the mortality rate associated
with the varying levels of T1D care across countries.
T1D levels of care and diagnosis rates were estimated
from an expert survey. Life expectancy was calculated
using standard methods.32

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 37

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for Surveillance. Geneva; 2003. Whiting, D. R. & Cho, N. H. The IDF Diabetes Atlas
methodology for estimating global prevalence of
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16. United Nations. World Population Prospects:
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https://diabetesatlas.org/scientific-papers- Obesity, and Lifestyle Study (AusDiab).
and-posters/ Circulation 116, 151–157 (2007).

6. United Nations. World Population Prospects: 20. Magliano, D. J. et al. Mortality, all-cause and
The 2022 Revision. New York; 2022. cardiovascular disease, over 15 years in
multiethnic mauritius: impact of diabetes and
7. United Nations Population Division. 2018 Revision intermediate forms of glucose tolerance.
of World Urbanization Prospects. New York; 2018. Diabetes Care 33, 1983–1989 (2010).

8. Central Intelligence Agency. The World Factbook, 21. Tian, Y. et al. Associations of Diabetes and
Ethnic Groups. Washington, DC; 2015. Prediabetes With Mortality and Life Expectancy in
China: A National Study. Diabetes Care 47,
9. Central Intelligence Agency. The World Factbook, 1969–1977 (2024).
Languages. Washington, DC; Languages; 2015.
22. Anjana, R. M. et al. Causes and predictors of
10. The World Bank. World Bank Income Group mortality in Asian Indians with and without
Classification; 2024. diabetes-10 year follow-up of the Chennai
Urban Rural Epidemiology Study (CURES - 150).
11. Sun, H. et al. IDF Diabetes Atlas: Global, regional PLoS One 13, e0197376 (2018).
and country-level diabetes prevalence estimates
for 2021 and projections for 2045. Diabetes Res 23. Ganna, A. & Ingelsson, E. 5 year mortality
Clin Pract 183, 109119 (2022). predictors in 498,103 UK Biobank participants: a
prospective population-based study. Lancet 386,
12. Ahmad OB, Boschi-Pinto C, Lopez AD, Murray CJ, 533–540 (2015).
Lozano R, Inoue M. Age Standardization of Rates:
A new WHO Standard. :14. 24. Kondal, D. et al. Cohort Profile: The Center for
Cardiometabolic Risk Reduction in South Asia
13. NCD Risk Factor Collaboration (NCD-RisC). Global (CARRS). Int J Epidemiol 51, e358–e371 (2022).
variation in diabetes diagnosis and prevalence
based on fasting glucose and hemoglobin A1c. 25. Follow-up of Indian Council of Medical Research-
Nat Med 29, 2885–2901 (2023). India Diabetes (ICMR-INDIAB) study Phase-I &
Northeast (Tamil Nadu & Arunachal Pradesh) -
14. Yuen, L. et al. Projections of the prevalence of Changes in prevalence of diabetes/prediabetes,
hyperglycaemia in pregnancy in 2019 and beyond: Incidence risk and rates of complications/
Results from the International Diabetes Federation mortality. Grant number: No.57/3/INDIAB/
Diabetes Atlas, 9th edition. Diabetes Res Clin Pract Ph-II/21-NCD-III (Unpublished data).
157, 107841 (2019).

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26. Saeedi, P. et al. Mortality attributable to diabetes
in 20-79 years old adults, 2019 estimates: Results
from the International Diabetes Federation
Diabetes Atlas, 9th edition. Diabetes Res Clin Pract
162, 108086 (2020).

27. Roglic, G. & Unwin, N. Mortality attributable to

diabetes: estimates for the year 2010. Diabetes Res
Clin Pract 87, 15–19 (2010).

28. IDF Diabetes Atlas Group. Update of mortality

attributable to diabetes for the IDF Diabetes Atlas:
estimates for the year 2011. Diabetes Res Clin Pract
100, 277–279 (2013).

29. World Health Organization. Global Health

Expenditure database. [Internet]. 2021. Available
from: https://apps.who.int/nha/database.

30. Williams, R. et al. Global and regional estimates

and projections of diabetes-related health
expenditure: Results from the International
Diabetes Federation Diabetes Atlas, 9th edition.
Diabetes Res Clin Pract 162, 108072 (2020).

31. Bommer, C. et al. The global economic burden

of diabetes in adults aged 20-79 years: a cost-of-
illness study. Lancet Diabetes Endocrinol 5,
423–430 (2017).

32. Gregory, G. A. et al. Global incidence, prevalence,

and mortality of type 1 diabetes in 2021 with
projection to 2040: a modelling study. Lancet
Diabetes Endocrinol 10, 741–760 (2022).

33. Ogle, G. D. et al. Global estimates of incidence

of type 1 diabetes in children and adolescents:
Results from the International Diabetes
Federation Atlas, 10th edition. Diabetes Res Clin
Pract 183, 109083 (2022).

34. Atun, R. et al. Diabetes in sub-Saharan Africa:

from clinical care to health policy. Lancet Diabetes
Endocrinol 5, 622–667 (2017).

35. D’Souza, D. et al. Incidence of Diabetes in Children

and Adolescents During the COVID-19 Pandemic:
A Systematic Review and Meta-Analysis. JAMA Netw
Open 6, e2321281 (2023).

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 39

3 Gulninder Kaur, UK - Living with type 2 diabetes

The global picture of diabetes

42 3.1 Diabetes prevalence in 2024 and projection to 2050 (20–79 years)
48 3.2 Diabetes prevalence in older adults in 2024 and projection to 2050
50 3.3 Undiagnosed diabetes
53 3.4 Intermediate states of hyperglycaemia
57 3.5 Hyperglycaemia in pregnancy
59 3.6 Diabetes-related mortality
60 3.7 The economic impact of diabetes
68 3.8 Type 1 diabetes estimates in children and adults
71 References

40 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Key messages:

An estimated 589 million adults aged 20–79 years

are living with diabetes. This represents 11.1% of
the world’s population in this age group.

The total number of adults living with diabetes is

predicted to rise to 853 million (13%) by 2050.

An estimated 252 million adults living with diabetes

are unaware they have the condition.

One in four adults (158 million) living with diabetes

are aged over 65.

An estimated 635 million adults aged 20–79 years

are living with impaired glucose tolerance (12%).

Over USD 1 trillion was spent on diabetes in 2024.

This represents 12% of global health expenditure.

Over 3.4 million people died as a result of diabetes

in 2024. This corresponds to 9.3% of global deaths
from all causes.

An estimated 9.1 million people are living with type

1 diabetes. The majority (69%) are aged 20-59.

An estimated 1 in 5 live births (23 million) are

affected by some form of hyperglycaemia
in pregnancy.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 41

This 11th edition of the IDF Diabetes Atlas provides While the world’s population is estimated to grow
estimates for diabetes in 2024 and projected 25% over the next 25 years, the number of people
estimates for 2050. The estimates include diagnosed with diabetes is estimated to increase by 45%
and undiagnosed diabetes for adults aged 20–79. (Map 3.1, Table 3.1, Map 3.2).
Worldwide, a total of 589 million adults aged 20–79
are estimated to have diabetes (11.1% of all adults in
this age group). By 2050, the number of adults living
with diabetes will rise to a projected 852.5 million.

Map 3.1 Estimated number of adults (20–79 years) with diabetes by country, 2024.

< 100 thousand

100-<500 thousand
500 thousand-<1 million
1 - <10 million
10-<20 million
≥20 million
No estimates

3.1 Diabetes prevalence in 2024 and projection to 2050 (20–79 years)

The estimates in the 11th edition of the IDF Diabetes Our projection for 2050 predicts a growth of 17% in
Atlas are provided for 215 countries and territories, the prevalence of diabetes due to the ageing of the
grouped into the seven IDF Regions: Africa (AFR), population and increased urbanisation across the
Europe (EUR), Middle East and North Africa (MENA), globe. It is estimated that 95% of the increase in the
North America and Caribbean (NAC), South and number of people with diabetes by 2050 will occur in
Central America (SACA), South-East Asia (SEA) and low- and middle-income countries, where population
Western Pacific (WP). In total, 246 data sources from growth is expected to be greater than in high-income
153 countries and territories were included in the countries (Table 3.2).
analyses (See Resources www.diabetesatlas.org).1
Data are presented considering each country´s current
age structure and, after adjustment to reflect the
prevalence, the age structure of the world population.

42 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Table 3.1 Global estimates of key aspects of diabetes, intermediate hyperglycaemia,
and hyperglycaemia in pregnancy in 2024 and 2050.

At a glance 2024 2050

World Population
Total 8.1 billion 9.7 billion
Adults (20-79 years) 5.3 billion 6.6 billion

All diabetes (20–79 years)

Number of people with diabetes 588.7 million 852.5 million
Prevalencei 11.1% 13.0%
Number of deaths attributed to diabetes 3.4 million -
Total health expenditure due to diabetesii (2024 USD) 1.015 trillion 1.043 trillion

Type 1 diabetes
Number of people with type 1 diabetes (all age groups) 9.2 million
Number of people with type 1 diabetes (>20 years) 1.8 million

Intermediate Hyperglycaemia

Impaired glucose tolerance (20–79 years)

Number of people 634.8 million 846.5 million
Prevalencei 12.0% 12.9%

Impaired fasting glucose (20–79 years)

Number of people with impaired fasting glucose 487.7 million 647.5 million
Prevalencei 9.2% 9.8%

Hyperglycaemia in pregnancy (20–49 years)

Number of live births affected 23 million
Proportion of live births affected 19.7%

i. National prevalence. Updated to reflect the country’s current age, sex and urbanisation structure.
ii. Health expenditure for people with diabetes is assumed to be on average two fold higher than people without diabetes

Table 3.2 Number of adults (20–79 years) with diabetes and diabetes prevalence for countries
grouped by World Bank income classification, 2024 and 2050.

At a glance 2024 2050

Age- Age-
Number of Number of
World Bank Diabetes standardised Diabetes standardised
people with people with
income prevalencei diabetes prevalencei diabetes
diabetes diabetes
classification (%) prevalenceii (%) prevalenceii
(millions) (millions)
(%) (%)

World 11.1 11.1 588.7 13.0 13.0 852.5

High- 12.4 10.2 114.1 14.0 12.0 126.5

income
countries

Middle- 11.3 11.5 452.9 13.7 13.5 674.8

income
countries

Low- 6.1 7.5 21.8 6.8 8.2 51.2

income
countries

i. National prevalence
ii. Prevalence is standardised to world population for the respective year

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 43

Variation in diabetes prevalence across age, sex and setting
Age is an important risk factor for diabetes. Ageing of The estimated diabetes prevalence is similar in women
the world’s population contributes to higher diabetes and men aged 20–79 (10.9% vs 11.3%). In 2024, the
prevalence that results in an increasing proportion of IDF estimates that 9.8 million more men than women
people with diabetes over the age of 60. were living with diabetes (Figure 3.2).
Prevalence was lowest among adults aged 20–24
(1.9% in 2024 and 2.2% in 2050). Conversely, it was
highest among adults aged 75–79, with an estimated
prevalence of 24.8% in 2024, which is expected to rise
to 25.4% by 2050.

Map 3.2 Estimated age-standardised country prevalence of diabetes in adults (20–79 years), 2024.

<4%
4-<5%
5-<7%
7-<9%
9-<12%
≥12%
No estimates

44 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Figure 3.1 Estimated numbers of people with diabetes (top panel) and estimated
world-standardised prevalence of diabetes (bottom panel) in adults (20–79 years) by age
group in 2024 and 2050.

140

120
Number of people with
diabetes (millions)

100

80

60

40

20

0
20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)
2024 2050

30
Diabetes prevalence (%)

25

20

15

10

0
20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)
2024 2050

Figure 3.2 Prevalence of diabetes among men and women (20–79 years), 2024.

30

25
Prevalence(%)

20

15

10

0
20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)
Male Female

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 45

 In 2024, more people with diabetes were living in while the number in rural areas should remain stable
urban (399.6 million) than rural (189.1 million) areas – (Figure 3.3). The projected prevalence is expected
the prevalence in urban areas was 12.7% and in rural to reach 14.5% and 9.6% in urban and rural
areas 8.8%. The number of people with diabetes living settings, respectively.
in urban areas is expected to increase to 654.7 million,

Figure 3.3 Number of adults (20–79 years) with diabetes living in urban and rural areas in 2024
and 2050.

700

600
People with diabetes (millions)

500

400

300

200

100

2024 2050

Rural Urban

Regional distribution Country distribution

As explained in Chapter 2, age is a major determinant The countries with the largest numbers of adults
of diabetes risk. Thus, age-standardised diabetes with diabetes aged 20–79 years in 2024 are China,
prevalence estimates and projections have been India, and the USA. Pakistan is predicted to overtake
generated to allow comparisons at IDF regional and the USA in the ranking of the estimated number of
country levels that remove the effect of different age people with diabetes by 2050 (Table 3.4). Because of
distributions, using age-standardisation based on differences in population sizes, the countries with
United Nations estimates of the age distribution of the highest number of people with diabetes do not
the world’s population, the “world-standard” for each necessarily have the highest prevalence. Differences
specific year. The MENA Region had the highest in age distribution across countries affect rankings of
age-standardised diabetes prevalence (19.9%) in the number of people with diabetes and the world-
people aged 20–79 years in 2024. This estimate is standardised prevalence estimates.
expected to increase, with the MENA Region
The highest age-standardised diabetes prevalence
continuing to have the highest age-standardised
rates in 2024 were reported in Pakistan (31.4%),
prevalence in 2050 (22.8%).
Marshall Islands (25.7%), and Kuwait (25.6%) (Table
The AFR Region currently has the lowest 3.5). The countries that are expected to have the
age-standardised estimates of prevalence (5.0% in highest overall age-standardised diabetes prevalence
2024 and 5.9% in 2050), which can be attributed in in 2050 are almost the same, with Pakistan reaching
part to low levels of urbanisation and low prevalence 34.2%, Marshall Islands 28.7% and Kiribati 28.5%.
of overweight and obesity. The increase in percentage
points over time is smaller than in other IDF regions
(Table 3.3). This is likely to be underestimated given
the rapid urbanisation and expected changes in
lifestyles and ecosystems in this region.

46 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Table 3.3 Number and world-standardised prevalence of diabetes in adults (20–79 years) in
the world and in IDF Regions, 2024 and 2050, ranked by the 2024 world-standardised prevalence.

2024 2050

Age- Age-
Number of Number of
standardised Diabetes standardised Diabetes
IDF people with people with
Rank

diabetes prevalence diabetes prevalence

Region diabetes diabetes
prevalence (%) prevalence (%)
(millions) (millions)
(%) (%)

World 11.1 11.1 588.7 13.0 13.0 852.5

1 MENA 19.9 17.6 84.7 22.8 21.0 162.6

2 NAC 13.8 15.1 56.2 15.3 16.4 68.1

3 WP 11.1 12.4 215.4 12.8 14.7 253.8

4 SEA 10.8 9.7 106.9 13.0 13.2 184.5

5 SACA 10.1 10.0 35.4 11.5 12.3 51.5

6 EUR 8.0 9.8 65.6 9.4 11.0 72.4

7 AFR 5.0 4.2 24.6 5.9 5.0 59.5

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA:
South and Central America; SEA: South-East Asia; WP: Western Pacific

Table 3.4 Top 10 countries or territories by number of adults (20–79 years) with diabetes in 2024
and 2050.

2024 2050

Number of Number of
people with people with
Rank

Rank

Country or territory Country or territory

diabetes diabetes
(millions) (millions)

1 China 148.0 1 China 168.3

2 India 89.8 2 India 156.7

3 United States of America 38.5 3 Pakistan 70.2

4 Pakistan 34.5 4 United States of America 43.0

5 Indonesia 20.4 5 Indonesia 28.6

6 Brazil 16.6 6 Egypt 24.7

7 Bangladesh 13.9 7 Brazil 24.0

8 Mexico 13.6 8 Bangladesh 23.1

9 Egypt 13.2 9 Mexico 19.9

10 Japan 10.8 10 Turkey 14.1

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 47

Table 3.5 Top 10 countries or territories with age-standardised diabetes prevalence in adults
(20–79 years) in 2024 and 2050.

2024 2050

Age- Age-
Rank

Rank
standardised standardised
Country or territory Country or territory
diabetes diabetes
prevalence (%) prevalence (%)

1 Pakistan 31.4 1 Pakistan 34.2

2 Marshall Islands 25.7 2 Marshall Islands 28.7

3 Kuwait 25.6 3 Kiribati 28.5

4 Samoa 25.4 4 Kuwait 28.2

5 Qatari 24.6 5 Samoa 27.2

6 Kiribati 24.6 6 Qatari 27.0

7 Saudi Arabia 23.1 7 Egypt 25.7

8 French Polynesia 22.8 8 Saudi Arabia 25.4

9 Egypt 22.4 9 Bahrain 25.3

10 Bahrain 22.1 10 French Polynesia 23.9

i. Countries without in-country data sources. Estimates are extrapolated.

Table 3.6 Global diabetes estimates in people (65-99 years) in 2024 and 2050.

2024 2050

Adult population (65-99 years) 667.8 million 1.1 billion

Prevalence (65-99 years) 23.7% 24.3%

Number of people over 65 with diabetes (65–99 years) 158.3 million 278 million

3.2 Diabetes prevalence in older adults in 2024 and projection to 2050

Diabetes prevalence increases with age. Therefore, Regional distribution
the highest estimated prevalence is in people over
There are significant regional differences in the
65 (Figure 3.1). In 2024, the estimated number of
prevalence of diabetes in people over 65. Regions
people with diabetes aged 65–99 years was 158.3
included in the top five places remained the same
million (23.7%). If the current trend continues, the
in 2024 compared with 2019, but the MENA region
number of people aged 65-99 years with diabetes will
had the highest prevalence at (32.3%). The lowest
be 278 million in 2050 (Table 3.6). These data point
prevalence remains in the AFR region (7.8%). This is
to a significant increase in the diabetes population of
generally true for 2050 as well (Table 3.7). However,
ageing societies in the next 25 years and the inevitable
the EUR region will fall to 6th place in the table with
public health and economic challenges this will bring.
the SEA region taking its place. Overall, the projected
It will require all countries to commit to sufficient
diabetes prevalence in 2050 in this age group does not
resources to tackle diabetes.
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.

48 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Country distribution
The countries with the highest number of people over people over 60. The global number of type 1 diabetes
65 with diabetes are China, India and the USA. India in adults is estimated to be 9.15 million, of which 1.1
ranked higher than the USA in the number of people million are over 60, with a breakdown by age 655,000
over 65 with diabetes for 2024 and 2050. (Map 3.3 (60-69), 325,000 (70-79), and 81,000 (80 and above).
and Table 3.8). Projected rises by 2050 are shown and
indicate that Germany and the Russian Federation will Mortality and health expenditure in older adults
be replaced by Turkey and Egypt in the top 10 list of
Total global mortality for people with diabetes over 60
countries with for people over 65 with diabetes.
is 2.2 million, and 9.2% of all-cause mortality deaths
were due to diabetes in this age group. In 2024, 63%
Type 1 diabetes in older adults
of deaths due to diabetes were in people over 60, and
For this edition of the IDF Diabetes Atlas, we were able total health expenditure for people with diabetes over
to report some additional data on type 1 diabetes in 60 is a staggering USD501.9 billion.

