TOP 10 Countries by Diabetes Prevalence in Adults (20–79, 2025)
Diabetes has moved from a rare chronic condition to a baseline feature of modern health systems. The latest IDF Diabetes Atlas (11th edition, released 2025) estimates that about 589 million adults aged 20–79 were living with diabetes in 2024 — roughly one in nine adults worldwide, with projections rising to 853 million by 2050. Four in five of these adults live in low- and middle-income countries.
This article analyses the ten countries with the largest and most consequential diabetes burdens — China, India, Pakistan, the United States, Indonesia, Brazil, Mexico, Bangladesh, Egypt and Turkey. These countries combine a high age-standardised diabetes prevalence with a very large number of adults living with diabetes, shaping global trends in mortality, disability, and health expenditure.
Unless otherwise noted, prevalence (%) and population estimates are drawn from the IDF Diabetes Atlas and harmonised with World Bank and WHO statistical series for adults aged 20–79. Numbers are rounded and should be interpreted as indicative rather than exact point estimates.
Global context: why these 10 countries matter
At the global level, diabetes prevalence in adults has roughly doubled over the past three decades. WHO estimates that around 14% of adults aged 18+ were living with diabetes by 2022, compared with about 7% in 1990. IDF estimates 589 million adults 20–79 with diabetes in 2024, projected to rise to 853 million by 2050; about 81% of them live in low- and middle-income economies.
The ten countries profiled here sit at the centre of this shift:
- China and India alone account for well over a quarter of all adults with diabetes worldwide.
- Pakistan, Bangladesh, Egypt and Turkey combine high prevalence with rapidly growing, relatively young populations.
- Mexico and Brazil illustrate the impact of urbanisation and dietary change in upper-middle-income economies.
- The United States and Indonesia link diabetes to ageing, obesity, and gaps in access to preventive care.
Understanding how common diabetes is in these settings (prevalence) and how many people live with the condition (absolute numbers) is key for planning sustainable health systems.
Table 1. Age-standardised diabetes prevalence (%), adults 20–79 — TOP 10 countries
Age-standardised comparative prevalence in adults aged 20–79 years, latest IDF-based estimates (around 2021–2024), % of adult population.
One of the highest diabetes prevalences in the world, driven by fast urbanisation, limited primary care capacity, and high rates of obesity and physical inactivity.
Rapid growth in diabetes and obesity, especially in urban areas, combined with high rates of hypertension and cardiovascular disease and uneven access to long-term chronic care.
High prevalence linked to dietary transition, sugary beverages, sedentary lifestyles, and persistent inequalities in access to prevention, early diagnosis, and glucose-lowering medicines.
An upper-middle-income country where population ageing, rising obesity, and urban lifestyles have pushed diabetes prevalence well above the global average.
A densely populated lower-middle-income country with rapid dietary change and urbanisation, where health systems are still catching up with the chronic-care burden.
High prevalence reflecting widespread overweight and obesity, major social and racial inequities, and regional clusters such as the “diabetes belt” in the south-eastern states.
Even with a prevalence close to the global average, China has the largest number of adults with diabetes worldwide due to its vast population and rapid lifestyle changes.
A large and diverse archipelago where urban–rural gaps in screening, diagnosis and treatment contribute to a growing pool of undiagnosed diabetes.
Despite a prevalence slightly below some middle-income peers, India now hosts the largest absolute number of adults with diabetes, with enormous implications for primary care and workforce productivity.
Brazil illustrates the double burden of disease: non-communicable diseases like diabetes rising alongside residual infectious diseases, stretching the finances of a universal health system.
Note: Values are rounded IDF-based estimates for adults 20–79 and may differ slightly from national surveys. All ten countries exceed or are close to the global prevalence average, but their combined impact is magnified by very large adult populations.
Table 2. Adults with diabetes (millions) and projections to 2045
Estimated number of adults 20–79 years living with diabetes (around 2021) and projected count for 2045, based largely on the IDF Diabetes Atlas 10th edition. Values are rounded to one decimal place.
(≈ 2021, million)
(2045, million)
Together, these ten countries already host well over half of all adults with diabetes worldwide. In every case, absolute numbers are projected to rise substantially by 2045, even where prevalence grows more slowly, due to population growth and population ageing.
Bar chart: prevalence (%) in high-burden countries
The bar chart below compares age-standardised diabetes prevalence among adults 20–79 in the same ten high-burden countries. Pakistan, Egypt, Mexico, Turkey and Bangladesh stand out with prevalence well above 14%, illustrating how a large absolute burden often coincides with very high risk at the individual level.
Note: Data are based on IDF comparative prevalence estimates (around 2021). The y-axis represents percentage of adults aged 20–79 living with diabetes after age-standardisation.
