An estimated 252 million adults have diabetes without knowing it, the International Diabetes Federation says. Taxes, labels and screening drives from Mexico to India show how countries are trying to slow the disease.
Only 57% of people with diabetes know they have it, according to the International Diabetes Federation. Its World Diabetes Day scorecard, out on 10 November, puts the undiagnosed total at 252 million adults. The World Health Organization’s target is 80% of cases diagnosed by 2030. That would take about 134 million extra diagnoses, or roughly 89,000 a day.
Behind that gap, diabetes has doubled in a generation. The share of adults with diabetes rose from about 7% in 1990 to 14% in 2022. That’s 828 million people, in a Lancet study led by Imperial College London with the WHO. The federation’s own estimate, from a separate model, is 589 million.
Diabetes now kills 3.4 million people a year. It also took more than $1tn of health spending in 2024, about 12% of the global total. Nearly nine in ten undiagnosed people live in low and middle-income countries, where treatment has stalled. So the question is whether any policy can slow the disease where it’s rising fastest.
New cases have levelled off in richer countries
In 19 of 23 data sources from mostly rich countries, new diagnoses were stable or falling after 2010. The 2021 study, in The Lancet Diabetes & Endocrinology, covered 22 million diagnoses in 21 countries from 1995 to 2018.
Care has improved in the same places. In 2022, more than 55% of people with diabetes got treatment in North America, western Europe and parts of East Asia. Belgium reached 86% of women. In some sub-Saharan African countries, the figure was 5% to 10%. For women, the gap between the best and worst countries grew from 56 to 78 points after 1990.
England’s NHS schemes cut risk and put some cases into remission
England’s NHS Diabetes Prevention Programme had enrolled more than 1.2 million people with raised blood sugar by late 2023. It opened in 2016. A PLoS Medicine study of almost 70,000 patients tracked them for three years. Those referred were 20% less likely to get type 2 diabetes. The raw gap was small, however: 6.2% of referred people got it, against 6.4% of others.
A second NHS scheme, Path to Remission, works with people who already have type 2 diabetes. Its low-calorie diet put 32% of completers into remission after a year, with average weight loss of 15.9kg. That covers the 450 people who finished, out of 7,540 sent to it.
Taxes and labels have changed what people drink
Mexico put a tax of one peso per litre on sugary drinks in 2014. Purchases then fell 5.5% in the first year and 9.7% in the second, a Health Affairs study found.
The UK’s Soft Drinks Industry Levy charges producers according to sugar content. Average sugar in the drinks it covers fell 47% between 2015 and 2024 as makers reformulated, the Treasury says. From January 2028 it will cover sweetened milkshakes and plant-based drinks. Its lower threshold also falls to 4.5g per 100ml.
Since December 2022, packaged drinks in Singapore have carried an A to D Nutri-Grade label. Purchases of the two worst grades fell 44%, while household sugar intake from packaged drinks dropped 18%, Duke-NUS researchers found. Richer households changed their habits the most.
South Africa’s sugar levy, introduced in April 2018, cut young adults’ intake of taxed drinks. Some of that sugar came back through untaxed drinks, though, according to a PLoS Medicine study.
India is screening adults over 30
India has the most people with untreated diabetes, 133 million in the Lancet estimate. Its health ministry ran a national drive in February and March 2025. The aim was to check everyone aged 30 and over for diabetes and high blood pressure. By June, 6.4 million people had been diagnosed with diabetes that year and put on treatment, a minister told parliament. That is fewer than one in 20 of the untreated total, although the two figures cover different years.
Diagnosis rates will show whether the push works
So far, the evidence shows taxes cutting sugar, labels shifting purchases and prevention courses cutting personal risk. None of these studies measures a fall in national prevalence.
The federation puts the diagnosed share at 57%, against the WHO’s target of 80% by 2030. Its next Diabetes Atlas and India’s screening returns will show whether that gap is closing where most undiagnosed people live.
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