Table 3.7 Diabetes age-standardised prevalence in people (65-99 years) by IDF Region
in 2024 and 2050.

2024 2050

Age- Number of Age- Number of

Rank

standardised people with standardised people with

IDF Region IDF Region
diabetes diabetes diabetes diabetes
prevalence (%) (millions) prevalence (%) (millions)

1 MENA 32.3 11.8 MENA 33.7 33.4

2 NAC 28.7 18.3 NAC 29.0 24.3

3 WP 25.3 67.0 WP 25.9 106.7

4 SACA 23.2 9.9 SACA 23.6 19.3

5 EUR 21.6 27.1 SEA 22.9 52.1

6 SEA 21.0 21.8 EUR 22.3 35.1

7 AFR 7.8 2.5 AFR 8.2 7.2

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA:
South and Central America; SEA: South-East Asia; WP: Western Pacific

Map 3.3 Number of people over 65 with diabetes in 2024.

<5 thousand
5-<10 thousand
10-<50 thousand
50-<200 thousand
200-<500 thousand
≥500 thousand
No estimates

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 49

Table 3.8 Top 10 countries or territories by number of adults (65-99 years) with diabetes in 2024
and 2050.

2024 2050

Number of people Number of people

Rank

Rank
Country or territory with diabetes Country or territory with diabetes
(millions) (millions)

1 China 47.9 1 China 76.6

2 India 19.3 2 India 45.8

3 United States of America 14.1 3 United States of America 16.4

4 Japan 5.8 4 Brazil 10.6

5 Brazil 5.2 5 Pakistan 9.6

6 Pakistan 4.2 6 Indonesia 7.8

7 Indonesia 3.4 7 Mexico 5.9

8 Russian Federation 3.2 8 Japan 5.6

9 Germany 3.0 9 Turkey 5.5

10 Mexico 2.7 10 Egypt 5.4

Table 3.9 Adults (20–79 years) with undiagnosed diabetes by World Bank income classification
in 2024.

Number of people with

World Bank income classification Proportion undiagnosed (%) undiagnosed diabetes
(millions)

High-income countries 28.9 32.9

Middle-income countries 45.5 206.0

Low-income countries 58.7 12.8

3.3 Undiagnosed diabetes

Estimates of undiagnosed diabetes were generated and improve quality of life.3 Furthermore, the early
using 193 data sources from 109 countries. For the detection and management of diabetes can help avoid
remaining 106 countries, which either lacked data substantial costs related to diabetes complications.4
sources or data sources did not meet the quality Scaling-up cost-effective diabetes screening and
criteria for inclusion, the prevalence of undiagnosed diagnostic capacity is a crucial first step towards
diabetes was extrapolated (see Chapter 2). improving care for people with diabetes.
In 2024, just over four in ten (42.8%; 251.7 million)
Global and regional disparities in
adults living with diabetes (20–79 years old) were
undiagnosed diabetes
undiagnosed. High prevalence of undiagnosed
diabetes is often the result of insufficient access to Across low-income, middle-income, and high-income
healthcare services, as well as a limited capacity countries, 58.7%, 45.5%, and 28.9% of adults living
of health systems to identify diabetes cases.2 with diabetes are undiagnosed (Table 3.9). Globally,
86.9% of all people with undiagnosed diabetes live in
Early diagnosis and the timely initiation of treatment
low- and middle-income countries, home to four-fifths
are crucial for individuals with diabetes to prevent
of the world’s population.5
or delay complications, avoid premature death,

50 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

There are large differences in the proportion of Overall, around half of all countries and territories
undiagnosed diabetes across IDF regions. The highest included in this edition of the IDF Diabetes Atlas
proportion of undiagnosed diabetes is found in Africa lack reliable in-country data sources (see Chapter
(72.6%), followed by the Western Pacific (50.0%), 2: Methods). To improve estimates of undiagnosed
and South-East Asia (42.7%) (Table 3.10). The lowest diabetes and guide health-system responses,
proportion of undiagnosed diabetes is found in investments in surveillance and monitoring systems
North America and Caribbean (29.1%). Variation in for diabetes are urgently needed. Crucially, data
undiagnosed diabetes across regions and countries quality depends on the collection of diabetes
is often linked to several factors, including social and biomarkers in population-based studies. For reliable
economic conditions, health system performance, and estimates, a combination of both HbA1c and FPG is
awareness about diabetes among health professionals recommended.6 However, diabetes monitoring efforts,
and the public. particularly in low-resource settings, will need to
balance diagnostic accuracy of different diabetes tests
The proportion of people living with undiagnosed
with their feasibility and the cost of implementation.
diabetes varies by country (Map 3.4). Colombia
(16.2%), Hungary (16.7%), and the Czech Republic Globally, more than four in ten adults with diabetes
(16.7%) have the lowest proportions of undiagnosed in 2024 were unaware that they have the condition.
diabetes, whereas Burkina Faso (90.4%), Benin This translates to 252 million people living with
(89.8%), and Mozambique (88.6%) have the highest. In undiagnosed – and therefore untreated – diabetes,
absolute terms, 50.5% of all people with undiagnosed placing them at increased risk of complications and
diabetes globally live in just three countries, namely premature death. Thus, there is a clear need to scale
China, India, and Indonesia (Table 3.11). These up screening programmes and high-quality, person-
three countries are among the four most populous centred health services, especially in low- and middle-
countries in the world and among the top five income countries, where over 85% of people with
countries in terms of number of people with undiagnosed diabetes live.
diabetes (Table 3.4).

Table 3.10 Adults (20–79 years) with undiagnosed diabetes in IDF Regions in 2024, sorted by
proportion undiagnosed from highest to lowest.

Proportion undiagnosed Number of people with undiagnosed

IDF Region
(%) diabetes (millions)

World 42.8 251.7

AFR 72.6 17.9

WP 50.0 107.6

SEA 42.7 45.6

MENA 37.2 31.5

EUR 33.6 22.0

SACA 30.4 10.7

NAC 29.1 16.3

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA:
South and Central America; SEA: South-East Asia; WP: Western Pacific

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 51

Map 3.4 Proportion of adults (20–79 years) with undiagnosed diabetes by country in 2024.

<24%
35-<45%
45-<55%
55-<64%
≥65%
No estimates

Table 3.11 Top 10 countries with the largest number of adults (20–79 years) with undiagnosed
diabetes in 2024.
Rank

Number of people with

Country Proportion undiagnosed (%)
undiagnosed diabetes (millions)

1 China 49.7 73.5

2 India 43.0 38.6

3 Indonesia 73.2 15.0

4 United States of America 24.8 9.6

5 Pakistan 26.9 9.3

6 Egypt 62.0 8.2

7 Mexico 41.3 5.6

8 Bangladesh 39.1 5.4

9 Brazil 31.9 5.3

10 Turkey 45.5 4.4

52 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

3.4 Intermediate states of hyperglycaemia
Prevalence of impaired glucose tolerance Prevalence of impaired fasting glucose
In 2024, 634.8 million adults or 12.0% of adults In 2024, an estimated 487.7 million adults or 9.2% of
worldwide were estimated to have impaired glucose the global adult population were estimated to have
tolerance (IGT). The age-standardised prevalence impaired fasting glucose (IFG). The age-standardised
of IGT in 2024 was highest in the South-East Asia prevalence of IFG in 2024 was highest in North
region and lowest in Europe (Table 3.12). The age- America and Caribbean regions and lowest in Europe
standardised prevalence of IGT was 10.4% for high- (Table 3.14). The age-standardised prevalence of IFG
income countries, 12.3% for middle-income countries, was 8.4% for high-income countries, 9.5% for middle-
and 11.6% for low-income countries (Table 3.13). By income countries, and 6.7% for low-income countries
2050, an estimated 846.5 million adults or 12.9% of (Table 3.15). By 2050, an estimated 647.5 million adults
the global adult population are projected to have IGT or 9.8% of the global adult population are projected to
have IFG.

Table 3.12 Age-standardised prevalence of impaired glucose tolerance (20–79 years) by IDF
regions, ranked by 2024 prevalence (%).

2024 2050
Rank

IDF Age-standardised IGT Number of people Age-standardised IGT Number of people

Region prevalence (%) with IGT (millions) prevalence (%) with IGT (millions)

1 SEA 13.8 145.7 14.6 204.9

2 WP 13.5 251.3 14.3 267.8

3 NAC 11.6 46.6 12.6 55.3

4 AFR 11.5 56.8 13.7 135.1

5 SACA 11.0 38.7 11.9 51.9

6 MENA 11.0 49.7 11.6 85.3

7 EUR 5.9 45.9 6.2 46.2

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA:
South and Central America; SEA: South-East Asia; WP: Western Pacific

Prevalence of HbA1c-based intermediate Summary

hyperglycaemia
The global prevalence of intermediate hyperglycaemia
The reported prevalence of intermediate is substantial, although there is no consensus
hyperglycaemia based on the ADA HbA1c criteria definition for intermediate states of hyperglycaemia
(see Chapter 1: What is diabetes?) ranged from 5.5% or “prediabetes”. However, regardless of definition,
in Ireland to 40.5% in Nigeria (Figure 3.4). intermediate states of hyperglycaemia are common
and important risk factors for the development of type
2 diabetes, suggesting major challenges for future risk
of diabetes across the globe.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 53

Table 3.13 Age-standardised prevalence of impaired glucose tolerance in adults (20–79 years),
by World Bank income group classification.

Impaired Glucose Tolerance

2024 2050

World Bank Age- Number of Age- Number of

N
income standardised IGT people with standardised IGT people with IGT
countries
classification prevalence (%) IGT (millions) prevalence (%) (millions)

High-income 84 10.4 108.6 11.3 112.7

countries

Middle-income 113 12.3 491.3 13.1 648.9

countries

Low-income 29 11.6 34.8 13.9 84.9

countries

IGT: Impaired glucose tolerance

Table 3.14 Comparative prevalence of impaired fasting glucose in adults (20–79 years),
by IDF regions, ranked by 2024 prevalence (%).

2024 2050
Rank

IDF Age-standardised IFG Number of people Age-standardised IFG Number of people

Region prevalence (%) with IFG (millions) prevalence (%) with IFG (millions)

1 NAC 13.6 53.0 14.3 61.6

2 SEA 12.2 129.4 12.8 180.9

3 SACA 9.2 32.2 10.0 43.2

4 WP 8.6 159.5 9.2 171.1

5 MENA 8.0 36.2 8.4 62.2

6 AFR 6.6 37.6 7.4 88.1

7 EUR 5.3 39.7 5.7 40.4

IFG: Impaired fasting glucose; IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North
Africa; NAC: North America and Caribbean; SACA: South and Central America; SEA: South-East Asia; WP: Western Pacific

54 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Table 3.15 Age-standardised prevalence of impaired fasting glucose in adults (20–79 years),
by World Bank income classification.

Impaired Fasting Glucose

2024 2050

Age- Age-
World Bank Number of Number of
N standardised standardised
income people with people with
countries IFG prevalence IFG prevalence
classification IFG (millions) IFG (millions)
(%) (%)

High-income 84 8.4 83.9 9.2 88.4

countries

Middle-income 113 9.5 381.3 10.2 507.4

countries

Low-income 29 6.7 22.5 7.2 51.7

countries

IFG: Impaired fasting glucose

Map 3.5 Age-standardised prevalence of impaired glucose tolerance in adults in 2024.

<5%
5-<8%
8-<10%
10-<12%
12-<14%
≥14%
No estimates

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 55

Map 3.6 Age-standardised prevalence of impaired fasting glucose in adults in 2024.

<5%
5-<8%
8-<10%
10-<12%
12-<14%
≥14%
No estimates

Figure 3.4 Reported prevalence of HbA1c between 5.7 to 6.4%. Label includes the country,
study year, and age range of the study participants.

Ireland (2009-2011) (50+ y)

Norway (2017-2019) (20+ y)
Samoa (2019) (15+ y)
Canada (2007-2011) (20+ y)
Portugal (2015) (25-74 y)
Brazil (2014-2015) (18+ y)
Marshall Islands (2004-2010) (18+ y)
India (2008-2020) (20+ y)
Russian Federation (2013-2015) (20-79 y)
Ireland (2007) (45+ y)
United States of America (2017-2020) (20+ y)
Germany (2008-2011) (18+ y)
New Zealand (2008-2009) (15+ y)
Germany (1999-2014) (38-79 y)
United Arab Emirates (2009-2010) (18+ y)
Czech Republic (2014) (25-64 y)
South Africa (2011-2012) (15+ y)
Kuwait (2012-2017) (18-65 y)
Republic of Korea (2019) (20+ y)
Haiti (2015-2016) (25-65 y)
Netherlands (2007-2013) (40+ y)
Singapore (2016-2018) (30-70 y)
Nigeria (2021) (15+ y)

0 5 10 15 20 25 30 35 40 45

Prevalence of HbA1c 5.7 - 6.4%

56 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

3.5 Hyperglycaemia in pregnancy
It is estimated that 23.0 million (19.7%) of live births compared to 13.8% in the AFR Region (Table 3.17).
to women in 2024 had some form of hyperglycaemia The vast majority (89.5%) of cases of hyperglycaemia
in pregnancy. Of these, 79.2% were due to in pregnancy are seen in low and middle-income
gestational diabetes (GDM), while 11% were the countries, where access to antenatal care is limited.
result of diabetes detected prior to pregnancy,
The prevalence of HIP as a proportion of all
and 9.9% due to diabetes (including type 1 and
pregnancies increases rapidly with age, with
type 2) first detected in pregnancy (Table 3.16).
the highest prevalence, almost half (49.2%), in
Differences in these results compared to previous women aged 45–49 years, although there are
editions of the IDF Diabetes Atlas are possibly due fewer pregnancies in this age group (Figure
to improved detection before and during pregnancy. 3.5). This age group has a higher prevalence
More information on the methods can be found of diabetes among non-pregnant women. As a
in Chapter 2. result of higher fertility rates in younger women,
almost half (43.5%) of all cases of HIP (10.2
There are some regional differences in the
million) occur in women under the age of 30.
prevalence of HIP, with the SEA Region having the
highest age-standardised prevalence at 31.7%,

Table 3.16 Global estimates of hyperglycaemia in pregnancy in 2024.

Global live births in women aged 20-49 years 118.5 million

Global prevalence of HIP 19.7%

Number of live births affected in millions 23.0 million

Proportion of cases due to GDM 79.2%

Proportion of cases due to other types of diabetes 9.9%

first detected in pregnancy

Proportion of cases due to diabetes detected prior 11.0%

to pregnancy

Table 3.17 Hyperglycaemia in pregnancy (20–49 years) by IDF Region, ranked by 2024
age-standardised prevalence estimates.

Age-standardised Number of live births

IDF Region Prevalence (%)
prevalence (%) affected in millions

World 19.7 19.7 23.0

SEA 31.7 27.8 7.1

NAC 22.4 23.6 1.4

WP 19.8 20.8 4.2

MENA 19.4 19.7 3.6

SACA 15.8 16.0 1.0

EUR 14.2 15.9 1.5

AFR 13.8 13.9 4.7

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC:
North America and Caribbean; SACA: South and Central America; SEA: South-East Asia; WP: Western Pacific

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 57

 Figure 3.5 Prevalence of hyperglycaemia in pregnancy by age-group in 2024.

60
Prevalence of hyperglycaemia in pregnancy (%)

49.2
50

39.9
40

30.5
30

23.5

20 17.1

11.4
10

20-24 25-29 30-34 35-39 40-44 45-49

Age groups

58 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

3.6 Diabetes-related mortality
Diabetes is a significant cause of mortality worldwide, NAC, with approximately 0.53 million deaths. The IDF
though its impact varies by region due to differences Regions with the lowest number of deaths are AFR
in the prevalence of diabetes, age distribution and and SACA, with approximately 0.22 million deaths
the role of other contributing causes of death. each. These regional discrepancies are largely driven
Approximately 3.4 million adults aged 20-79 years by the relative size of their respective populations
are estimated to have died because of diabetes or its with diabetes and their age distribution.
complications in 2024 (2.4 million diagnosed diabetes-
The proportion of total deaths associated with
related deaths and 1 million undiagnosed diabetes-
diabetes is an indicator of the relative mortality
related deaths). This corresponds to 9.3% of global
burden of diabetes within each IDF Region. Diabetes
deaths from all causes in this age group. Almost 40%
is associated with the highest percentage of deaths
of the estimated number of deaths related to diabetes
from all causes in NAC at 21.4% (Map 3.7). The second
occurred in the most economically active age group
highest region is MENA, with 16.7% of all deaths
(20-59 years) (Figure 3.6). Diabetes led to nearly one in
associated with diabetes. The IDF Region with the
ten (9.3%) of all deaths in this age group.
lowest percentage of deaths associated with diabetes
The 2024 estimates for the number of deaths related is AFR, at 4.0%.
to diabetes are lower than in prior editions of Diabetes
Atlas due to multiple changes in methodology. The Country distribution
original source data for overall country-level mortality
Partly due to its large population, China has the
data was switched from an older WHO source to an
highest estimated number of deaths from diabetes,
updated United Nations source. The updated United
at approximately 0.76 million. Due to its large
Nations source has lower overall mortality numbers.
population and high prevalence of diabetes, the
In addition, the new estimates now account for
USA has the second highest number of deaths with
mortality risk differences between diagnosed and
0.36 million. The next highest is India (0.33 million),
undiagnosed diabetes. Relative risks of mortality
followed by Pakistan (0.23 million), Indonesia (0.13
compared to people without diabetes are
million) and Mexico (0.12 million).
generally lower in individuals with undiagnosed
vs diagnosed diabetes. The countries with the highest proportion of total
deaths associated with diabetes are Guam (36%),
Regional distribution New Caledonia (34%), French Polynesia (31%), Israel
(30%), and Italy (29%). The countries with the lowest
The IDF Western Pacific Region has the highest
proportions are Russia (0.42%), followed by Zimbabwe
estimated number of diabetes-related deaths among
and Rwanda, each with approximately 1.3% of total
adults aged 20-79 years of all the IDF Regions, with
deaths estimated to be associated with diabetes.
approximately 1.2 million deaths. This is followed by

Map 3.7 Proportion of total deaths related to diabetes among adults (20-79 years) in 2024.

<5%
5-<8%
8-<13%
13-<17%
≥17%
No estimates

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 59

Figure 3.6 Estimated number of deaths due to diabetes in adults (20–79 years), by age and sex
in 2024.

