Global, Regional, and National Estimates of Undiagnosed Diabetes in Adults: Findings From the 2025 IDF Diabetes Atlas.
Level 3 - non-randomized controlled study
Global epidemiological modeling and synthesis across population-based surveys (analogy for non-clinical observational epidemiology).
PubMed 41604596 · doi:10.2337/dc25-2583
What was done
Researchers systematically compiled population-based studies and gray literature from 2003 to 2024 to estimate global, regional, and national prevalence and case counts of undiagnosed diabetes among adults aged 20 to 79 years. Data on biomarker-based diabetes prevalence and self-reported diagnoses were analyzed across 215 countries and territories. For countries lacking primary data, values were extrapolated using data from the same geographic region and income group. Country-level estimates were benchmarked against the World Health Organization target of an 80% diagnosis rate.
What was found
The synthesis incorporated 193 data sources from 109 countries. In 2024, 42.8% of individuals with diabetes globally were undiagnosed, equating to 251.7 million adults (95% uncertainty interval [UI] 250.4–253.0 million). The proportion undiagnosed ranged from 16.2% in Colombia to 90.4% in Burkina Faso, and from 29.1% in North America and the Caribbean to 72.6% in Africa. Undiagnosed rates were higher in low-income (58.7%) than in high-income countries (28.9%). Middle-income countries accounted for 206.0 million undiagnosed individuals (95% UI 202.3–209.7 million; 81.8% of the global total), with China, India, and Indonesia alone comprising 127.1 million cases (95% UI 121.2–133.0 million; 50.5% of the total). Fewer than 5% of all countries achieved diabetes diagnosis levels ≥80%.
Why it matters
This study provides comprehensive global estimates showing that more than four in ten adults with diabetes remain undiagnosed, concentrated largely in middle-income countries. It shows that the vast majority of nations fall short of international detection targets, highlighting an urgent need for targeted screening and expanded primary health care access.
Limits
Direct empirical data were missing for 106 of the 215 evaluated countries and territories, requiring statistical extrapolation from regional and income-level peers. Input data spanned a 21-year period (2003–2024), introducing potential historical inconsistency and heterogeneity in biomarker definitions or survey methods. Subgroup disparities (such as rural versus urban differences or specific diabetes types) were not reported in the abstract.
Cited by
- supports Approximately one-third of all people in the world with type 2 diabetes are undiagnosed.