Global diabetes prevalence surged from 200 million people in 1990 to 830 million in 2022, according to World Health Organization data. By 2022, 14 percent of adults aged 18 and older lived with the condition, while more than half of those diagnosed received no medication.
The global impact of diabetes has expanded dramatically over recent decades, driven by a sharp rise in low- and middle-income countries. According to World Health Organization findings, the number of individuals affected globally climbed from 200 million in 1990 to 830 million in 2022. Prevalence has been rising more rapidly in low- and middle-income countries than in high-income countries. By 2022, 14% of all adults aged 18 years and older were living with the disease, marking a substantial increase from 7% in 1990.
Treatment Gaps and Mortality Risks Worldwide
Access to essential care remains uneven across regions. Data shows that more than half of all people living with diabetes—specifically 59% of adults aged 30 years and over—did not take medication for their condition in 2022. Furthermore, diabetes treatment coverage was lowest in low- and middle-income countries, where prevalence has risen most rapidly.
The health consequences of untreated or poorly managed high blood sugar are severe. According to World Health Organization reporting, diabetes causes blindness, kidney failure, heart attacks, stroke, and lower limb amputation. In 2021, diabetes and associated kidney disease caused over 2 million deaths. Specifically, diabetes was the direct cause of 1.6 million deaths that year, with 47% of all deaths due to diabetes occurring before the age of 70 years. An additional 530,000 kidney disease deaths were caused by diabetes, while high blood glucose causes around 11% of cardiovascular deaths. Mortality rates from the disease have been increasing since 2000. By contrast, the probability of dying from any one of the four main noncommunicable diseases between the ages of 30 and 70 decreased by 20% globally between 2000 and 2019.
Understanding Type 1, Type 2, and Gestational Diabetes
Diabetes manifests in distinct clinical forms. Type 1 diabetes, previously known as insulin-dependent, juvenile, or childhood-onset diabetes, is characterized by deficient insulin production and requires daily administration of insulin for survival. In 2017 there were 9 million people with type 1 diabetes; the majority of them live in high-income countries. Neither its cause nor the means to prevent it are known. Type 1 diabetes cannot currently be prevented.
By contrast, type 2 diabetes affects how your body uses sugar (glucose) for energy. It stops the body from using insulin properly, which can lead to high levels of blood sugar if not treated. More than 95% of people with diabetes have type 2 diabetes. Type 2 diabetes was formerly called non-insulin dependent, or adult onset. Until recently, this type of diabetes was seen only in adults but it is now also occurring increasingly frequently in children. Symptoms of diabetes may occur suddenly. In type 2 diabetes, the symptoms can be mild and may take many years to be noticed. Symptoms of diabetes include feeling very thirsty, needing to urinate more often than usual, blurred vision, feeling tired, and losing weight unintentionally. Factors that contribute to developing type 2 diabetes include being overweight, not getting enough exercise, and genetics.
Gestational diabetes is hyperglycaemia with blood glucose values above normal but below those diagnostic of diabetes. Gestational diabetes occurs during pregnancy. Women with gestational diabetes are at an increased risk of complications during pregnancy and at delivery. These women and possibly their children are also at increased risk of type 2 diabetes in the future. Gestational diabetes is diagnosed through prenatal screening, rather than through reported symptoms.
Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are intermediate conditions in the transition between normality and diabetes. People with IGT or IFG are at high risk of progressing to type 2 diabetes, although this is not inevitable.
Prevention Strategies and Early Diagnosis
Effective approaches are available to prevent type 2 diabetes and to prevent the complications and premature death that can result from all types of diabetes. Lifestyle changes are the best way to prevent or delay the onset of type 2 diabetes. To help prevent type 2 diabetes and its complications, people should reach and keep a healthy body weight, stay physically active with at least 150 minutes of moderate exercise each week, eat a healthy diet and avoid sugar and saturated fat, and not smoke tobacco.
The starting point for living well with diabetes is an early diagnosis—the longer a person lives with undiagnosed and untreated diabetes, the worse their health outcomes are likely to be. Early diagnosis can be accomplished through relatively inexpensive testing of blood glucose. Easy access to basic diagnostics, such as blood glucose testing, should therefore be available in primary health care settings.
Global Targets and Long-Term Outlook
Patients will need periodic specialist assessment or treatment for complications. A series of cost-effective interventions can improve patient outcomes, regardless of what type of diabetes they may have. One of the most important ways to treat diabetes is to keep a healthy lifestyle. Some people with type 2 diabetes will need to take medicines to help manage their blood sugar levels, which can include insulin injections or other medicines such as metformins, sulfonylureas, and sodium-glucose co-transporters type 2 (SGLT-2) inhibitors. Along with medicines to lower blood sugar, people with diabetes often need medications to lower their blood pressure and statins to reduce the risk of complications. Additional medical care may be needed to treat the effects of diabetes, including foot care to treat ulcers, screening and treatment for kidney disease, and eye exams to screen for retinopathy.