700,000

600,000

500,000
Deaths

400,000

300,000

200,000

100,000

-
20-29 30-39 40-49 50-59 60-69 70-79

Age (years)
Women Men

3.7 The economic impact of diabetes

Diabetes imposes a substantial economic burden
on countries, health systems, people with diabetes,
and their families.7–9

Direct costs of diabetes

Direct costs are the health expenditures that
occur due to diabetes – regardless of whether the
expenditure is borne out of pocket by people living
with diabetes or by private or public payers, including
governments. The IDF Diabetes Atlas has included
estimates of health expenditure due to diabetes10–14
since its 3rd edition in 2006. The increase in global
health expenditure due to diabetes has been
considerable, growing from USD 232 billion in 2007
to more than a trillion USD (1,015 billion) in 2024
for adults aged 20–79 years (Figure 3.7).
This represents a 338% increase over 17 years. Part In 2024, the total global
of this increase can be attributed to improved data diabetes-related health
quality. The direct costs of diabetes are expected to
continue to grow. IDF estimates that total diabetes-
expenditure exceeded
related health expenditure will reach USD 1.043 one trillion USD for the
trillion by 2050. This projection is conservative as first time.
it considers only population size, ageing, changes
in sex distribution and urbanisation and assumes
that age and sex-specific diabetes prevalence and
diabetes-related expenditure remain constant.

60 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Figure 3.7 Total diabetes-related health expenditure for adults (20–79 years) with diabetes from
2006 to 2050.

1200

1000

800
USD billion

600

400

200

2006 2009 2011 2013 2015 2017 2019 2021 2024 2050

Year

Regional distribution
The NAC Region has the highest total diabetes-related Expenditure due to diabetes has a substantial
health expenditure of the seven IDF Regions (USD impact on total health expenditure worldwide,
438.6 billion) and accounts for 43.2% of total global representing 11.9% of total global health spending.
diabetes-related health expenditure in 2024. The In the SACA Region, an average of 22.4% of the
second highest is the WP Region, with USD 246.3 total health expenditure was due to diabetes, the
billion, followed by the EUR Region (USD 192.9 billion), highest percentage of the IDF Regions, followed by
corresponding to 24.3% and 19.0% of total global 17.0% in the MENA Region. The lowest percentage
diabetes-related health expenditure, respectively. of health expenditure due to diabetes was
Despite being home to 42.7% of people with observed in the EUR Region (8.8%) (Figure 3.10).
diabetes in the world, the SACA, MENA, SEA, and AFR
Regions collectively account for only 13.5% of global
diabetes-related health expenditure (Figure 3.8).
The NAC Region also has the highest diabetes-related
health expenditure per adult with diabetes (USD
7,811), followed by the EUR Region (USD 2,950),
SACA Region (USD 2,417) and WP Region (USD 1,173)
(Figure 3.9). Health expenditure is USD 429 per person
with diabetes in the MENA region, USD 414 in the AFR
region, and USD 108 in the SEA region (Figure 3.9).
In 2024, diabetes-related health expenditure per
adult with diabetes varied across IDF regions by
more than 70-fold.

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 Figure 3.8 Total diabetes-related health expenditure (USD billion) in adults with diabetes
(20–79 years) by IDF Region in 2024.

500
Total diabetes-related health expenditure (USD billion)

439
450

400

350

300

246
250

193
200

150

100 81

50 35
12 10

0
NAC WP EUR SACA MENA SEA AFR

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC:
North America and Caribbean; SACA: South and Central America; SEA: South-East Asia; WP: Western Pacific

Figure 3.9 Diabetes-related health expenditure (USD) per adult with diabetes (20–79 years)
by IDF Region in 2024.

9,000

7,812
8,000
Diabetes-related health expenditure

7,000
per person (USD)

6,000

5,000

4,000
2,951
3,000 2,417

2,000
1,174

1,000 429 414

108

-
NAC EUR SACA WP MENA AFR SEA

IDF Regions
IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC:
North America and Caribbean; SACA: South and Central America; SEA: South-East Asia; WP: Western Pacific

62 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

 Figure 3.10 Diabetes-related health expenditure as a percentage of total health expenditure
for adults (20–79 years) with diabetes by IDF Region in 2024.

25.0
22.4

20.0

17.0

14.9
15.0
%

11.2
10.3
9.7
10.0 8.8

5.0

0.0

SACA MENA WP NAC AFR SEA EUR

IDF Regions
IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC:
North America and Caribbean; SACA: South and Central America; SEA: South-East Asia; WP: Western Pacific

Figure 3.11 Diabetes-related health expenditure as a percentage of Gross Domestic Product

(GDP) by IDF region in 2024.

3.0

2.5
2.5
Percentage of GDP (%)

1.9
2.0

1.5
1.3
1.1
1.0
1.0
1.0

0.4
0.5

0.0
SACA NAC MENA WP AFR EUR SEA

IDF Regions

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC:
North America and Caribbean; SACA: South and Central America; SEA: South-East Asia; WP: Western Pacific

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 63

 Diabetes-related health expenditure as a percentage expenditure as a percentage of GDP is highest
of Gross Domestic Product (GDP) is highest in the amongst high-income countries (1.4%), followed by
SACA Region at 2.5%, followed by 1.9% in the NAC middle income countries (1.3%), and followed distantly
Region (Figure 3.11). When considering World by low-income countries (0.8%) (Figure 3.12).
Bank income classification, diabetes-related health

Figure 3.12 Diabetes-related health expenditure as a percentage of Gross Domestic Product

(GDP) by World Bank income classification, 2024.
1.6

1.4
1.4 1.3

1.2
Percentage of GDP (%)

1.0

0.8
0.8

0.6

0.4

0.2

0.0

High-income countries Middle-income countries Low-income countries

World bank income classification

64 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Country distribution
On a country level, the highest diabetes-related health The countries with the lowest diabetes-related health
expenditure is observed in the USA (USD 404.5 billion), expenditure in 2024 were Niue and Nauru, with total
followed by China and Brazil, (USD 168.9 billion and expenditure of USD 0.8 million and USD 1.7 million,
USD 45.1 billion, respectively) (Table 3.18). respectively (Map 3.8).

Table 3.18 Ten countries or territories with the highest and lowest total health expenditure (USD)
in adults (20–79 years) due to diabetes in 2024.

Total diabetes-related health expenditure in 2024

Rank Country or territory
(USD billion) in adults (20-79 years)

Highest

1 United States of America 404.5

2 China 168.9

3 Brazil 45.1

4 Germany 40.4

5 Japan 34.0

6 United Kingdom 23.6

7 France 22.5

8 Mexico 19.5

9 Argentina 15.4

10 Italy 15.4

Lowest

1 Niue 0.8

2 Nauru 1.7

3 Tuvalu 2.1

4 Tonga 4.5

5 St Kitts and Nevis 5.6

6 St Vincent and the Grenadines 5.9

7 Gambia 5.9

8 Sao Tome and Principe 6.3

9 Seychelles 6.6

10 Comoros 7.1

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 65

Map 3.8 Total diabetes-related health expenditure (USD) by country for adults (20–79 years) with
diabetes in 2024.

<50 million
10-<50 million
50-<200 million
200 million-<1 billion
≥1 billion
No estimates

Map 3.9 Diabetes-related health expenditure (USD) by country per adult (20–79 years) with
diabetes in 2024.

<250
250-<500
500-<1,000
1,000-<2,000
2,000-<5,000
≥5,000
No estimates

66 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

In 2024, considerable disparities in diabetes-related Of the 10 countries with the highest health
health expenditure per person (20–79 years) existed expenditure for diabetes per person, nine are
among countries. The countries with the highest from the EUR Region and one is from the NAC
yearly expenditure per person are Switzerland (USD Region (Table 3.19).
12,234), followed by the USA (USD 10,497) and Norway
(USD 10,226). Countries with the lowest annual
expenditure per person are Bangladesh (USD 74),
Pakistan (USD 79) and Democratic Republic of the
Congo (USD 81) (Map 3.9).

Table 3.19 Ten countries or territories with the highest and lowest diabetes-related health
expenditure (USD) per person with diabetes (20–79 years) in 2024.

Diabetes-related health expenditure in 2024

Rank Country or territory
(USD) per person with diabetes (20-79 years)

Highest

1 Switzerland 12,234

2 United States of America 10,497

3 Norway 10,227

4 Iceland 8,055

5 Luxembourg 8,026

6 Denmark 7,718

7 Ireland 7,234

8 Sweden 7,081

9 Austria 6,268

10 Germany 6,237

Lowest

1 Bangladesh 74

2 Pakistan 79

3 Democratic Republic of the Congo 81

4 Madagascar 91

5 Nepal 91

6 Ethiopia 96

7 Burundi 103

8 Gambia 109

9 India 109

10 Chad 111

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 67

3.8 Type 1 diabetes estimates in children and adults
Previous editions of the IDF Diabetes Atlas were Findings
restricted to children and adolescents living with
In 2024, there were an estimated 9.15 million
type 1 diabetes (T1D) and did not consider potential
individuals worldwide living with diagnosed clinical
changes in incidence and mortality in the interval
T1D,17 with 22.3% (2.04 million) of these living in
between the study dates of the respective individual
low-income and lower-middle-income countries.
country data and publication dates of the Atlas.
Of this total population of 9.15 million, 1.81 million
Development of the Type 1 Diabetes Index (T1D Index)
(19.8%), were younger than 20 years, 6.28 million
has enabled more current and accurate estimates to
(68.6%) were between 20 and 59 and 1.06 million
be calculated for all ages across all countries.15–17 The
(11.8%) were 60 or older.
T1D Index is a joint initiative of Breakthrough T1D, Life
for a Child, The International Diabetes Federation, and Figure 3.13 shows the number of people with T1D
the International Society for Paediatric and Adolescent in each of these age brackets by IDF Region. The IDF
Diabetes. The Index uses a Markov model with Europe Region has the highest number of cases,
machine learning and all available population-based followed by the IDF North America and Caribbean
incidence, prevalence and mortality data to produce Region. The lowest number of people with T1D was
national and, thereby, global estimates.17 observed in the Africa Region.

Figure 3.13 Number of individuals with type 1 diabetes in each world region in 2024.

3,000,000
Number of people with T1D

2,500,000

2,000,000

1,500,000

1,000,000

500,000

-
AFR EUR MENA NAC SACA SEA WP

IDF Region
All ages <20 years of age 20 - 59 years of age >=60 years of age

IDF: International Diabetes Federation; AFR: Africa; EUR: Europe; MENA: Middle East and North Africa; NAC: North America and Caribbean; SACA:
South and Central America; SEA: South-East Asia; WP: Western Pacific

In 2024, there were 503,000 new cases of T1D For the 83 countries with published data from recent
diagnosed at all ages, with 219,000 of these new cases years, the ten countries with the highest estimated
in children and young adults under 20 years of age. incidence in children under 15 years of age in 2024
were Finland, Saudi Arabia, Kuwait, Qatar, Estonia,
The T1D Index numbers clearly show that T1D is not
Algeria, Sweden, Canada, Norway and Libya, ranked
just a condition that affects children and youth. With
in order of highest incidence.
good care, people developing T1D in childhood live
to older ages, adding to the number of adults with Table 3.20 shows the ten countries with the highest
diabetes. Furthermore, adult onset of T1D is common. number of people of all ages living with T1D, and the
In 2024, 284,000 (56.5%) of all new clinically diagnosed number of children and adolescents living with T1D.
T1D cases occurred in people aged 20 years or older. The different ranking in the two columns reflects
The current mean age of a person living with T1D the younger population and the higher T1D-specific
is 35 years. and overall mortality in lower-income countries such
as India. This reduces the relative proportion of the
number of adults living with T1D.

68 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Table 3.20 Countries with the highest number of people living with T1D in 2024.

Number of Number of children

Rank Country people of all ages Country and adolescents
living with T1D under 20 living with T1D

1 United States of America 1,477,000 India 301,000

2 India 941,000 United States of America 197,000

3 China 599,000 China 117,000

4 Brazil 499,000 Brazil 99,000

5 United Kingdom 341,000 Egypt 69,000

6 Germany 337,000 Russian Federation 61,000

7 Russian Federation 323,000 Algeria 56,000

8 Canada 243,000 Turkey 47,000

9 Saudi Arabia 223,000 Saudi Arabia 46,000

10 Turkey 196,000 Morocco 43,000

Access to quality diabetes care has an impact on life with T1D in 2024, which ranges from 6 years in
expectancy and varies markedly around the world. one Sub-Saharan African country to over 66 years
Map 3.10 shows the estimated average remaining life in some high-income countries.
expectancy for a 10-year-old child diagnosed

Map 3.10: Remaining life expectancy of a 10-year-old child diagnosed with type 1 diabetes in 2024.

<15 years
15-29 years
30-44 years
45-59 years
≥60 years
No estimates

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 69

In 2024 there were an estimated 168,000 premature One new feature of the T1D Index is its ability to
deaths due to T1D among which 30,000 were in the estimate ‘Missing Prevalence’ (the number of people
SEA Region, 31,000 in AFR, 34,000 in EUR, 18,000 in who would still be living in 2024 if they had not
NAC, 27,000 in MENA, 14,000 in WP, and 14,000 developed T1D) The number is estimated to be 4.0
in SACA. million. This highlights the substantial past and
current premature mortality associated with T1D.
Notably, approximately 30,000 of T1D deaths in
2024 were in non-diagnosed individuals under 25 Many gaps in T1D epidemiological knowledge
years of age who died within 12 months of the onset remain, particularly with regard to mortality and
of symptoms. These young people develop typical prevalence. There are also gaps in our knowledge of
symptoms and signs of T1D, including passing too T1D incidence, especially in adults. The difficulty of
much urine, drinking excessive amounts of water and distinguishing T1D from type 2 diabetes in adults is
unexpected weight loss. In time, if not diagnosed and an area that requires further investigation.22,23
treated, diabetic ketoacidosis develops. Regretfully,
Full data are available at the T1D Index website:
T1D is frequently misdiagnosed as pneumonia,
www.t1dindex.org.
gastroenteritis, malaria, typhoid, appendicitis or other
condition.18 Without a fast and accurate diagnosis, the
child or young adult dies quickly. Health professional
and community education and awareness initiatives
have been shown to reduce the rate of ketoacidosis
in some high-income countries19 and increase T1D
diagnosis rates in low-income countries.20,21

70 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

References
1. IDF Diabetes Atlas scientific papers and posters. 15. Gregory, G. A. et al. Global incidence, prevalence,
https://diabetesatlas.org/scientific-papers- and mortality of type 1 diabetes in 2021 with
and-posters/ projection to 2040: a modelling study. Lancet
Diabetes Endocrinol 10, 741–760 (2022).
2. Manne-Goehler, J. et al. Health system
performance for people with diabetes in 28 low- 16. Ogle, G. D. et al. The T1D Index: Implications
and middle-income countries: A cross-sectional of Initial Results, Data Limitations, and Future
study of nationally representative surveys. PLoS Development. Curr Diab Rep 23, 277–291 (2023).
Med 16, e1002751 (2019).
17. Ogle, G. et al. Global type 1 diabetes prevalence,
3. Chan, J. C. N. et al. The Lancet Commission on incidence, and mortality estimates 2025: Results
diabetes: using data to transform diabetes care from the International Diabetes Federation Atlas,
and patient lives. Lancet 396, 2019–2082 (2021). 11th Edition and the T1D Index. Diabetes Res Clin
Pract (2025).
4. Dall, T. M. et al. The economic burden of elevated
blood glucose levels in 2012: diagnosed and 18. Ogle, G. D., Middlehurst, A. C. & Silink, M. The IDF
undiagnosed diabetes, gestational diabetes Life for a Child Program Index of diabetes care for
mellitus, and prediabetes. Diabetes Care 37, children and youth. Pediatr Diabetes 17, 374–384
3172–3179 (2014). (2016).

5. United Nations Department of Economic and 19. Cherubini, V. et al. Effectiveness of ketoacidosis
Social Affairs. World Population Prospects: the prevention campaigns at diagnosis of type 1
2022 Revision. New York, USA, 2022. diabetes in children: A systematic review and
meta-analysis. Diabetes Res Clin Pract 175, 108838
6. NCD Risk Factor Collaboration (NCD-RisC). Global (2021).
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based on fasting glucose and hemoglobin A1c. Nat 20. Sandy, J. L. et al. Rapid increases in observed
Med 29, 2885–2901 (2023). incidence and prevalence of Type 1 diabetes in
children and youth in Mali, 2007-2016. Pediatr
7. American Diabetes Association. Economic Costs Diabetes 22, 545–551 (2021).
of Diabetes in the U.S. in 2017. Diabetes Care 41,
917–928 (2018). 21. Sagna, Y. et al. Incidence, prevalence, and mortality
of type 1 diabetes in children and youth in Burkina
8. Peters, M. L., Huisman, E. L., Schoonen, M. & Faso 2013-2022. Diabetes Res Clin Pract 207, 111086
Wolffenbuttel, B. H. R. The current total economic (2024).
burden of diabetes mellitus in the Netherlands.
Neth J Med 75, 281–297 (2017). 22. Tomic, D., Harding, J. L., Jenkins, A. J., Shaw, J. E. &
Magliano, D. J. The epidemiology of type 1 diabetes
9. Yang, W. et al. Medical care and payment for mellitus in older adults. Nat Rev Endocrinol 21,
diabetes in China: enormous threat and great 92–104 (2025).
opportunity. PLoS One 7, e39513 (2012).
23. Leslie, R. D. et al. Adult-Onset Type 1 Diabetes:
10. International Diabetes Federation. IDF Diabetes Current Understanding and Challenges. Diabetes
Atlas, 8th edition. Brussels, Belgium; 2017. Care 44, 2449–2456 (2021).

11. International Diabetes Federation. IDF Diabetes

Atlas, 7th edition. Brussels, Belgium; 2015.

12. International Diabetes Federation. IDF Diabetes

Atlas, 6th edition. Brussels, Belgium; 2013.

13. International Diabetes Federation. IDF Diabetes

Atlas, 5th edition. Brussels, Belgium; 2011.

14. International Diabetes Federation. IDF Diabetes

Atlas, 4th edition. Brussels, Belgium; 2009.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 71

4
Nupur Lalvani, India - Living with type 1 diabetes

Diabetes by region
74 Africa
76 Europe
78 Middle-East and North Africa
80 North America and the Caribbean
82 South and Central America
84 South-East Asia
86 Western Pacific

72 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Key messages:

The total number of people with diabetes in the IDF Africa

Region is predicted to increase by 142% to 60 million by
2050, the highest percentage increase of all IDF Regions.

The IDF Europe Region has the highest number of people

with type 1 diabetes (2.7 million).

1 in 6 adults has diabetes in the IDF Middle-East and North

Africa Region – 85 million. The highest proportion of all
IDF Regions.

The North America and Caribbean Region has the highest

diabetes-related expenditure (USD 439 billion), 43% of
global expenditure.

1 in 3 (30.4%) adults living with diabetes in the IDF South

and Central America Region are undiagnosed.

1 in 3 live births in the IDF South-East Asia Region are

affected by hyperglycaemia in pregnancy, the highest
proportion of all IDF Regions.