Long-term trends: growth in diabetes cases since 2000
IDF estimates suggest that global diabetes prevalence in adults 20–79 increased from around 10.5% in 2021 to about 11% in 2024, while WHO data indicate that diabetes in the broader 18+ population roughly doubled between 1990 and 2022. In absolute terms, IDF places the number of adults with diabetes at about 151 million in 2000, over 530 million by 2021, and nearly 590 million by 2024. This is a shift from a relatively rare non-communicable disease to a near-ubiquitous cardiometabolic risk factor.
The ten high-burden countries mirror this global pattern, but with varying speeds of growth. To illustrate these dynamics, the chart below uses index values (2000 = 100) based on IDF historical trends and regional evidence for four representative countries: China, India, Pakistan and the United States. The exact values are indicative rather than official point estimates, but they capture the relative acceleration in each setting.
Index (2000 = 100) approximates the relative growth in the number of adults with diabetes. For example, an index of 250 suggests that the number of adults with diabetes is roughly 2.5 times the level in 2000.
What the numbers mean for health systems
1. A shift from acute care to chronic disease management
Diabetes is no longer a marginal condition managed mainly in specialist clinics. In all ten countries, it has become a core workload for primary care. Health systems that were designed around acute infections are having to re-orient towards lifelong disease management, including regular screening, HbA1c monitoring, retinal and kidney checks, and cardiovascular risk management.
2. Concentrated burden in working-age adults
While prevalence rises steeply with age, a substantial fraction of adults with diabetes in India, Pakistan, Bangladesh and Indonesia are still in their working years. This increases the risk of productivity losses, absenteeism and early retirement, especially in occupations that involve manual labour or shift work. In upper-middle-income countries like Mexico, Brazil and Turkey, diabetes and its complications already make a visible contribution to disability pensions and social protection costs.
3. Unequal exposure and unequal outcomes
Diabetes prevalence and outcomes are highly unequal within countries. In the United States, there is a well-described “diabetes belt” across the south-east; in India and China, urban residents and higher-income groups were initially more affected, but prevalence is rising fast in smaller towns and rural areas as diets and activity patterns change. Across the ten countries, poorer households often face higher risk factors and more barriers to treatment, including the cost of medicines and glucose monitoring.
4. Fiscal pressure from diabetes-related health expenditure
IDF estimates that global diabetes-related health expenditure already exceeds USD 1 trillion per year, having more than tripled over the last 15–20 years. High-burden countries face a difficult trade-off: either invest heavily in prevention and early control, or absorb spiralling costs from advanced complications such as kidney failure, myocardial infarction, stroke and amputations. In lower- and middle-income settings, the cost of long-term glucose-lowering therapy and insulin can still be catastrophic for uninsured households.
Policy priorities for high-burden countries
Evidence from IDF, WHO and recent global burden studies points to a consistent set of policy levers that are particularly relevant for the ten countries profiled here:
- Population-wide prevention — taxation and regulation of sugar-sweetened beverages, food labelling, urban design that enables walking and cycling, and school-based nutrition programmes.
- Early detection in primary care — systematic screening of adults at higher risk (age > 40, obesity, family history, gestational diabetes) and integration of diabetes checks into routine visits.
- Affordable essential medicines and technologies — reliable access to insulin, metformin and other first-line glucose-lowering agents, along with basic glucose monitoring, at prices that do not lead to catastrophic out-of-pocket spending.
- Integrated management of co-morbidities — treating diabetes together with hypertension, dyslipidaemia and obesity, using team-based primary care models and standardised treatment protocols.
- Data and surveillance — strengthening national diabetes registries and survey systems to track prevalence, incidence, complications and treatment coverage, disaggregated by age, sex, geography and income.
For countries like China and India, the sheer scale of the diabetes epidemic makes it a central macroeconomic issue. For Pakistan, Bangladesh, Egypt and Turkey, the combination of high prevalence, rapid growth in absolute numbers, and relatively constrained fiscal space underscores the urgency of cost-effective, population-level prevention. For high-income countries such as the United States, the key challenge is to close inequality gaps in access to high-quality chronic care and to address upstream drivers such as food environments and built-environment constraints on physical activity.
Data sources and further reading
- International Diabetes Federation — IDF Diabetes Atlas (11th edition, 2025) — global and country-level estimates for diabetes prevalence and projections.
- IDF — Diabetes facts and figures — summary of key global statistics for 2024 and projections to 2050.
- World Bank — Diabetes prevalence (% of population ages 20 to 79) — country-level time series for adults.
- World Health Organization — Diabetes fact sheet — trends in global prevalence and major risk factors.
- Sun H. et al. (2022) — IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045.
- World Population Review — Diabetes rates by country — compilation of IDF-based prevalence and case counts by country.
