Nearly half of global diabetes cases may go undiagnosed – with young adults and people in central sub-Saharan Africa the most affected – according to new research published in The Lancet Diabetes & Endocrinology.

The study, led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington and funded by the Bill & Melinda Gates Foundation, analysed diabetes diagnosis and treatment in 204 countries and territories between 2000 and 2023.

Researchers estimated that 44% of people aged 15 and older with diabetes were unaware of their condition. Although diagnosis rates have improved since 2000, many who are identified are not receiving adequate care.

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

By 2050, 1.3 billion people are projected to be living with diabetes. With almost half potentially unaware they have the condition, experts warn it could evolve into a ‘silent epidemic’.

Among those diagnosed, 91% were prescribed some form of pharmacological treatment. However, only 42% of treated patients achieved optimal blood sugar management. In effect, just 21% of all people living with diabetes globally have their condition under control.

Global disparities

The analysis highlighted stark regional differences. High-income North America recorded the highest diagnosis rates, while the Asia Pacific region showed the strongest treatment rates among diagnosed individuals. Southern Latin America led in optimal blood sugar management.

By contrast, central sub-Saharan Africa recorded the lowest diagnosis levels, with fewer than one in five people aware of their condition.

“Despite progress over the past two decades, substantial gaps remain, particularly in low- and middle-income countries,” the study said.

In 2022, the World Health Organization set a target of having 80% of people with diabetes clinically diagnosed by 2030. The research emphasises that reaching this goal will require significant investment in screening, treatment access, and long-term disease management strategies worldwide.

According to new research from the Independent Healthcare Providers Network (IHPN) nearly half (49%) of UK adults aged 35 to 44 expect to pay for healthcare treatment in the next 12 months.