Western Pacific is the IDF region with the highest number

of adults living with diabetes (215 million) – 1 in 8.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 73

 Diabetes in Africa
2024

Estimates are provided for 49 Sub-Saharan African Map 4.1 Age-standardised prevalence
countries and territories in the IDF Africa (AFR) Region. (%) of diabetes (20–79 years), IDF Africa
For this edition of the IDF Diabetes Atlas, a total of Region 2024.
35 data sources from 27 countries met the inclusion
criteria. About half (45%) of the countries in the IDF
AFR Region lack high-quality, in-country data sources.
Only three countries (Cape Verde, Gambia and Sao
Tome and Principe) had studies conducted within
the past five years.
Despite the lowest prevalence estimate of 5.0%
among IDF Regions, the expected increase in the
number of people with diabetes by 2050 is the
highest at 142%, reaching 60 million. The AFR Region
is also predicted to have the highest increase in the
number of people with impaired glucose tolerance <5%
and impaired fasting glucose by 2050, reaching 135 5-<6%
million (138% increase) and 88 million (134% increase)
6-<7%
respectively. The proportion of undiagnosed diabetes
≥7%
is also highest of all the IDF Regions at 72.6%.
Diabetes care receives the lowest level of investment
in the AFR Region, with only 10 billion USD spent on
diabetes, representing a mere 1% of the total spent
worldwide, despite the Region being home to 11.4%
of people with diabetes worldwide.

Figure 4.1 Estimated prevalence (%) of diabetes by age and sex, IDF Africa Region 2024.

9.0
8.0
Prevalence (%)

7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)
Women Men

74 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

At a glance Top 5 countries

2024 2050 2024 2050

Adult population 581m 1.2b Top five countries for number of people
(20-79 years) with diabetes (20-79 years)
Diabetes (20-79 years) Nigeria 3.0m 6.6m
Regional prevalence 4.2% 5.0% United Republic 2.9m 7.6m
of Tanzania
Age-standardised 5.0% 5.9%
prevalence Democratic Republic 2.9m 7.3m
of the Congo
Number of people with 25m 60m
diabetes (20-79 years) South Africa 2.3m 4.0m
Number of deaths 216,000 Ethiopia 2.3m 6.0m
due to diabetes
(20-79 years) Top five countries for age-standardised prevalence
of people with diabetes (20-79 years)
Healthcare expenditure due to diabetes (20-79 years)
Sao Tome and Principe 12.1% 13.7%
Total healthcare 10.0b 18.0b
expenditure, USD Comoros 10.8% 12.7%

Impaired glucose tolerance (20-79 years) Zambia 10.3% 12.5%

Regional prevalence 9.8 11.3 United Republic 9.8% 11.2%

of Tanzania
Age-standardised 11.5 13.7
prevalence Seychelles 10.1% 10.1%

Number of people 57.0m 135m m = million | b = billion

with impaired
glucose tolerance

Impaired fasting glucose (20-79 years) Highlights

Regional prevalence 6.5 7.4
● 
1 in 20 adults have diabetes — 25 million.
Age-standardised 6.6 7.4
prevalence ● 
The total number of adults with diabetes
is predicted to increase by 142% to 60
Number of people 38m 88m million by 2050, the highest percentage
with impaired
increase of all IDF Regions.
glucose tolerance
● 
4 in 5 (73%) adults living with diabetes
Undiagnosed diabetes (20-79 years)
are undiagnosed, the highest proportion
Regional proportion 72.6% of all IDF Regions.

Number of people with 18m ● 

Diabetes was responsible for 216,000
undiagnosed diabetes deaths in 2024.
Type 1 diabetes (all age groups) ● 
Africa has the lowest diabetes-related
expenditure (USD 10 billion) associated
Number of people with 352,000
type 1 diabetes with diabetes, 1% of global expenditure.
● 
1 in 7 live births are affected by
hyperglycaemia in pregnancy.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 75

 Diabetes in Europe
2024

Estimates were produced for 60 countries and The estimated diabetes prevalence (9.8%) and the
territories in the IDF Europe (EUR) Region. A total of number of people with diabetes (66 million) in the
71 data sources from 41 countries met our inclusion EUR Region will see a 10% increase by 2050. The EUR
criteria and were used to generate the diabetes Region has the highest number of people with type
estimates for adults in the Region. Estimates for 1 diabetes (2.7 million), 15% of whom are people <20
nine countries (Bulgaria, United Kingdom, Russian years (419,000). In 2024, an estimated 193 billion USD
Federation, Lithuania, Denmark, Israel, Italy, United was spent on diabetes in the EUR Region, representing
Kingdom, Uzbekistan) were based on studies 19% of the total spent worldwide. The Region has the
conducted within the past five years. second highest average cost per person with diabetes
(USD 2,951).

Map 4.2 Age-standardised prevalence (%) of diabetes (20–79 years), IDF Europe
Region 2024.

<5%
5-<6%
6-<7%
7-<8%
≥8%

Figure 4.2 Estimated prevalence (%) of diabetes by age and sex, IDF Europe Region 2024.

30.0

25.0
Prevalence (%)

20.0

15.0

10.0

5.0

0.0

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)

Women Men

76 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

At a glance Top 5 countries

2024 2050 2024 2050

Adult population 672m 659m Top five countries for number of people
(20-79 years) with diabetes (20-79 years)

Diabetes (20-79 years) Turkey 9.6m 14.1m

Regional prevalence 9.8% 11.0% Russian Federation 7.6m 7.7m

Age-standardised 8.0% 9.4% Germany 6.5m 6.1m

prevalence
Italy 5.0m 4.7m
Number of people with 66m 72m
diabetes (20-79 years) Spain 4.7m 4.9m

Number of deaths 433,000 Top five countries for age-standardised prevalence

due to diabetes of people with diabetes (20-79 years)
(20-79 years)
Turkey 16.5% 18.6%
Healthcare expenditure due to diabetes (20-79 years)
Montenegro 10.7% 12.3%
Total healthcare 193b 179b
Albania 10.6% 12.3%
expenditure, USD
Portugal 10.5% 12.2%
Impaired glucose tolerance (20-79 years)
Croatia 10.5% 12.2%
Regional prevalence 6.8% 7.0%
m = million | b = billion
Age-standardised 5.9% 6.2%
prevalence

Number of people 45.9m 46.2m

with impaired Highlights
glucose tolerance
● 
1 in 10 adults have diabetes – 66 million.
Impaired fasting glucose (20-79 years)
● 
1 in 3 (34%) adults living with diabetes
Regional prevalence 5.9% 6.0%
are undiagnosed.
Age-standardised 5.3% 5.7%
● 
1 in 7 live births are affected by
prevalence
hyperglycaemia in pregnancy.
Number of people 39.7m 40.4m
with impaired ● 
The Region has the highest
glucose tolerance number of people with type 1 diabetes
(2.7 million).
Undiagnosed diabetes (20-79 years)
● 
Diabetes-related expenditure totals USD
Regional proportion 33.6% 193 billion – 19% of global expenditure.
Number of people with 22m ● 
The Region has the second highest
undiagnosed diabetes
average cost per person with diabetes
Type 1 diabetes (all age groups) (20-79 years) – USD 2,951.

Number of people with 2.7m

type 1 diabetes

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 77

 Diabetes in Middle-East and North Africa
2024

Estimates were made for 21 countries and territories a predicted 163 million by 2050. The MENA Region has
in the IDF Middle-East and North Africa (MENA) 1.4 million people with type 1 diabetes. The Region
Region. A total of 34 data sources from 18 countries has the highest percentage (21.6%) of diabetes-
were used to estimate diabetes prevalence among related deaths in people of working age (<60 years).
adults aged between 20 and 79 years. Three countries: Despite being home to 14.4% of people with diabetes
Islamic Republic of Iran, State of Palestine and Jordan worldwide, only 35 billion USD was spent on diabetes
had studies conducted within the past five years. in the Region, representing 3.4% of the total
invested worldwide.
The MENA Region has the highest regional prevalence
at 17.6% and the second highest expected increase
(92%) in the number of people with diabetes, reaching

Map 4.3 Age-standardised prevalence (%) of diabetes (20–79 years), IDF Middle-East and North
Africa Region 2024.

<8%
8-<10%
10-<12%
≥12%

Figure 4.3 Estimated prevalence (%) of diabetes by age and sex, Middle-East and North Africa
Region 2024.

40.0

35.0

30.0
Prevalence (%)

25.0

20.0

15.0

10.0

5.0

0.0

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)

Women Men

78 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

At a glance Top 5 countries

2024 2050 2024 2050

Adult population 480m 773m Top five countries for number of people
(20-79 years) with diabetes (20-79 years)

Diabetes (20-79 years) Pakistan 35.0m 70.0m

Regional prevalence 17.6% 21.0% Egypt 13.0m 25.0m

Age-standardised 19.9% 22.8% Islamic Republic of Iran 5.5m 8.2m

prevalence
Saudi Arabia 5.3m 9.5m
Number of people with 85m 163m
diabetes (20-79 years) Algeria 4.8m 7.9m

Number of deaths 467,000 Top five countries for age-standardised prevalence

due to diabetes of people with diabetes (20-79 years)
(20-79 years)
Pakistan 31.4% 34.2%
Healthcare expenditure due to diabetes (20-79 years)
Kuwait 25.6% 28.2%
Total healthcare 35b 50b
Qatar 24.6% 27.0%
expenditure, USD
Saudi Arabia 23.1% 25.4%
Impaired glucose tolerance (20-79 years)
Egypt 22.4% 25.7%
Regional prevalence 10.4% 11.0%
m = million | b = billion
Age-standardised 11.0% 11.6%
prevalence

Number of people 50m 85m

with impaired Highlights
glucose tolerance
● 
1 in 6 adults has diabetes – 85 million.
Impaired fasting glucose (20-79 years)
The highest proportion of all IDF Regions.
Regional prevalence 7.5% 8.1%
● 
The number of adults with diabetes
Age-standardised 8.0% 8.4% is predicted to increase by 92% to 163
prevalence million by 2050 – the second highest
Number of people 36m 62m
increase of all IDF Regions.
with impaired ● 
1 in 3 adults living with diabetes
glucose tolerance
are undiagnosed.
Undiagnosed diabetes (20-79 years)
● 
The Region has the highest diabetes
Regional proportion 37.2% prevalence in older adults (32.3%).

Number of people with 32m ● 

Diabetes-related expenditure totals
undiagnosed diabetes USD 35 billion in 2024.
Type 1 diabetes (all age groups) ● 
1 in 5 live births are affected by
hyperglycaemia in pregnancy.
Number of people with 1.4m
type 1 diabetes

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 79

 Diabetes in North America and Caribbean
2024

Estimates were made for Canada, Mexico, the United Map 4.4 Age-standardised prevalence
States of America and 22 Caribbean countries and (%) of diabetes (20–79 years), IDF North
territories in the IDF North America and Caribbean America and Caribbean Region 2024.
(NAC) Region. Estimates for diabetes in adults in the
Region were based on 21 data sources, representing
15 of the 22 countries. Estimates for Mexico and USA
were based on studies conducted within the past
five years.
The NAC Region has the second highest diabetes
prevalence among IDF Regions at 15.1%. IDF projects
that the number of people with diabetes in the NAC
Region will increase by 22%, to reach 68 million by
2050. The NAC Region has the second highest number
of people with type 1 diabetes – 1.9 million in total.
The NAC Region has the highest proportion (21.4%) of
diabetes-related mortality to all-cause mortality and
the second highest number of deaths due to diabetes
(526,000) among IDF Regions. The NAC Region has the
highest diabetes-related expenditure (USD 439 billion), <10%

43% of global expenditure, and has the highest 10-<11%

average cost per person with diabetes (20–79 years) 11-<12%

at USD 7,811. ≥12%

Figure 4.4 Estimated prevalence (%) of diabetes by age and sex, IDF North America and
Caribbean Region 2024.

40.0

35.0

30.0
Prevalence (%)

25.0

20.0

15.0

10.0

5.0

0.0

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)

Women Men

80 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

 At a glance Top 5 countries

2024 2050 2024 2050

Adult population 373m 415m Top five countries for number of people
(20-79 years) with diabetes (20-79 years)

Diabetes (20-79 years) United States 39.0m 43.0m

of America
Regional prevalence 15.1% 16.4%
Mexico* 14.0m 20.0m
Age-standardised 13.8% 15.3%
prevalence Canada 2.8m 3.3m

Number of people with 56m 68m Haiti 542.0t 884.0t

diabetes (20-79 years)
Jamaica 236.0t 329.0t
Number of deaths 526,000
due to diabetes Top five countries for age-standardised prevalence
(20-79 years) of people with diabetes (20-79 years)

Healthcare expenditure due to diabetes (20-79 years) Mexico 16.4% 18.0%

Total healthcare 439b 446b Guyana 16.4% 17.9%

expenditure, USD
Belize 14.1% 14.9%
Impaired glucose tolerance (20-79 years)
St Kitts and Nevis 13.8% 15.8%
Regional prevalence 12.5% 13.3% Suriname 13.8% 15.2%
Age-standardised 11.6% 12.6% t = thousand | m = million | b = billion
prevalence

Number of people 47m 55m

with impaired
glucose tolerance Highlights
Impaired fasting glucose (20-79 years) ● 
1 in 7 adults have diabetes – 56 million.
Regional prevalence 14.2% 14.8% ● 
The Region has the second highest
Age-standardised 13.6% 14.3% diabetes prevalence (15.1%) of all
prevalence IDF Regions.

Number of people 53m 62m ● 

1 in 3 adults living with diabetes
with impaired are undiagnosed.
glucose tolerance
● 
The Region has the highest diabetes-
Undiagnosed diabetes (20-79 years) related expenditure (USD 439 billion),
Regional proportion 29.1% 43% of global expenditure.

Number of people with 16m ● 

The Region has the highest proportion
undiagnosed diabetes of diabetes-related mortality, 21.4%.

Type 1 diabetes (all age groups) ● 

The Region has the second highest
number of people with type 1 diabetes
Number of people with 1.9m – 1.9 million in total.
type 1 diabetes
● 
The Region has the highest average cost
per person with diabetes (20-79 years)
– USD 7,811.
● 
1 in 4 live births are affected by
hyperglycaemia in pregnancy, the second
highest prevalence among all IDF regions.

*At the time of analysing the data for this edition, Mexico was included in the country listing for the IDF NAC Region.
The country will be listed among the countries in the IDF SACA Region for future editions.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 81

 Diabetes in South and Central America
2024

Estimates were made for 19 countries and Map 4.5 Age-standardised prevalence (%)
territories in the IDF South and Central of diabetes (20–79 years), IDF South and
America (SACA) Region. Estimates for Central America Region 2024.
diabetes prevalence in adults aged 20–79
years were based on 29 data sources from
15 countries. Five countries: Brazil, Peru,
Brazil, Panama and Bolivia had studies
conducted within the past five years.
IDF projects that the number of people with
diabetes in the SACA Region will increase by
46%, reaching 52 million by 2050. Over the
same period, the prevalence of diabetes will
increase by 23%, reaching 12.3%. In 2024,
81 billion USD was spent on diabetes in
the SACA Region, representing 8% of total
expenditure worldwide. <6%
6-<7%
7-<8%
8-<9%
≥9%

Figure 4.5 Estimated prevalence (%) of diabetes by age and sex, IDF South and Central America
Region 2024.

30.0

25.0
Prevalence (%)

20.0

15.0

10.0

5.0

0.0

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)

Women Men

82 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

At a glance Top 5 countries

2024 2050 2024 2050

Adult population 355m 420m Top five countries for number of people
(20-79 years) with diabetes (20-79 years)

Diabetes (20-79 years) Brazil 17.0m 24.0m

Regional prevalence 10.0% 12.3% Argentina 4.3m 5.9m

Age-standardised 10.1% 11.5% Colombia 3.0m 4.3m

prevalence
Chile 1.9m 2.4m
Number of people with 35m 52m
diabetes (20-79 years) Venezuela 1.6m 2.4m

Number of deaths 224,000 Top five countries for age-standardised prevalence

due to diabetes of people with diabetes (20-79 years)
(20-79 years)
Dominican Republic 17.6% 19.9%
Healthcare expenditure due to diabetes (20-79 years)
Argentina 14.0% 15.4%
Total healthcare 81b 95b
Guatemala 13.2% 13.8%
expenditure, USD
El Salvador 12.7% 14.8%
Impaired glucose tolerance (20-79 years)
Chile 12.2% 13.7%
Regional prevalence 10.9% 12.4%
m = million | b = billion
Age-standardised 11.0% 12.0%
prevalence

Number of people 39m 52m

with impaired Highlights
glucose tolerance
● 
1 in 10 adults have diabetes – 35 million.
Impaired fasting glucose (20-79 years)
● 
The number of adults with diabetes
Regional prevalence 9.1% 10.3%
is expected to increase by 46% to 52
Age-standardised 9.2% 10.0% million by 2050.
prevalence
● 
1 in 3 adults living with diabetes
Number of people 32m 43m (30.4%) are undiagnosed.
with impaired
glucose tolerance ● 
Diabetes is responsible for 224,000
deaths in 2024.
Undiagnosed diabetes (20-79 years)
● 
797,000 people live with type 1 diabetes.
Regional proportion 30.4%
● 
Diabetes-related expenditure totals
Number of people with 11m USD 81 billion in 2024.
undiagnosed diabetes
● 
1 in 6 live births are affected by
Type 1 diabetes (all age groups)
hyperglycaemia in pregnancy.
Number of people with 797,000
type 1 diabetes

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 83

 Diabetes in South-East Asia
2024

Estimates were made for the seven countries and Map 4.6 Age-standardised prevalence (%)
territories in the IDF South-East Asia (SEA) Region. of diabetes (20–79 years), IDF South-East
All countries except Bhutan had primary data Asia Region 2024.
sources, which were used to generate estimates
for diabetes in adults aged 20–79 years. A total of
nine data sources from these six countries were
used. Estimates for Mauritius, India and Sri Lanka
were based on studies conducted within the past
five years.
IDF projects that the number of people with
diabetes in the SEA Region will increase by 73%,
reaching 185 million by 2050. Over the same period,
the prevalence of diabetes will increase 36% to reach
13.2%. The proportion of undiagnosed diabetes
is the third highest of the seven IDF Regions at
42.7%. The proportion of pregnancies affected by
hyperglycaemia is also the highest at 27.8%.
Only 12 billion USD was spent on diabetes in the SEA <9%

Region, representing a mere 1% of the total spent 9-<10%

≥10%
worldwide, despite the region being home to 18.2%
of people with diabetes worldwide.

Figure 4.6 Estimated prevalence (%) of diabetes by age and sex, IDF South-East Asia Region 2024.

25.0

20.0
Prevalence (%)

15.0

10.0

5.0

0.0

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)
Women Men

84 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

At a glance Top 5 countries

2024 2050 2024 2050

Adult population 1.1b 1.4b Top five countries for number of people
(20-79 years) with diabetes (20-79 years)

Diabetes (20-79 years) India 90.0m 157.0m

Regional prevalence 9.7% 13.2% Bangladesh 14.0m 23.0m

Age-standardised 10.8% 13.0% Sri Lanka 1.6m 1.9m

prevalence
Nepal 1.3m 2.4m
Number of people with 106.9m 184.5m
diabetes (20-79 years) Mauritius 218.0t 248.0t

Number of deaths 374,000 Top five countries for age-standardised prevalence of

due to diabetes people with diabetes (20-79 years)
(20-79 years)
Mauritius 20.1% 23.5%
Healthcare expenditure due to diabetes (20-79 years)
Bangladesh 13.2% 15.4%
Total healthcare 11.5b 17.5b
Bhutan 12.0% 13.8%
expenditure, USD
India 10.5% 12.8%
Impaired glucose tolerance (20-79 years)
Sri Lanka 10.2% 12.0%
Regional prevalence 13.3% 14.7%
t = thousand | m = million | b = billion
Age-standardised 13.8% 14.6%
prevalence

Number of people 145.7m 204.9m

with impaired Highlights
glucose tolerance
● 
1 in 10 adults have diabetes – 107 million.
Impaired fasting glucose (20-79 years)
● 
India accounts for 1 in 7 of all adults
Regional prevalence 11.8% 12.9%
living with diabetes worldwide.
Age-standardised 12.2% 12.8%
● 
The number of adults living with
prevalence
diabetes is predicted to increase by
Number of people 129.4m 180.9m 73% to 185 million by 2050.
with impaired
glucose tolerance ● 
Almost 1 in 2 (42.7%) adults living
with diabetes are undiagnosed.
Undiagnosed diabetes (20-79 years)
● 
Diabetes was responsible for an estimated
Regional proportion 42.7% 374,000 deaths in 2024.
Number of people with 46m ● 
Total diabetes-related expenditure in
undiagnosed diabetes
the Region amounts to USD 12 billion –
Type 1 diabetes (all age groups) the second lowest of all IDF Regions.

Number of people with 1m ● 

1 in 3 live births are affected by
type 1 diabetes hyperglycaemia in pregnancy.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 85

 Diabetes in Western Pacific
2024

Estimates were made for 37 countries and Map 4.7 Age-standardised prevalence (%)
territories in the IDF Western Pacific (WP) Region. of diabetes (20–79 years), IDF Western
For this edition of the IDF Diabetes Atlas, 40 data Pacific Region 2024.
sources from 28 countries were used to generate
estimates of diabetes in adults aged 20–79 years.
Estimates for Australia, Vietnam, Republic of
Korea, Singapore, Malaysia and Mongolia were
based on studies conducted within the past
five years.
The WP Region accounts for over a third (37%)
of the total number of adults living with diabetes.
The WP Region has the third highest prevalence of
diabetes (12.4%) in the world. IDF projects that the
number of people with diabetes in the WP Region
will increase by 18%, reaching 254 million by 2050,
and that the prevalence of diabetes will increase
by 19% to reach 14.7% in 2050. The proportion of
undiagnosed diabetes (50%) is the second highest
of all IDF Regions. Diabetes is responsible for 1.2 <8%
million deaths in 2024, the highest number of all 8-<10%
IDF Regions. Diabetes-related expenditure in
10-<12%
2024 totals USD 246 billion, the second highest
≥12%
of all IDF Regions and representing 24% of
global expenditure.

Figure 4.7 Estimated prevalence (%) of diabetes by age and sex, IDF Western Pacific Region 2024.

30.0

25.0
Prevalence (%)

20.0

15.0

10.0

5.0

0.0

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79

Age (years)

Women Men

86 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

At a glance Top 5 countries

2024 2050 2024 2050

Adult population 1.74b 1.72b Top five countries for number of people
(20-79 years) with diabetes (20-79 years)

Diabetes (20-79 years) China 148.0m 168.3m

Regional prevalence 12.4% 14.7% Indonesia 20.4m 28.6m

Age-standardised 11.1% 12.8% Japan 10.1m 9.4m

prevalence
Thailand 6.4m 6.6m
Number of people with 215m 254m
diabetes (20-79 years) Republic of Korea 5.0m 5.1m

Number of deaths 1.2m Top five countries for age-standardised prevalence

due to diabetes of people with diabetes (20-79 years)
(20-79 years)
Marshall Islands 25.7% 28.7%
Healthcare expenditure due to diabetes (20-79 years)
Samoa 25.4% 27.2%
Total healthcare 246.3b 237.7b
Kiribati 24.6% 28.5%
expenditure, USD
French Polynesia 22.8% 23.9%
Impaired glucose tolerance (20-79 years)
New Caledonia 22.0% 23.3%
Regional prevalence 14.4% 15.5%
m = million | b = billion
Age-standardised 13.5% 14.3%
prevalence

Number of people 251m 268m

with impaired Highlights
glucose tolerance
● 
1 in 8 adults have diabetes – 215 million.
Impaired fasting glucose (20-79 years)
● 
The Region accounts for over a third
Regional prevalence 9.1% 9.9%
(37%) of the total number of adults living
Age-standardised 8.6% 9.2% with diabetes.
prevalence
● 
China accounts for 1 in 4 of all adults
Number of people 160m 171m living with diabetes worldwide.
with impaired
glucose tolerance ● 
Half (50%) of adults living with diabetes
in the Region are undiagnosed.
Undiagnosed diabetes (20-79 years)
● 
Diabetes was responsible for 1.2 million
Regional proportion 50.0% deaths in 2024 – the highest number of
Number of people with 108m all IDF Regions.
undiagnosed diabetes
● 
Diabetes-related expenditure in 2024
Type 1 diabetes (all age groups) totals USD 246 billion – 24% of global
expenditure.
Number of people with 991,000
type 1 diabetes ● 
1 in 5 live births are affected by
hyperglycaemia in pregnancy.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 87

5
Ana Alvarez, Spain - Living with type 1 diabetes

Diabetes complications
90 5.1 Type 2 diabetes and the risk of cardiovascular diseases
92 5.2 Diabetes and the risk of dementia
95 5.3 Diabetes-related eye disease
98 References

88 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Key messages:
People with type 2 diabetes are at higher risk of
cardiovascular diseases, including a 72% higher
risk of heart attack, a 52% higher risk of stroke,
and an 84% higher risk of heart failure.

People with diabetes have a 56% higher risk of

dementia compared with people who do not
have diabetes.

The earlier someone develops type 2 diabetes,

the higher their chance of dementia in later life.

Close to one in four adults with diabetes have

some form of diabetes-related retinopathy.

More than one in ten people with some form of

diabetes-related retinopathy are at risk of losing
their vision or have lost it already.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 89

5.1 Type 2 Diabetes and the risk of cardiovascular diseases
Cardiovascular diseases (CVD) are a leading cause of of Science. The search identified nine studies that met
illness and death among people with type 2 diabetes our inclusion criteria (i.e. population representative
(T2D).1–3 Diabetes-related metabolic changes include studies in people with type 2 diabetes and without
elevated blood glucose, increased levels of fat in the diabetes who have experienced cardiovascular
blood (including high cholesterol and triglycerides), incidents). We selected studies since the last meta-
high blood pressure, as well as weight gain and a analysis undertaken by the Emerging Risk Factor
build-up of ectopic fat (excess fat within vital tissues Collaborative group in 2010. New studies all focused
that do not typically contain it, such as the liver, on risks in individuals with T2D compared to those
muscles, heart, and pancreas). Together, these without and studies that adequately captured
factors significantly increase the risk of serious heart atherosclerotic cardiovascular disease (ASCVD) risk,
diseases, including heart attack, stroke, and heart stroke, myocardial infarction and heart failure. Where
failure.4 This chapter explores the latest research data clearly appeared to be from the same country
on how T2D might increase the risk of developing covering similar or overlapping patient populations,
heart-related diseases, with some additional data the latest representative data were included.
on cardiovascular risk in people with undiagnosed
The included studies came from Australia, China,
diabetes and pre-diabetes.
Hungary, Italy, Sweden, Taiwan (POC), the UK and
the US. The studies included a total of over 6.3 million
Risk of cardiovascular diseases in people with
individuals. Among these individuals, more than 1.02
type 2 diabetes
million had T2D with reported CVD incidents. The
A systematic review of the latest evidence up findings from these studies were then pooled
to December 2024 was conducted using major in a meta-analysis (Figure 5.1).3,5–21
databases, including MEDLINE, SCOPUS, and Web

Findings from these studies indicate that, compared

to those without diabetes, people with T2D face:

60%
higher
of developing any form 54%
higher of stroke
of CVD
risk risk

73%
higher
of myocardial infarction 84%
higher of heart failure
(heart attack)
risk risk

Considerable differences between the studies reflect, greater obesity and longer time to exposure to risk
in part, adjustments for conventional risk factors, but factors. In people with pre-diabetes and undiagnosed
other factors are also likely to be relevant, especially diabetes in the UK, and after adjustment for classical
in the context of heart failure, which could reflect risk factors, cardiovascular risks were 11% (2-30%)
different diagnostic practices across countries. and 20% (4-38%) higher relative to those with normal
glycaemia (HbA1c <42 mmol/mol), respectively.23
Notably, the greater relative risk of CVD events in
women with diabetes is likely due to the low risk A major limitation of these cardiovascular findings
in women without diabetes, though absolute risk is the lack of data from low- and middle-income
remains higher in men with T2D.22 The absolute countries (LMICs), making it impossible to estimate
lifetime risk is, however, substantially greater in the true burden of non-fatal CVD among people
people who develop T2D when much younger (e.g. with T2D in these regions.
<40 years) as compared to later in life, linked to far

90 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Gaps to be addressed
The IDF Diabetes Atlas highlights critical data gaps To address these gaps, improving data collection
in the capture of cardiovascular outcome data that and strengthening healthcare infrastructure in LMICs
compare risks in people living with and without would be essential. Expanding global surveillance
T2D in LMICs. Studies suggest that individuals with systems and investing in targeted healthcare
diabetes in these countries face a higher risk of interventions will be crucial in mitigating the growing
diabetes-related deaths compared to those in high- impact of diabetes-related cardiovascular diseases in
income countries (HICs).2 For instance, the rates of these vulnerable populations.
heart-related mortality among people with diabetes
are significantly higher in low-income countries (LICs) Summary
(5.7 per 1,000 person-years) compared to middle- The evidence reinforces the link between diabetes
income countries (MICs) (2.2) and HICs (1.0).2 These and cardiovascular diseases, emphasising the need
disparities highlight the greater risk of adverse for early detection, comprehensive management, and
cardiovascular outcomes in LICs. However, the lack public health interventions to mitigate the risks. As
of comprehensive data in these regions on non- the global prevalence of diabetes continues to rise,
fatal outcomes in representative population studies tackling its cardiovascular complications must
limits an understanding of the full extent of diabetes remain a priority for healthcare systems and
cardiovascular complications in these regions, which policymakers worldwide.
will also be changing over time due to multiple,
potentially opposing, changes in preventative
medications versus increases in incidence, especially
at younger ages.

Figure 5.1 Meta-analysis of the incidence risk of atherosclerotic cardiovascular disease,

stroke, myocardial infarction, and heart failure in people with type 2 diabetes versus
those without diabetes.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 91

5.2 Diabetes and the risk of dementia
Globally, an estimated 57.4 million people currently
live with dementia. This figure is projected to increase
to 152.8 million by 2050, largely due to population
ageing.24 Dementia incidence is expected to increase
more in low- and-middle-income countries than in
high-income countries. The most common type of
dementia is caused by Alzheimer’s disease (65%),
followed by vascular dementia, which comprises about
20% of cases. Diabetes has been associated with
an increased risk of cognitive decline and dementia
in cohort studies for over 20 years.25 The 2024
Lancet Commission report on dementia26 estimates
that diabetes accounts for 2.6% of dementia cases
globally. Diabetes is associated with midlife obesity,
and hypertension, which are both risk factors for
dementia.27 Diabetes also increases the risk of stroke,3 The younger a person
and dementia occurs in approximately 16.5% of older develops T2D, the higher
adults within 6-18 months of stroke.28 In general, T2D
has been shown to have a greater impact on the risk the risk of developing
of vascular dementia (VaD) than Alzheimer’s disease dementia in later life.
(AD), which is borne out in neuropathological studies
as well as epidemiological research.29

Figure 5.2 Relative risks of dementia in midlife, late life and combined age ranges.

2.5

1.5

1.78 1.48 1.56

0.5

Midlife (<65 years) Late life (≥ 65 years) Combined

Age group

92 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Systematic review of current evidence on incidence The proportion of dementia cases in the population
and prevalence of dementia in T2D that can be attributed to having diabetes was
estimated using the IDF Diabetes Atlas prevalence data
The IDF Diabetes Atlas conducted a systematic review for 2024 and 205030 and the relative risk estimates in
and meta-analysis of the global literature to obtain our meta-analysis using Levin’s equation.31 Map 5.1
up-to-date estimates of the risk of dementia in people shows the cases of dementia globally attributable to
living with diabetes. In order to be included, articles diabetes in 2024, and Map 5.2 shows the same figures
had to be population-based, include more than 100 projected for 2050 using data from the IDF Diabetes
participants and report data on the diagnosis of Atlas 11th Edition.
diabetes and dementia from clinical tests or medical
records using established criteria. Of 127 articles Limitations
identified, 34 had the required data on both diabetes
and dementia to be included in the meta-analyses. The Epidemiological studies primarily classify dementia
relative risk of dementia for people with diabetes was subtypes according to clinical symptoms and not
estimated with mean age < 65 as 1.78 and for studies biomarkers. Hence there is likely some degree of
that had a mean age of ≥ 65 as 1.48 (Figure 5.2). misclassification of AD, and VaD. In addition, many
older adults have mixed pathology. Diabetes may lead
There were insufficient studies to differentiate by to shorter life expectancy due to other conditions such
age group when considering subtypes of dementia. as heart disease and stroke, which means that the
Among the participants in the included studies, people meta-analysis did not account for competing causes
with diabetes had a 56% increased risk of all-cause of death. There are modifiable risk factors for
dementia. When examined by subtype, they had a 34% dementia and diabetes, as well as emerging risk
increased risk of developing Alzheimer’s disease and factors that were not considered in the cohort studies
a 103% increased risk of developing vascular which provided the data.
dementia (Figure 5.3).

Figure 5.3 Relative risk of vascular dementia (VaD), Alzheimer’s disease (AD) and all-cause
dementia in people with diabetes.

2.5

1.5

2.03 1.34 1.56

0.5

Vascular dementia Alzheimer's disease All-cause dementia

Dementia Subtype

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 93

Summary

Diabetes is a risk factor for dementia occurring both the occurrence of which depends in part on lifestyle
beyond and before age 65 years. The younger a factors. Thus, vascular dementia risk associated with
person develops T2D, the higher the risk of developing diabetes may be potentially modifiable. Intensive
dementia in later life. A recent study has indicated preventive efforts using all available interventions are
that for each year earlier that T2D is diagnosed, the required to prevent the enormous global burden of
individual’s risk of developing dementia increases disease that is projected from diabetes and dementia
by 1.9%.32 Diabetes is a cause of vascular disease, with population ageing.

Map 5.1 The proportion of dementia cases in the population attributed to diabetes, in 2024.

<3%
3-<5%
5-<8%
8-<10%
10-<15%
No estimates

Map 5.2 The proportion of dementia cases in the population attributed to diabetes, in 2050.

<3%
3-<5%
5-<8%
8-<10%
10-<15%
No estimates

94 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

 5.3 Diabetes-related eye disease
The adoption of various methods for detecting and In the UK, the introduction of systematic
defining the severity of diabetes-related retinopathy screening for diabetes-related eye disease, along
(DR), including maculopathy, has compounded the with enhancements in diabetes management,
difficulty of generalising the extent of the problem has relegated DR as a primary cause of serious
globally.33,34 However, reviewers who have attempted sight impairment (blindness) in the working-age
this task suggest that around 30% of people with population.43 Progression to referable retinopathy
diabetes show signs of DR, with a proportion below rarely occurs within two years in individuals without
10% developing sight-threatening lesions, such as retinopathy or considered to be at low risk. As a
proliferative diabetic retinopathy and/or diabetic result, the screening interval has been extended
macular oedema.33,35–37 beyond yearly to biennially, allowing those with
more advanced eye disease to be reviewed more
If left unchecked, the current global prevalence of frequently.44,45 Telemedicine has also had a significant
diabetes at 589 million and the anticipated increase positive impact on screening programmes.46,47
to 853 million by 2050 presents a monumental
challenge to global health.38 The number of people Despite all the progress in screening for DR over
living with undiagnosed diabetes and the increasing the last two decades, the Diabetic Retinopathy
prevalence of pre-diabetes39 add to this challenge, Barometer Study, conducted across41 countries,
underscoring a pressing need to take action to found considerable deficiencies in education of
address the numerous complications associated with people with diabetes, professional training48,49 and
diabetes. Among the complications, loss of vision is access to affordable treatment, especially in LMICs,
one of the most feared. Elevated blood glucose, high and among minority populations where the highest
blood pressure, renal dysfunction, and the duration disease burden resides.50,51
and type of diabetes are potent risk factors.40,41
Worryingly, there is also evidence for increased
susceptibility to retinopathy in people who develop
T2D early in life.42

Since the beginning of this century, important

advances have been made in both the diagnosis
and management of diabetes-related eye disease.
However, the application of these innovations
has varied considerably both within and between
countries and regions of the world.

Figure 5.4 The overall global prevalence of any DR per IDF Regions in 201934 and 2024.52

40 38
Prevalence of any diabetic retinopathy (%)

36
34
35
30
30
27
26
25 25
25 23
22
21 21
20
20

15 13

10

0
AFR EUR MENA NAC SACA SEA WP

IDF Region

2019 2024

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 95

The latest review of the global prevalence of DR, noted the presence of proliferative retinopathy
restricted to studies published between 2017 and (24/42, 57%), macular oedema (15/42, 36%) and
2024 where DR was assessed using retinal images, sight-threatening DR (27/42, 64%).
includes 42 studies from 21 countries involving a
total of 707,657 individuals, predominantly living with The overall global prevalence of any DR, as
T2D. The IDF Western Pacific (WP) Region contributed represented by countries within the studies across
38% (16/42) of the studies, with seven studies each the seven IDF regions, was 23.0% (95% CI: 20-26%),
from the IDF Europe (EUR) and North America and with proliferative DR at 6.0% (95% CI: 3-9%), diabetes
Caribbean (NAC) Regions, three each from IDF Africa related macular oedema 5.0% (95% CI: 4-6%), and
(AFR) and Middle East and North Africa (MENA) sight-threatening DR at 11.0% (95% CI: 9 to 14%). This
Regions, and one study from the South and Central represents a slight decrease in the prevalence of any
America (SACA) Region. A total of 39 studies recorded DR from 27% reported earlier in the IDF Diabetes Atlas
the presence of any DR, whereas a lesser number 10th Edition.34

Table 5.1 Prevalence the any diabetes-related retinopathy and sight threatening diabetes-related
retinopathy within the IDF Regions in 2024.52

Any diabetes-related retinopathy Sight threatening diabetes-related retinopathy

Modelled Modelled
IDF Number Total Number Total
Cases prevalence Cases prevalence
Region studies population studies population
(95% CI) (95% CI)

EUR 6 493,837 59,559 23 (21,26) 4 418,368 6,861 9 (1,23)

WP 16 39,102 9,341 25 (19,31) 10 33,364 3,341 10 (6,15)

SEA 4 62,735 11,555 20 (16,25) 5 63,457 3,529 11 (7,15)

SACA 1 219 54 25 (19,31) 1 219 18 8 (5,12)

NAC 6 107,789 26,068 21 (16,27) 3 58,163 3,588 16 (9,25)

MENA 3 2,505 370 27 (5,59) 2 616 110 19 (6,38)

AFR 3 1,771 451 26 (15,39) 2 1,275 114 7 (0,23)

GLOBAL 39 707,657 107,257 23 (20,26) 27 575,462 17,561 11 (9,14)

*Sight Threatening diabetes-related retinopathy - presence of severe non-proliferative retinopathy, proliferative DR, or clinically significant
macular oedema

96 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

A reduction in the prevalence of any DR was seen in This review further highlights the continuing burden
five IDF regions (AFR, MENA, NAC, SACA, WP), two of of diabetes-related eye disease worldwide52 and the
which (SACA and WP) recorded a decrease of more inherent difficulties in accurately estimating the global
than 10% (12.7% and 11.2%, respectively) (Figure 5.4). prevalence of DR in its various forms, and especially
In contrast, the remaining two regions (EUR and SEA) when attempting to make meaningful comparisons
exhibited increases of 2.4% and 7.5%, respectively over time.
(Figure 5.4). In addition, the current analysis reveals
a four-fold higher prevalence of proliferative DR than
seen previously, whereas macular oedema remains
unchanged at approximately 5%.

Table 5.2 Prevalence the proliferative diabetes-related retinopathy and macular oedema within
IDF Regions in 2024.52

Proliferative diabetes-related retinopathy Diabetes-related macular oedema

Prevalence
IDF Number Total Prevalence Number Total
Cases Cases (95% CI)
Region studies population (95% CI) studies population

EUR 1 2,272 107 5 (4,6) 0 N/A

WP 9 15,466 437 4 (2,7) 5 5,877 396 9 (6,13)

SEA 4 62,735 11,557 20 (16,25) 3 56,602 2,045 4 (2,6)

SACA 1 219 3 1 (0,4) 1 219 10 5 (2,8)

NAC 6 106,807 2,815 3 (2,4) 4 101,198 2,717 3 (2,4)

MENA 2 2,110 232 11 (10,12) 1 1,889 40 2 (1,3)

AFR 1 739 5 1 (0,2) 1 739 81 11 (9,13)

GLOBAL 24 190,348 15,156 6 (3,9) 15 166,524 5,290 5 (4,6)

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 97

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vascular dementia and Alzheimer’s disease. 40. Frank, R. N. Diabetic retinopathy. N Engl J Med
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30. Sun, H. et al. IDF Diabetes Atlas: Global, regional 41. Ting, D. S. W., Cheung, G. C. M. & Wong, T. Y.
and country-level diabetes prevalence estimates Diabetic retinopathy: global prevalence, major
for 2021 and projections for 2045. Diabetes Res risk factors, screening practices and public health
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260–277 (2016).

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42. Wong, J., Molyneaux, L., Constantino, M., Twigg, S.
M. & Yue, D. K. Timing is everything: age of onset
influences long-term retinopathy risk in type 2
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43. Liew, G., Michaelides, M. & Bunce, C. A comparison

of the causes of blindness certifications in England
and Wales in working age adults (16-64 years),
1999-2000 with 2009-2010. BMJ Open 4,
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44. Thomas, R. L. et al. Incidence of diabetic

retinopathy in people with type 2 diabetes
mellitus attending the Diabetic Retinopathy
Screening Service for Wales: retrospective analysis.
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45. Leese, G. P. et al. Progression of diabetes retinal

status within community screening programs
and potential implications for screening intervals.
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examinations for diabetic retinopathy: a time to
maximize real-world outcomes. JAMA Ophthalmol
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status and future directions. Middle East Afr J
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48. Cavan, D. et al. The Diabetic Retinopathy

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provision of diabetic retinopathy screening and
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50. Tan, T.-E. & Wong, T. Y. Diabetic retinopathy:

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100 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Appendices
102 Country summary tables
118 Abbreviations and acronyms
119 Glossary
124 List of figures, maps and tables

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 101

Country summary in IDF Africa Region
2024

Africa

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

AFR 24,600 4.2 5.0 73.0

Angola 688.8 4.1 4.9 68.8
Benin 466.8 7.1 8.1 89.8
Botswana 58.2 3.7 4.6 60.5
Burkina Faso 372.3 3.4 4.5 90.4
Burundi 214.1 3.6 4.3 60.2
Cameroon 774.2 5.6 6.9 73.1
Cabo Verde 22.0 5.6 6.8 30.8
Central African Republic 141.1 6.0 7.6 73.1
Chad 464.2 5.9 7.3 73.1
Comoros 39.0 8.6 10.8 47.5
Democratic Republic of the Congo 2,859.8 6.3 7.7 73.1
Djibouti 41.0 5.9 6.5 60.2
Equatorial Guinea 65.6 7.2 8.2 73.1
Eritrea 70.2 3.7 4.4 46.1
Eswatini 40.8 6.1 7.9 61.3
Ethiopia 2,297.3 3.6 4.4 76.4
Gabon 100.9 7.5 8.5 73.1
Gambia 54.0 4.1 5.5 78.7
Ghana 317.4 1.7 2.7 78.7
Guinea 244.6 3.5 4.6 78.7
Guinea-Bissau 39.9 3.7 4.8 78.7
Côte d'Ivoire 529.2 3.7 5.0 78.7
Kenya 813.3 2.8 3.1 53.6
Lesotho 63.3 4.8 6.2 58.2
Liberia 198.1 7.4 9.2 85.1
Madagascar 599.3 3.8 4.6 68.8
Malawi 540.1 5.5 5.7 78.7
Mali 357.4 3.6 4.8 78.7
Mauritania 95.7 4.0 5.2 78.7
Mayotte 6.4 4.1 4.6 68.8
Mozambique 404.5 2.5 3.0 88.6
Namibia 62.8 4.4 5.3 56.4
Niger 505.9 4.5 4.1 78.7
Nigeria 2,988.5 2.8 3.0 78.7
Congo 213.7 7.0 8.1 73.1
Rwanda 130.8 1.8 2.1 85.6
Sao Tome and Principe 12.4 10.7 12.1 73.1
Senegal 251.6 2.9 3.8 78.7
Seychelles 7.4 9.9 9.3 39.7
Sierra Leone 170.0 3.7 4.8 78.7
Somalia 377.6 4.8 5.8 60.2
South Africa 2,324.2 6.1 7.2 70.3
South Sudan 207.4 4.1 4.6 60.2
Togo 177.5 3.9 4.8 80.1
Uganda 369.1 1.7 2.2 61.2
United Republic of Tanzania 2,928.0 9.2 9.8 60.2
Western Sahara 22.3 5.5 5.8 78.7
Zambia 750.4 7.6 10.3 86.0
Zimbabwe 106.5 1.28 1.5 68.8

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 Age-adjusted Age-adjusted
Diabetes-related
Total Diabetes- comparative comparative
expenditure Type 1
diabetes-related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
414.3 9,931,943,458.2 216,000.0 351,955.0 12.0 7.0
470.3 323,950,519.2 5,113.0 13,960.0 7.4 8.1
130.2 60,754,792.2 3,700.1 4,001.0 9.6 7.4
2,261.4 131,664,518.0 353.0 1,330.0 7.6 4.6
167.7 62,426,663.6 2,573.2 543.0 9.3 7.0
103.1 22,082,446.3 2,058.6 2,856.0 15.8 4.2
252.0 195,127,919.5 5,439.7 8,715.0 9.8 7.9
756.2 16,650,758.5 112.8 215.0 9.8 8.4
236.7 33,388,943.4 1,520.1 243.0 9.5 7.7
110.7 51,395,689.6 6,207.2 1,158.0 9.2 6.4
182.4 7,106,522.7 336.9 343.0 11.5 4.7
80.6 230,517,629.4 25,111.2 23,951.0 9.6 7.9
313.6 12,848,559.1 311.4 1,794.0 24.0 6.5
1,293.9 84,830,484.3 496.5 667.0 9.9 8.7
110.7 7,774,891.6 524.8 6,913.0 20.9 1.7
912.1 37,216,896.2 464.4 423.0 5.5 11.4
96.2 221,036,089.1 13,369.5 16,513.0 17.2 4.6
961.3 96,988,941.6 572.6 979.0 10.2 9.5
109.4 5,912,371.8 397.9 225.0 9.9 9.0
258.8 82,156,351.0 2,328.4 10,189.0 9.8 7.9
164.1 40,126,219.4 2,154.6 1,184.0 9.4 6.8
239.2 9,541,433.2 296.8 182.0 9.5 7.8
342.1 181,068,826.1 5,381.6 9,233.0 9.7 7.6
409.6 333,162,955.3 9,377.0 20,818.0 17.3 4.1
434.2 27,486,725.1 982.4 721.0 5.7 6.2
180.6 35,762,062.7 1,468.4 363.0 9.7 12.8
91.3 54,738,046.5 4,785.6 9,971.0 6.6 7.3
141.1 76,180,418.7 2,960.2 7,196.0 5.4 4.5
170.7 61,005,100.2 2,977.3 1,424.0 9.5 7.8
255.2 24,431,208.8 544.3 462.0 9.8 4.7
17.1 953.0 13.8 5.7
213.1 86,184,701.1 2,306.8 11,476.0 6.6 7.1
2,126.3 133,452,384.2 567.1 1,332.0 6.9 5.8
126.1 63,790,188.9 2,829.7 1,596.0 9.1 6.0
474.8 1,419,060,879.3 40,990.2 59,097.0 9.7 7.6
210.8 45,037,113.1 1,621.8 1,970.0 9.9 8.4
252.6 33,029,254.8 721.3 4,114.0 16.5 4.4
506.5 6,295,337.8 71.8 77.0 10.0 13.9
255.1 64,186,040.9 1,186.4 6,340.0 9.6 2.0
899.9 6,624,636.4 56.2 438.0 9.7 3.9
360.5 61,267,964.6 1,167.7 702.0 9.5 7.7
4,020.0 19,822.0 21.5 5.8
1,978.9 4,599,462,032.3 24,797.9 30,629.0 9.0 4.2
2,413.8 9,362.0 17.0 4.5
174.8 31,026,891.3 1,513.8 696.0 9.5 7.7
222.6 82,153,655.1 2,750.4 18,191.0 18.1 2.0
153.4 449,128,737.6 21,907.7 24,955.0 18.4 11.0
94.6 61.0 10.1 10.4
318.6 239,041,584.3 3,790.8 8,099.0 6.4 10.1
796.6 84,868,073.3 1,091.4 5,473.0 5.1 6.3

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Country summary in IDF Europe Region
2024

Europe

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

EUR 65,600 9.8 8.0 34.0

Albania 261.4 12.4 10.6 33.5
Andorra 7.9 12.5 10.1 28.5
Armenia 168.1 8.5 7.7 40.6
Austria 479.4 7.2 5.4 28.5
Azerbaijan 715.3 9.9 10.2 33.9
Belarus 445.4 6.3 5.1 29.1
Belgium 641.6 7.6 5.9 37.0
Bosnia and Herzegovina 316.4 12.9 10.3 33.5
Bulgaria 482.0 9.6 7.4 38.1
Croatia 409.8 13.7 10.5 28.5
Cyprus 106.1 11.1 10.0 36.6
Czechia 765.9 9.8 7.6 16.7
Denmark 354.7 8.2 6.4 22.3
Estonia 83.9 8.8 6.9 48.7
Faroe Islands 2.5 7.0 5.3 31.4
Finland 400.4 9.8 6.9 18.8
France 4,107.0 9.0 6.5 24.1
Georgia 200.7 7.8 6.7 36.9
Germany 6,485.3 10.6 7.8 20.4
Greece 873.8 11.4 8.0 28.5
Greenland 2.0 5.0 4.3 28.5
Guernsey 4.2 8.9 7.6 28.5
Hungary 765.0 10.1 8.3 16.7
Iceland 21.9 8.1 6.9 28.5
Ireland 158.5 4.4 3.6 31.2
Isle of Man 6.4 10.2 7.5 28.5
Israel 616.4 10.8 10.1 28.5
Italy 5,018.4 11.4 7.7 28.5
Jersey 7.6 8.8 7.6 28.5
Kazakhstan 842.3 6.9 6.8 56.7
Kosovo (under UNSC res.1244) 119.6 10.4 10.4 33.5
Kyrgyzstan 263.1 6.8 7.6 56.7
Latvia 126.6 9.6 7.1 28.5
Liechtenstein 2.9 9.7 7.2 28.5
Lithuania 210.6 10.6 7.5 28.5
Luxembourg 33.1 6.7 5.8 26.2
Malta 48.0 11.5 10.0 43.2
Republic of Moldova 165.5 6.8 6.3 36.9
Monaco 2.8 11.4 6.9 28.5
Montenegro 57.8 12.7 10.7 33.5
Netherlands 895.7 6.9 5.0 28.5
North Macedonia 140.8 8.9 7.4 33.5
Norway 246.2 6.1 4.8 28.5
Poland 3,098.6 10.2 8.1 18.9
Portugal 1,094.8 14.3 10.5 43.6
Romania 1,320.0 9.1 7.5 21.4
Russian Federation 7,577.6 7.1 5.9 40.5
San Marino 3.1 12.2 8.6 28.5
Serbia 718.5 13.3 10.5 33.5
Slovakia 393.6 9.1 7.1 28.5

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 Age-adjusted Age-adjusted
Diabetes-related
Total Diabetes- comparative comparative
expenditure Type 1
diabetes-related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
2,950.9 192,880,787,692.9 433,000.0 2,740,885.0 5.9 5.3
653.2 170,770,833.2 1,120.4 3,497.0 7.5 8.5
3,138.9 24,918,211.5 43.5 9.5 5.5
1,181.1 198,534,698.8 1,125.2 3,382.0 2.8 4.7
6,267.7 3,004,882,944.8 4,452.7 27,042.0 4.3 4.1
483.8 346,056,181.3 4,378.7 9,533.0 3.1 5.3
1,213.2 540,340,717.2 3,660.5 27,792.0 1.9 4.5
5,688.7 3,649,563,678.5 5,377.3 39,326.0 4.2 5.5
1,156.3 365,844,483.7 2,116.4 6,077.0 7.5 8.4
1,864.8 898,947,982.2 3,425.1 9,244.0 1.5 6.2
1,088.3 445,995,047.9 4,657.6 11,399.0 7.5 7.7
2,307.6 244,924,276.3 741.9 2,984.0 6.3 7.6
2,184.6 1,673,241,959.2 4,341.4 33,205.0 2.2 4.0
7,717.7 2,737,744,209.4 3,476.3 30,596.0 10.7 5.6
1,704.4 143,055,162.7 434.2 5,260.0 7.1 4.1
27.9 1.1 5.2
5,118.0 2,049,075,184.1 4,042.1 54,307.0 7.9 4.6
5,478.5 22,500,449,823.6 33,902.9 174,694.0 9.5 5.5
930.3 186,712,560.2 1,510.4 7,291.0 2.9 2.1
6,236.9 40,448,132,549.2 62,716.6 336,936.0 8.3 5.5
1,706.9 1,491,460,097.7 8,271.6 23,699.0 7.4 7.6
40.6 8.0 5.1
33.8 349.0 4.4 5.7
1,396.7 1,068,496,147.1 5,786.4 30,670.0 2.3 3.8
8,054.8 176,657,677.2 165.5 1,406.0 8.5 5.0
7,234.2 1,146,587,524.4 1,465.3 25,659.0 1.4 5.6
56.0 4.3 5.6
4,641.4 2,861,112,399.1 7,059.7 22,819.0 4.4 4.0
3,073.3 15,423,128,121.7 62,364.5 183,782.0 9.6 5.5
74.7 556.0 4.4 5.7
762.2 642,040,133.0 4,848.8 23,273.0 3.9 3.5
1,149.9 2,247.0 7.5 8.4
231.5 60,918,197.1 1,779.4 2,557.0 3.7 4.4
1,290.0 163,375,362.2 735.2 6,921.0 2.5 4.1
19.7 4.4 4.1
1,304.2 274,611,769.2 1,946.8 7,675.0 2.5 4.1
8,026.0 265,337,496.9 247.7 2,327.0 4.3 5.5
2,833.4 136,126,487.7 334.2 2,519.0 9.5 5.5
558.4 92,390,518.4 1,833.5 3,040.0 3.7 4.4
2,690.6 7,420,529.2 16.7 9.4 5.5
383.2 1,663.0 7.5 8.5
6,235.4 5,585,326,123.0 8,574.6 66,784.0 4.3 5.5
952.6 134,140,566.5 938.1 2,292.0 7.5 8.4
10,226.8 2,517,503,425.1 1,367.7 36,351.0 7.8 5.0
1,234.8 3,826,247,143.7 20,326.1 130,658.0 7.9 4.1
2,157.8 2,362,337,321.8 8,729.8 33,353.0 12.0 5.6
900.1 1,188,180,622.6 10,033.6 25,578.0 3.2 4.1
1,835.5 13,908,283,934.9 5,062.4 323,062.0 2.2 4.5
3,720.0 11,715,633.9 15.6 9.4 5.5
1,396.3 1,003,244,301.7 5,213.1 13,487.0 7.5 8.4
1,565.0 615,928,526.7 2,707.4 18,679.0 3.2 4.1

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Country summary in IDF Europe Region cont.
2024

Europe

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

Slovenia 153.4 9.7 7.0 28.5

Spain 4,660.2 13.1 9.7 35.5
Sweden 566.6 7.5 5.8 28.5
Switzerland 433.3 6.6 5.3 28.5
Tajikistan 383.5 6.8 8.0 56.7
Türkiye 9,603.1 16.3 16.5 45.5
Turkmenistan 264.1 6.6 7.1 39.5
Ukraine 2,276.8 8.0 6.0 36.9
United Kingdom 4,454.6 9.2 7.4 28.7
Uzbekistan 1501.9 6.9 7.5 74.0

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 Age-adjusted Age-adjusted
Diabetes-related
Total diabetes- Diabetes- comparative comparative
expenditure Type 1
related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
2,349.3 360,439,568.9 1,453.4 5,462.0 7.5 7.7
2,808.9 13,089,885,041.1 22,125.1 189,078.0 7.1 5.5
7,081.1 4,011,914,709.5 4,483.7 82,827.0 8.1 5.0
12,234.2 5,301,343,052.5 2,847.6 20,756.0 4.3 5.5
160.1 61,401,514.0 1,936.3 4,465.0 3.5 4.7
1,005.5 9,656,242,550.9 42,558.2 195,853.0 7.6 8.6
1,664.5 439,649,418.1 1,854.0 3,488.0 3.8 7.7
624.5 1,421,868,149.9 18,003.2 108,643.0 2.5 4.5
5,304.7 23,630,576,669.6 27,193.7 340,794.0 5.4 5.5
210.2 315,706,453.7 7,447.4 15,548.0 3.7 1.4

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 107

Country summary in IDF Middle-East and North Africa Region
2024

Middle-East and North Africa

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

MENA 84,700 17.6 19.9 37.2

Afghanistan 1,932.8 9.7 11.7 71.4
Algeria 4,761.8 16.9 17.5 31.7
Bahrain 197.6 17.8 22.1 46.4
Egypt 13,214.5 19.8 22.4 62.0
Iraq 2,669.4 11.0 13.4 47.1
Iran (Islamic Republic of) 5,453.6 8.8 9.0 32.6
Jordan 1,086.5 16.3 20.5 18.6
Kuwait 908.5 28.4 25.6 37.3
Lebanon 439.7 13.6 12.3 26.1
Libya 634.8 14.6 15.8 31.7
Morocco 2,881.0 11.6 11.9 31.7
Oman 412.3 13.2 17.0 50.0
Pakistan 34,532.4 26.5 31.4 26.9
Qatar 409.3 18.7 24.6 46.4
Saudi Arabia 5,344.6 21.4 23.1 43.6
State of Palestine 315.3 11.2 15.5 30.2
Sudan 3,860.6 16.0 19.0 37.3
Syrian Arab Republic 2,246.1 15.7 19.0 26.1
Tunisia 1,392.9 16.6 16.0 31.7
United Arab Emirates 1,274.2 16.5 20.7 64.0
Yemen 720.8 4.1 5.5 22.3

108 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

 Age-adjusted Age-adjusted
Diabetes-related
Total diabetes- Diabetes- comparative comparative
expenditure Type 1
related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
429.1 34,661,252,786.4 467,000.0 1,410,471.0 11.1 8.0
137.8 266,352,048.3 11,641.7 13,600.0 8.7 5.0
653.4 3,111,168,073.4 20,642.0 188,195.0 6.5 6.8
960.9 189,841,149.7 337.9 7,706.0 17.6 16.1
234.9 3,104,049,277.5 72,039.1 191,776.0 18.1 6.3
778.4 2,077,975,623.8 14,683.1 65,550.0 8.6 9.2
1341.8 7,317,829,779.6 23,379.9 134,623.0 8.5 4.0
853.7 927,612,390.0 4,643.9 25,881.0 9.4 2.5
1421.2 1,291,242,801.1 923.2 28,739.0 19.1 16.5
1746.8 768,128,215.8 2,861.4 12,438.0 7.5 7.1
5,164.3 28,085.0 8.1 6.9
453.8 1,307,452,860.2 16,235.0 139,699.0 9.2 11.0
720.6 297,078,595.6 625.0 34,676.0 6.8 14.9
79.3 2,737,622,416.4 226,752.3 24,440.0 9.8 8.5
1439.0 589,002,372.9 364.3 12,862.0 18.1 18.8
1372.5 7,335,543,452.3 8,038.3 222,942.0 17.2 15.1
2,722.7 10,958.0 5.6 6.4
149.2 575,946,852.2 29,268.7 94,809.0 13.2 6.3
13,677.4 42,393.0 8.6 9.0
536.0 746,648,526.0 6,390.7 41,279.0 8.8 6.8
1583.5 2,017,758,351.5 829.9 79,074.0 18.2 17.0
5,997.6 10,746.0 8.6 8.6

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 109

Country summary in IDF North America and the Caribbean Region
2024

North America and the Caribbean

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

NAC 56,200.0 15.1 13.8 29.1

Antigua and Barbuda 8.6 12.5 11.6 24.5
Aruba 4.2 5.2 4.6 22.5
Bahamas 26.8 8.9 8.9 24.5
Barbados 34.4 16.4 13.2 23.8
Belize 31.4 12.0 14.1 41.9
Bermuda 8.1 16.7 13.4 26.4
Canada 2,822.1 9.7 7.7 28.9
Cayman Islands 6.2 11.4 11.1 26.4
Curaçao 22.1 15.5 13.4 24.5
Dominica 6.7 12.8 12.9 24.5
Grenada 9.4 11.1 11.3 24.5
Guyana 75.7 14.9 16.4 36.0
Haiti 541.8 7.9 8.5 29.4
Jamaica 235.6 11.6 12.5 24.3
Mexico 13,587.4 15.8 16.4 41.3
Saint Kitts and Nevis 5.0 14.5 13.8 24.5
Saint Lucia 15.2 11.3 11.4 24.5
Saint Vincent and the Grenadines 6.4 9.0 8.6 24.5
Suriname 53.2 13.2 13.8 39.6
Trinidad and Tobago 151.2 13.5 12.4 24.5
United States of America 38,536.4 15.7 13.7 24.8
United States Virgin Islands 8.7 12.5 9.1 26.9

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 Age-adjusted Age-adjusted
Diabetes-related
Total diabetes- Diabetes- comparative comparative
expenditure Type 1
related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
7811.7 438,603,587,491.7 526,000.0 1,853,030.0 11.6 13.6
991.5 8,573,690.0 85.8 71.0 5.6 4.1
17.0 87.0 5.6 4.1
2449.6 65,547,669.2 344.5 341.0 5.6 4.1
1172.2 40,285,229.1 404.6 229.0 5.6 4.1
791.6 24,864,109.2 308.5 391.0 5.2 12.9
37.6 11.6 12.2
4867.8 13,737,322,842.5 23,139.8 243,390.0 11.5 12.2
33.9 11.5 12.2
185.3 115.0 5.5 4.1
1296.7 8,745,588.4 113.9 5.4 4.5
1152.2 10,818,602.7 115.4 93.0 5.2 4.3
360.6 27,285,389.2 1,072.5 405.0 5.6 4.0
241.5 130,843,628.5 6,683.6 4,536.0 5.3 4.5
863.4 203,389,462.0 3,621.5 1,658.0 5.3 4.4
1438.0 19,539,071,826.1 123,364.6 122,731.0 12.9 13.5
1103.4 5,552,250.8 71.7 5.6 4.1
934.2 14,195,630.9 209.4 143.0 5.0 4.2
913.1 5,886,640.5 104.5 72.0 5.3 2.5
1212.8 64,544,131.8 610.6 514.0 12.6 8.9
1230.9 186,073,348.5 1,944.5 1,218.0 5.6 6.5
10497.4 404,530,587,452.5 363,427.0 1,476,859.0 11.5 14.2
133.7 177.0 11.5 12.1

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Country summary in IDF South and Central America Region
2024

South and Central America

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

SACA 35,400 10.0 10.1 30.4

Argentina 4,342.1 14.1 14.0 29.1
Bolivia (Plurinational State of) 194.0 2.6 3.4 25.5
Brazil 16,621.4 10.7 10.6 31.9
Chile 1,863.7 13.0 12.2 17.1
Colombia 3,033.8 8.3 8.4 16.2
Costa Rica 375.7 10.0 9.8 26.4
Cuba 847.4 10.1 9.4 39.0
Dominican Republic 1,203.7 16.6 17.6 42.8
Ecuador 552.8 4.6 4.9 20.0
El Salvador 463.3 11.2 12.7 23.2
Guatemala 1,103.7 10.5 13.2 48.8
Honduras 259.6 4.0 5.0 51.9
Nicaragua 377.0 8.7 10.4 44.6
Panama 312.8 10.7 11.1 39.8
Paraguay 352.2 8.2 9.4 33.2
Peru 1,335.8 6.0 6.4 25.5
Puerto Rico 345.8 14.1 10.9 26.9
Uruguay 201.5 8.4 7.8 48.9
Venezuela (Bolivarian Republic of) 1,580.7 8.5 8.6 33.6

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 Age-adjusted Age-adjusted
Diabetes-related
Total diabetes- Diabetes- comparative comparative
expenditure Type 1
related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
2,417.4 80,840,139,260.0 224,000.0 796,838.0 11.0 9.0
3,553.1 15,427,924,938.7 26,163.8 86,977.0 11.6 10.0
1,092.8 211,977,463.7 1,699.7 3,246.0 7.0 8.7
2,714.9 45,125,340,371.2 111,392.9 499,402.0 11.3 9.7
1,600.0 2,982,003,925.8 9,444.9 40,712.0 11.9 4.8
1,909.8 5,794,051,819.7 15,092.0 47,732.0 10.9 9.4
2,913.3 1,094,482,802.4 1,783.6 4,772.0 10.9 9.4
2,877.5 2,438,279,617.1 4,906.7 6,424.0 10.5 9.1
1,353.9 1,629,660,833.4 7,156.8 6,506.0 11.1 9.5
2,204.6 1,218,644,466.4 2,545.1 16,130.0 9.6 8.3
958.3 444,018,847.6 3,655.3 5,316.0 10.5 9.0
839.9 926,959,846.1 6,116.9 15,367.0 8.8 7.5
789.4 204,919,357.7 1,724.7 8,820.0 9.3 8.0
587.0 221,305,928.3 1,854.5 5,315.0 10.3 8.0
1,317.8 412,172,423.6 1,331.7 3,925.0 11.6 4.7
1,474.7 519,375,809.5 2,558.0 5,930.0 9.5 8.2
1,408.0 1,880,823,770.4 7,217.8 19,247.0 10.7 9.2
3,160.8 2,714.0 12.1 4.9
1,529.8 308,197,038.3 1,269.7 3,113.0 12.1 4.9
14,464.6 15,190.0 11.4 9.8

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Country summary in IDF South-East Asia Region
2024

South and Central America

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

SEA 106,900 9.7 10.8 42.7

Bangladesh 13,877.4 12.3 13.2 39.1
Bhutan 57.3 10.4 12.0 39.9
India 89,826.9 9.5 10.5 43.0
Maldives 30.9 8.4 9.5 28.2
Mauritius 218.1 22.2 20.1 28.2
Nepal 1,259.1 6.6 7.7 70.4
Sri Lanka 1,600.5 10.7 10.2 37.7

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 Age-adjusted Age-adjusted
Diabetes-related
Total diabetes- Diabetes- comparative comparative
expenditure Type 1
related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
107.6 11,497,657,846.3 375,000.0 1,005,022.0 13.8 12.2
74.4 1,031,800,822.1 31,619.5 25,520.0 13.5 17.1
374.1 21,420,759.3 155.2 572.0 13.5 10.4
109.5 9,834,399,121.6 334,922.2 940,840.0 13.9 11.7
1,619.3 50,089,665.8 33.1 485.0 11.6 10.3
671.3 146,430,963.8 814.7 4,170.0 11.8 5.7
91.4 115,064,511.1 2,775.8 18,087.0 4.7 5.0
186.5 298,452,002.7 4,159.9 15,348.0 19.2 10.1

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Country summary in IDF Western Pacific Region
2024

Western Pacific

Number of Age-adjusted
Diabetes Proportion of
adults with comparative
prevalence undiagnosed
Country or territory diabetes diabetes
adults diabetes
(20–79 years), prevalence
(20-79 years), (%) (20–79 years), %
in 1,000s (20–79 years), (%)

WP 215,400 12.4 11.1 50.0

Australia 1,693.7 8.85 7.4 28.0
Brunei Darussalam 44.6 13.85 13.7 44.7
Cambodia 723.2 6.8 7.5 50.0
China 147,981.2 13.79 11.9 49.7
Dem. People's Republic of Korea 2,043.5 10.78 9.9 53.5
Micronesia (Fed. States of) 12.1 17.41 19.2 73.2
Fiji 90.3 15.34 16.6 47.5
French Polynesia 51.2 23.47 22.8 32.9
Guam 24.4 21.93 20.3 32.9
China, Hong Kong SAR 706.0 11.91 8.2 54.2
Indonesia 20,426.4 11.0 11.3 73.2
Japan 10,763.5 12.0 8.1 31.3
Kiribati 16.0 21.5 24.6 55.0
Lao People's Democratic Republic 255.1 5.5 6.7 41.9
China, Macao SAR 52.3 9.3 8.1 54.2
Malaysia 4,753.9 19.9 21.1 50.4
Marshall Islands 6.0 24.0 25.7 65.0
Mongolia 208.5 10.0 10.3 74.7
Myanmar 2,365.8 6.4 6.7 49.7
Nauru 1.3 19.1 21.8 32.9
New Caledonia 46.1 22.8 22.0 32.9
New Zealand 292.0 7.8 6.7 25.7
Niue 0.3 21.1 18.1 56.3
Palau 2.7 20.8 19.3 56.3
Papua New Guinea 838.0 14.2 14.1 73.2
Philippines 4,726.3 6.6 7.5 53.5
Republic of Korea 5,030.1 12.2 9.6 28.3
Samoa 28.2 23.7 25.4 83.9
Singapore 699.1 14.1 11.4 37.3
Solomon Islands 38.4 10.0 12.0 80.6
Taiwan, Province of China 2,598.2 13.7 10.7 54.2
Thailand 6,360.8 11.7 10.2 33.3
Timor-Leste 21.6 2.9 3.2 77.5
Tonga 10.1 17.0 19.6 73.2
Tuvalu 1.2 17.9 19.0 56.3
Vanuatu 29.0 16.7 19.7 73.2
Viet Nam 2,499.9 3.6 3.4 37.8

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 Age-adjusted Age-adjusted
Diabetes-related
Total diabetes- Diabetes- comparative comparative
expenditure Type 1
related related prevalence prevalence
per person diabetes
expenditure deaths of impaired of impaired
with diabetes across all
(20–79 years), in adults glucose fasting glucose
(20–79 years), age groups
(USD) (20–79 years) tolerance (20–79 (20–79 years),
(USD)
years), (%) (%)
1,173.5 246,342,889,303.4 1,200,000.0 990,990.0 13.5 8.6
5,471.4 9,266,818,019.7 8,294.9 114,545.0 9.4 3.1
816.4 36,378,598.7 447.4 132.0 16.3 2.5
236.4 170,939,731.3 4,983.4 582.0 7.3 7.0
1,141.2 168,882,601,413.0 755,511.4 598,906.0 13.3 9.9
13,503.3 12,247.0 9.7 12.4
835.6 10,100,754.1 91.4 4.0 7.6 11.9
564.5 50,991,991.7 973.8 120.0 7.8 13.7
176.6 14.0 7.8 5.0
294.0 7.0 7.9 5.0
4,552.0 4,435.0 14.9 1.0
308.2 6,296,212,412.0 131,643.8 11,713.0 16.3 7.7
3,155.9 33,968,521,728.8 84,288.1 79,463.0 14.8 5.0
499.4 7,966,913.5 106.5 4.0 7.8 12.4
190.6 48,609,643.8 1,784.6 138.0 10.0 2.4
352.4 462.0 14.9 5.2
1,052.5 5,003,555,184.7 21,796.3 10,275.0 16.3 5.9
1,589.4 9,564,067.0 39.3 7.9 13.8
505.5 105,399,492.2 1,165.4 1,373.0 8.8 18.5
164.1 388,127,700.6 19,968.3 1,739.0 10.1 7.2
1,331.0 1,693,645.6 14.0 8.0 6.4
318.9 13.0 7.9 5.0
4,232.3 1,235,884,639.8 1,964.8 17,474.0 9.4 5.0
3,010.3 777,033.3 0.3 7.9 12.6
3,858.2 10,279,127.6 21.9 7.8 14.0
154.4 129,418,207.3 4,516.4 333.0 7.5 11.5
454.5 2,148,007,104.9 35,309.9 29,870.0 6.6 2.6
2,312.1 11,630,291,893.8 33,204.5 32,615.0 14.8 8.8
420.1 11,837,150.2 146.4 7.0 7.0 24.2
2,444.9 1,709,175,241.8 4,013.2 3,931.0 14.7 5.0
262.6 10,079,696.6 234.5 28.0 7.6 12.4
25,980.0 26,707.0 14.8 5.0
647.2 4,116,695,867.4 34,752.6 20,689.0 15.9 7.6
365.8 7,890,377.8 122.5 49.0 10.1 7.2
444.1 4,473,027.6 64.9 4.0 8.8 1.5
1,772.3 2,136,602.0 8.5 7.7 13.5
255.6 7,417,862.7 150.8 11.0 7.6 11.9
428.4 1,071,044,173.8 7,563.4 23,100.0 15.4 3.6

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Abbreviations and Acronyms

A H O
ADA American Diabetes HAPO hyperglycaemia OGTT oral glucose tolerance test
Association and adverse
AHP analytical hierarchy process pregnancy outcomes

AFR IDF Africa Region HbA1c haemoglobin A1c

(or glycosylated
S
ARDS acute respiratory distress haemoglobin) SACA IDF South and Central
syndrome America Region
HDL high-density lipoprotein
AD Alzheimer’s disease STEPS WHO STEPwise approach
HIP hyperglycaemia
to surveillance
in pregnancy

B T
BP blood pressure I T1D type1 diabetes
IADPSG International Association
of Diabetes and T2D type2 diabetes
C ID
Pregnancy Study Group
international dollar
CVD
CI
cardiovascular diseases
confidence intervals
IDF International Diabetes U
Federation
UHC universal health coverage
IFG impaired fasting glucose
UN United Nations
D IGT impaired glucose
tolerance
UNPD United Nations Population
DIP diabetes in pregnancy Division USD United
IMR infant mortality rate States dollar
DKA diabetic ketoacidosis
DR diabetes-related
retinopathy
L V
LDL-C low-density lipoprotein VaD vascular dementia

E cholesterol

EUR IDF Europe Region

M W
WDD World Diabetes Day

F MENA IDF Middle East and North

Africa Region
WHO World Health Organization

FBG fasting blood glucose WP IDF Western Pacific Region

mg/dL milligrams per decilitre
FPG fasting plasma glucose mmol/L millimoles per litre mmol/
FIGO International Federation
of Gynaecology and MODY
mol millimoles per mole
maturity onset diabetes
Y
Obstetrics of the young YLD Young Leaders in Diabetes

G N
GDM gestational diabetes NAC IDF North America and
mellitus Caribbean Region
GDP gross domestic product

GLP-1 glucagon-like peptide 1

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Glossary

A D
Age-adjusted comparative prevalence Dementia
Also referred to as comparative prevalence, this is A progressive condition (such as Alzheimer’s disease)
the prevalence calculated by adjusting to the age marked by the development of multiple cognitive
structure of a standard population. In this IDF Diabetes deficits (such as memory impairment, aphasia, and
Atlas, the standard population is the UN population in the inability to plan and initiate complex behaviour).
2021, 2030 or 2045. Adjusting rates is a way to make
fairer comparisons between groups with different Diabetes complications
distributions. Age-adjusted rates are rates that would Acute and chronic conditions caused by diabetes.
have existed if the population under study had the
same age distribution as the “standard” population. Diabetic foot
A foot that exhibits any disease that results directly
Analytical hierarchy process (AHP) scoring from diabetes or a complication of diabetes.
A methodological approach that quantifies the relative Diabetes in pregnancy (DIP)
value of a variety of different aspects of study methods.
Diabetes occurring in pregnancy in women who have
Attributable fraction method previously been diagnosed with diabetes or those who
have hyperglycaemia first diagnosed during pregnancy,
The contribution of a risk factor to a disease is
meeting the WHO criteria of diabetes in
measured using the population attributable
the non-pregnant state.
fraction (PAF). The PAF is the proportional reduction
in population disease that would occur if exposure to Diabetic ketoacidosis (DKA)
a risk factor was removed from the population.
A complex metabolic disorder that occurs when the
Autoimmune reaction liver starts breaking down fat at an excessive rate.
The by-product of this process, ketones, can cause
A reaction that is characterised by a specific humoral
the blood to become dangerously acidic.
or cell-mediated immune response against the
constituents of the body’s own tissues. Diabetes (mellitus)
A chronic condition marked by high concentrations of
glucose (sugar) in the blood. It is caused by the body

B being unable to produce insulin (a hormone made by

the pancreas to control blood glucose levels) or to use
Beta cells insulin effectively, or both. The three most common
forms of diabetes are type 1, type 2 and gestational.
Cells found in the pancreas that produce, store and
release insulin. Diabetic neuropathy
Body mass index (BMI) A type of nerve damage that can occur if a person
has diabetes; depending on the affected nerves,
A measure of weight (or body mass), which is symptoms of diabetic neuropathy can range from
approximately independent of height. It is calculated pain and numbness in the legs and feet to problems
by dividing weight in kilograms by the square of with the digestive system, urinary tract, blood vessels,
height in metres. The units are kilograms per and heart.
square metre (kg/m2).
Direct costs
The costs of providing, for a given condition or

C disease, health services (preventive and curative),

family planning activities, nutrition activities and
emergency aid designated for health. It does not
Cardiovascular diseases (CVD)
include the provision of water and sanitation, but it
Diseases and injuries of the circulatory system: the does include health expenditures from both public
heart, blood vessels of the heart and the system of and private sources.
blood vessels throughout the body and to (and in)
the brain; generally, refers to conditions that involve DPP-4 inhibitors
narrowed or blocked blood vessels. A class of oral hypoglycaemic drugs that blocks the
enzyme dipeptidyl peptidase4 (DPP-4), used to
treat type 2 diabetes.

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Glossary

E Glucagon
A hormone produced in the pancreas. If blood glucose
Epidemiology levels decrease, it triggers the body to release stored
The study of the occurrence, distribution and glucose into the bloodstream.
patterns of disease in populations, including factors
Glucagon-like peptide1
that influence disease and the application of this
knowledge to improve public health. Also known as GLP-1, a naturally occurring peptide
hormone, released from the gut after eating. Glucose
Essential hormone Also called dextrose or blood sugar. The main sugar
Hormones that are required for life including: insulin, the body absorbs, uses as a form of energy and stores
parathyroid hormone, glucocorticosteroids (cortisol), for future use. Glucose is the major source of energy
mineral corticosteroids (aldosterone). for living cells and is carried to each cell through the
bloodstream. However, the cells cannot use glucose
Estimates without the action of insulin.
Values that are usable for some purpose even if input
data may be incomplete, uncertain, or unstable; the
value is nonetheless usable because it is derived
from the best information available. H
Extrapolate Haemoglobin A1c (HbA1c)
Extending values or conclusions from a known Also referred to as glycosylated haemoglobin,
situation to an unknown situation, assuming that a haemoglobin to which glucose is bound.
similar conditions, methods or trends are applicable. Glycosylated haemoglobin is measured to
determine the average level of blood glucose
over the past two to three months.

F Heterogeneity
The quality or state of being diverse in character
Fasting plasma glucose (FPG) or content.
FPG is a person’s blood glucose concentration after High-income country
fasting – not eating anything for at least eight hours. A country defined by the World Bank to have a gross
Normal FPG is less than or equal to 6.1 millimoles per national income per capita of USD 12,696 or more
litre (mmol/l) or less than or equal to 110 milligrams (in 2020).
per decilitre (mg/dL). The disadvantages of using
FPG for screening include: the possibility that the Hyperglycaemia
person has not fasted, its inability to detect diabetes
A raised concentration of glucose in the blood. It occurs
diagnosed by a post-glucose load value alone and the
when the body does not have enough insulin or cannot
fact that FPG alone cannot identify impaired glucose
use the insulin it does have to turn glucose into energy.
tolerance (see letter I). FPG alone fails to detect
Signs of hyperglycaemia include great thirst, dry
approximately 30% of undiagnosed diabetes. Using
mouth, weight loss and the need to urinate often.
FPG to detect diabetes is a common but less sensitive
diagnostic method. G Genes The basic physical and Hyperglycaemia in pregnancy (HIP)
functional units of heredity found in the nuclei of
Hyperglycaemia in pregnancy (HIP) can be classified as
all cells.
either gestational diabetes mellitus (GDM) or diabetes
in pregnancy (DIP).

G Hypoglycaemia
A low concentration of glucose in the blood. This may
Gestational diabetes mellitus (GDM) occur when a person with diabetes has injected too
much insulin, eaten too little food, or has exercised
Gestational diabetes is a condition where a woman without extra food.
develops high blood glucose, less than overt diabetes,
that begins in, or is first recognised during pregnancy.

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I L
IDF Region Low-income country
The International Diabetes Federation (IDF) is divided A country defined by the World Bank with a gross
into seven regions: Africa, Europe, Middle East and national income per capita of USD 1,045 or less
North Africa, North America and the Caribbean, South (in 2020).
and Central America, South-East Asia and Western
Pacific. The IDF Regions aim to strengthen the work

M
of national diabetes associations and enhance
collaboration between them.

Impaired fasting glucose (IFG) Macrosomia

Blood glucose that is higher than normal blood Birth weight more than 4.0 kg Maturity-onset diabetes
glucose, but below the diagnostic threshold for of the young (MODY) A group of rare forms of diabetes
diabetes after fasting (typically after an overnight fast). caused by one of several single gene mutations,
Sometimes termed impaired fasting glycaemia. belonging to the monogenic types of diabetes.

Impaired glucose tolerance (IGT) Metformin

Blood glucose that is higher than normal but below An oral therapy for type 2 diabetes, and one of a
the diagnostic threshold for diabetes, after ingesting group of drugs known as biguanides. These lower
a standard amount of glucose during an oral glucose blood glucose levels in people with type 2 diabetes by
tolerance test. Fasting and two-hour glucose values increasing the sensitivity of muscle cells to insulin,
are needed for its diagnosis. and by reducing the amount of glucose produced
by the liver.
Incidence
The number of new cases of a disease or condition Microvascular complications
among a group of people without the disease who are Complications of diabetes that include diabetic
at risk of developing this condition during a specified nephropathy, neuropathy and retinopathy, which
time period. are caused by pathological changes in
the microvasculature.
Insulin
A hormone produced in the pancreas, as a response to Monogenic diabetes
glucose. Insulin triggers cells to take up glucose from Less common types of diabetes, resulting from
the blood stream and convert it to energy. single genetic mutations. Examples include MODY
and Neonatal Diabetes Mellitus.
Insulin resistance
The inability of cells to adequately respond to

N
circulating insulin, resulting in increased levels of
blood glucose.

Intermediate hyperglycaemia Neonatal diabetes mellitus

The condition of raised blood glucose levels above A rare form of diabetes that is diagnosed in children
the normal range and below the diabetes diagnostic under six months of age. Caused by a mutation in
threshold. Alternative terms are prediabetes, a single gene. It is a type of monogenic diabetes.
non-diabetic hyperglycaemia, IFG and IGT.

International Dollar (ID)

A hypothetical unit of currency that has the same
purchasing power in every country. Conversions from
local currencies to international dollars are calculated
using tables of purchasing power parities, taken from
studies of prices for the same basket of goods and
services in different countries. Internationals Dollars
are used to compare expenditures between different
countries or regions.

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Glossary

O Primary prevention
Disease prevention before a disease or condition
Obesity occurs. Usually refers to the prevention of exposures
A condition in which a person carries excess weight or to hazards that cause disease or injury and altering
body fat that might affect their health (Defined by, for unhealthy or unsafe behaviours.
example, a BMI ≥30 Kg/m2 in non-Asians).
Projections
Oral glucose tolerance test (OGTT) Estimates of a future situation based on a study of past
A medical test in which glucose is given orally after an and present trends.
overnight fast and blood samples taken after a certain
time to determine how quickly it is cleared from
the blood.

Oral medication
R
Ratio
A medication administered by mouth.
The diabetes cost ratio, which is the ratio of health
Overweight expenditures for people with diabetes compared
A condition of having more body fat than is optimally to health expenditures for age and sex matched
healthy, though not in the obese range (Defined by a persons who do not have diabetes. The R=2 estimates
BMI of 25.0 Kg/m2 to 29.9 Kg/m2 in non-Asians). assume that healthcare expenditures for people with
diabetes are on average two-fold higher than people
without diabetes, and the R=3 estimate assumes that
healthcare expenditures for people with diabetes
P are on average three-fold higher than people
without diabetes.
Pancreas
Raw diabetes prevalence
An organ situated behind the stomach, which
produces several important hormones, including Also called country, national or regional prevalence, the
insulin and glucagon. percentage of each country or region’s population that
has diabetes. It is useful for assessing the impact of
Peripheral vascular disease (PVD) or peripheral diabetes for each country or region.
artery disease (PAD)
Relative risk
A progressive disorder that causes narrowing or
blocking of the blood vessels outside the heart, The ratio of the probability of an outcome in an
including arteries, veins, or lymphatic vessels. exposed group to the probability of an outcome in an
unexposed group.
Prediabetes
Elevated blood glucose above the normal range but
below the diabetes diagnostic threshold. Alternative
terms are IFG, IGT, non-diabetic hyperglycaemia, and
intermediate hyperglycaemia.
S
Screening approach
Polydipsia A method used to make a diagnosis of a given disease
Excessive thirst. or condition before it has caused symptoms.

Polyuria Secondary diabetes

Frequent urination. Less common forms of diabetes, which arise as a

consequence of other diseases or conditions (e.g.
Prevalence diseases of the pancreas such as cystic fibrosis).
The proportion of individuals in a population that has Self-management
a disease or condition at a particular time (a point
in time or over a period of time). For example, the Management of or by oneself; the taking of
proportion of adults aged 20–79 with diabetes in 2017. responsibility for one’s own behaviour and well-being.
For prevalence, the numerator is the number of people Sulphonylureas
with the condition or disease and the denominator
is the total population. It can be expressed as a Oral medications used for the treatment of type 2
proportion or a percentage. diabetes. They work mainly by stimulating the cells in
the pancreas to release more insulin.

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T
Type 1 diabetes
Type1 diabetes is thought to be an autoimmune
disease that usually occurs in childhood or early
adulthood, resulting in the inability to produce enough
insulin due to the destruction of insulin producing islet
cells in the pancreas. The condition can affect people
of any age, but onset usually occurs in children or
young people.

Type 2 diabetes
Type 2 diabetes is the most common form of diabetes
and is characterised by high blood glucose, called
hyperglycaemia. In people with type 2 diabetes, the
body does not use the hormone insulin properly or
cannot produce enough insulin, or both which in turn
leads to hyperglycaemia. It is potentially preventable
and is often associated with lifestyle factors such as
insufficient physical activity, unhealthy diet, obesity
and tobacco smoking. Risk is also associated with
genetic and family-related factors. Type 2 diabetes is
much more common than type 1 and occurs mainly in
adults, although it is now also increasingly diagnosed
in children and young people.

U
Universal health coverage (UHC)
Universal healthcare coverage, also referred to as
universal coverage or universal care, is a healthcare
system that provides free healthcare at the point of
delivery to all residents of a particular country
or region.

IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org | 123

Figures
Figure 1 Estimates and projections of the global Figure 3.11 Diabetes-related health expenditure as a
prevalence of diabetes in the 20–79 year age group percentage of Gross Domestic Product (GDP) by IDF
in millions (IDF Diabetes Atlas editions 1st to 11th). region in 2024.
Figure 1.1 Diagnostic criteria for diabetes. Figure 3.12 Diabetes-related health expenditure as a
percentage of Gross Domestic Product (GDP) by World
Figure 1.2 The typical symptoms of type 1 diabetes.
Bank income classification, 2024.
Figure 1.3. Other specific types of diabetes.
Figure 3.13 Number of individuals with type 1 diabetes in
Figure 2.1 Classification of diabetes data sources. each world region in 2024.
Figure 3.1 Estimated numbers of people with diabetes Figure 4.1 Estimated prevalence (%) of diabetes by age
(top panel) and estimated world-standardised prevalence and sex, IDF Africa Region 2024.
of diabetes (bottom panel) in adults (20–79 years) by age
Figure 4.2 Estimated prevalence (%) of diabetes by age
group in 2024 and 2050.
and sex, IDF Europe Region 2024.
Figure 3.2 Prevalence of diabetes among men and
Figure 4.3 Estimated prevalence (%) of diabetes by age
women (20–79 years), 2024.
and sex, Middle-East and North Africa Region 2024.
Figure 3.3 Number of adults (20–79 years) with diabetes
Figure 4.4 Estimated prevalence (%) of diabetes by age
living in urban and rural areas in 2024 and 2050.
and sex, IDF North America and Caribbean Region 2024.
Figure 3.4 Reported prevalence of HbA1c between 5.7
Figure 4.5 Estimated prevalence (%) of diabetes by age
to 6.4%. Label includes the country, study year, and age
and sex, IDF South and Central America Region 2024.
range of the study participants.
Figure 4.6 Estimated prevalence (%) of diabetes by age
Figure 3.5 Prevalence of hyperglycaemia in pregnancy by
and sex, IDF South-East Asia Region 2024.
age-group in 2024.
Figure 4.7 Estimated prevalence (%) of diabetes by age
Figure 3.6 Estimated number of deaths due to diabetes
and sex, IDF Western Pacific Region 2024.
in adults (20–79 years), by age and sex in 2024.
Figure 5.1 Meta-analysis of the incidence risk of
Figure 3.7 Total diabetes-related health expenditure for
atherosclerotic cardiovascular disease, stroke, myocardial
adults (20–79 years) with diabetes from 2006 to 2050.
infarction, and heart failure in people with type 2
Figure 3.8 Total diabetes-related health expenditure diabetes versus those without diabetes.
(USD billion) in adults with diabetes (20–79 years) by
Figure 5.2 Relative risks of dementia in midlife, late life
IDF Region in 2024.
and combined age ranges.
Figure 3.9 Diabetes-related health expenditure (USD) per
Figure 5.3 Relative risk of vascular dementia (VaD),
adult with diabetes (20–79 years) by IDF Region in 2024.
Alzheimer’s disease (AD) and all-cause dementia in
Figure 3.10 Diabetes-related health expenditure as people with diabetes.
a percentage of total health expenditure for adults
Figure 5.4 The overall global prevalence of any DR
(20–79 years) with diabetes by IDF Region in 2024.
per IDF Regions in 2019 and 2024.

Maps
Map 1 Number of people with diabetes worldwide Map 2.5 Countries and territories with selected data
and per IDF Region, in 2024–2050 (20–79 years). sources on hyperglycaemia in pregnancy in adults
(20–49 years).
Map 2.1 Countries and territories with in-country data
sources on diabetes. Map 3.1 Estimated number of adults (20–79 years) with
diabetes by country, 2024.
Map 2.2 Countries and territories with data sources on
the proportion of adults (20–79 years) with previously Map 3.2 Estimated age-standardised country prevalence
undiagnosed diabetes. of diabetes in adults (20–79 years), 2024.

Map 2.3 Countries and territories with selected data Map 3.3 Number of people over 65 with diabetes in 2024.
sources on impaired glucose tolerance of adults Map 3.4 Proportion of adults (20–79 years) with
(20–79 years). undiagnosed diabetes by country in 2024.
Map 2.4 Countries and territories with selected data Map 3.5 Age-standardised prevalence of impaired
sources on impaired fasting glucose of adults glucose tolerance in adults in 2024.
(20–79 years).

124 | IDF Diabetes Atlas 11th Edition - 2025 | diabetesatlas.org

Map 3.6 Age-standardised prevalence of impaired fasting Map 4.4 Age-standardised prevalence (%) of diabetes
glucose in adults in 2024. (20–79 years), IDF North America and Caribbean
Region 2024.
Map 3.7 Proportion of total deaths related to diabetes
among adults (20-79 years) in 2024. Map 4.5 Age-standardised prevalence (%) of diabetes
(20–79 years), IDF South and Central America
Map 3.8 Total diabetes-related health expenditure (USD)
Region 2024.
by country for adults (20–79 years) with diabetes in 2024.
Map 4.6 Age-standardised prevalence (%) of diabetes
Map 3.9 Diabetes-related health expenditure (USD) by
(20–79 years), IDF South-East Asia Region 2024.
country per adult (20–79 years) with diabetes in 2024.
Map 4.7 Age-standardised prevalence (%) of diabetes
Map 3.10 Remaining life expectancy of a 10-year-old child
(20–79 years), IDF Western Pacific Region 2024.
diagnosed with type 1 diabetes in 2024.
Map 5.1 The proportion of dementia cases in the
Map 4.1 Age-standardised prevalence (%) of diabetes
population attributed to diabetes, in 2024.
(20–79 years), IDF Africa Region 2024.
Map 5.2 The proportion of dementia cases in the
Map 4.2 Age-standardised prevalence (%) of diabetes
population attributed to diabetes, in 2050.
(20–79 years), IDF Europe Region 2024.
Map 4.3 Age-standardised prevalence (%) of diabetes
(20–79 years), IDF Middle-East and North Africa
Region 2024.

Tables
Table 1.1 Diagnostic criteria in studies used for Table 3.12 Age-standardised prevalence of impaired
estimating hyperglycaemia in pregnancy. glucose tolerance (20–79 years) by IDF regions, ranked
Table 3.1 Global estimates of key aspects of diabetes, by 2024 prevalence (%).
intermediate hyperglycaemia, and hyperglycaemia in Table 3.13 Age-standardised prevalence of impaired
pregnancy in 2024 and 2050. glucose tolerance in adults (20–79 years), by World Bank
Table 3.2 Number of adults (20–79 years) with diabetes income group classification.
and diabetes prevalence for countries grouped by World Table 3.14 Age-standardised prevalence of impaired
Bank income classification, 2024 and 2050. fasting glucose in adults (20–79 years) by IDF regions,
Table 3.3 Number and world-standardised prevalence of ranked by 2024 prevalence (%).
diabetes in adults (20–79 years) in the world and in IDF Table 3.15 Age-standardised prevalence of impaired
Regions, 2024 and 2050, ranked by the 2024 fasting glucose in adults (20–79 years), by World Bank
world-standardised prevalence. income classification.
Table 3.4 Top 10 countries or territories by number of Table 3.16 Global estimates of hyperglycaemia in
adults (20–79 years) with diabetes in 2024 and 2050. pregnancy in 2024.
Table 3.5 Top 10 countries or territories with Table 3.17 Hyperglycaemia in pregnancy (20–49 years)
age-standardised diabetes prevalence in adults by IDF Region, ranked by 2024 age-standardised
(20–79 years) in 2024 and 2050. prevalence estimates.
Table 3.6 Global diabetes estimates in people Table 3.18 Ten countries or territories with the highest
(65-99 years) in 2024 and 2050. and lowest total health expenditure (USD) in adults
Table 3.7 Diabetes age-standardised prevalence in (20–79 years) due to diabetes in 2024.
people (65-99 years) by IDF Region in 2024 and 2050. Table 3.19 Ten countries or territories with the highest
Table 3.8 Top 10 countries or territories by number of and lowest diabetes-related health expenditure (USD)
adults (65-99 years) with diabetes in 2024 and 2050. per person with diabetes (20–79 years) in 2024.

Table 3.9 Adults (20–79 years) with undiagnosed Table 3.20 Countries with the highest number of people
diabetes by World Bank income classification in 2024. living with T1D in 2024.

Table 3.10 Adults (20–79 years) with undiagnosed Table 5.1 Prevalence the any diabetes-related
diabetes in IDF Regions in 2024, sorted by proportion retinopathy and sight threatening diabetes-related
undiagnosed from highest to lowest. retinopathy within the IDF Regions in 2024.

Table 3.11 Top 10 countries with the largest number of Table 5.2 Prevalence the proliferative diabetes-related
adults (20–79 years) with undiagnosed diabetes in 2024. retinopathy and macular oedema within IDF Regions
in 2024.

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