Diabetes: 830 million people worldwide live with this chronic disease
Diabetes: 830 million affected worldwide—half receive no treatment
Rajesh Kumar noticed the symptoms gradually, then all at once.
The 42-year-old shopkeeper in Mumbai felt constantly thirsty, drinking water throughout the day but never feeling satisfied. He needed to urinate frequently, sometimes waking four or five times during the night. Despite eating normally, he’d lost 15 pounds in two months. His vision became blurry. Fatigue overwhelmed him.
“I thought I was just getting older, working too hard,” Rajesh recalled. “I ignored it for months.”
When he finally visited a clinic, a simple finger-prick blood test revealed the truth: his blood glucose measured 280 mg/dL—nearly triple the normal level. The diagnosis was type 2 diabetes.
Rajesh joined 830 million people worldwide living with diabetes, according to WHO’s latest data on diabetes. The majority live in low- and middle-income countries. More than half—over 400 million people—are not receiving treatment.
That last number should alarm everyone. We’re talking about hundreds of millions of people with a chronic, life-threatening condition getting no care whatsoever.
What Diabetes Actually Is
Diabetes is a chronic metabolic disease characterized by elevated blood glucose levels, as explained in WHO’s fact sheet on diabetes. Over time, high blood sugar seriously damages the heart, blood vessels, eyes, kidneys, and nerves.
Two main types exist, with very different causes.
Type 1 diabetes, once called juvenile diabetes or insulin-dependent diabetes, occurs when the pancreas produces little or no insulin by itself. The immune system mistakenly attacks and destroys insulin-producing cells in the pancreas. People with type 1 diabetes require daily insulin injections to survive. This type can develop at any age but typically appears in children and young adults. Type 1 cannot currently be prevented.
Type 2 diabetes, the most common form accounting for about 90% of cases, occurs when the body becomes resistant to insulin or doesn’t make enough insulin. It usually develops in adults, though increasing numbers of children and adolescents are being diagnosed as obesity rates rise globally. Type 2 diabetes can often be prevented or delayed through healthy lifestyle choices.
The distinction matters enormously. Type 1 diabetes is not caused by lifestyle factors—it’s an autoimmune condition. Type 2 diabetes has strong connections to obesity, physical inactivity, and unhealthy diet, though genetics also play a role.
Dr. Sarah Chen, an endocrinologist who treats diabetes patients, emphasized the stigma issue: “People with type 2 diabetes often face judgment, assumptions that they caused their own illness through poor choices. That’s overly simplistic and ignores genetic predisposition, social determinants of health, and environmental factors. Blame doesn’t help anyone.”
The Alarming Global Trends
Here’s what should terrify public health officials: in the past three decades, the prevalence of type 2 diabetes has risen dramatically in countries of all income levels.
About 830 million people now have diabetes globally. Both the number of people with diabetes and the number with untreated diabetes have been steadily increasing over recent decades.
Despite a globally agreed target to halt the rise in diabetes and obesity by 2025, we’re moving in the wrong direction. Instead of plateauing, diabetes prevalence continues climbing.
What’s driving this crisis?
Obesity rates have exploded globally. Urbanization has reduced physical activity—people drive instead of walk, work desk jobs instead of physical labor, spend leisure time on screens instead of moving. Diets have shifted toward processed foods high in sugar, unhealthy fats, and calories but low in nutrients. These changes happened rapidly in developing countries undergoing economic transitions, contributing to diabetes surges in regions that historically had low rates.
For more on global chronic disease trends, see our article on noncommunicable diseases.
Symptoms: Often Missed Until Damage Occurs
Type 1 diabetes symptoms include frequent urination, excessive thirst, constant hunger, weight loss, vision changes, and fatigue. These symptoms may occur suddenly, prompting quick medical attention.
Type 2 diabetes symptoms are generally similar but often less pronounced. The disease may develop gradually over years, diagnosed only after complications have already developed—heart disease, kidney damage, vision loss, nerve damage.
“I see patients who’ve had diabetes for five or ten years before diagnosis,” Dr. Chen explained. “By the time they come in, they already have retinopathy affecting their vision, or neuropathy causing numbness in their feet, or early kidney disease. All that damage happened silently while blood sugar remained uncontrolled.”
This delayed diagnosis makes awareness of risk factors critical. Family history, obesity, physical inactivity, previous gestational diabetes, and age over 45 all increase type 2 diabetes risk. People with risk factors should get screened regularly even without symptoms.
WHO recently launched guidelines on diabetes during pregnancy, recognizing that hyperglycemia during pregnancy affects both maternal and infant health outcomes.
The Devastating Complications
Uncontrolled diabetes destroys the body progressively and relentlessly.
High blood glucose damages blood vessels throughout the body. Cardiovascular disease—heart attacks and strokes—represents the leading cause of death among people with diabetes. Diabetes increases cardiovascular disease risk two to three times.
Diabetes is a leading cause of kidney failure, requiring dialysis or kidney transplant for survival. Diabetic retinopathy causes blindness, with diabetes representing a major cause of vision loss globally. Diabetic neuropathy damages nerves, causing numbness, tingling, and pain, particularly in feet and hands. Severe nerve damage combined with poor circulation leads to diabetic foot ulcers, infections, and amputations.
The human cost is staggering. The economic cost is enormous—healthcare expenses, lost productivity, disability, and premature death impose massive burdens on individuals, families, and health systems.
Yet most diabetes complications can be prevented or delayed through proper blood glucose control, blood pressure management, cholesterol control, regular screening, and early intervention when problems arise.
The Treatment Gap Crisis
For people living with diabetes, access to affordable treatment—including insulin—is critical to survival. This statement from WHO’s diabetes overview reveals a stark reality: access remains inadequate globally.
More than half of people with diabetes—over 400 million people—receive no treatment. Even among those who do receive care, many can’t afford medications, blood glucose monitoring supplies, or specialist consultations needed for optimal management.
Insulin, discovered over a century ago, remains unaffordable for millions who need it. Three pharmaceutical companies control most global insulin production. Prices in some countries exceed what families earn in months. People ration insulin, skipping doses to make supplies last longer—a dangerous practice that leads to complications and death.
WHO’s Essential Medicines List now includes key diabetes treatments, aiming to improve access. But listing medicines as essential doesn’t automatically make them affordable or available.
Maria Santos, who lives in rural Guatemala with type 1 diabetes, described her reality: “The insulin I need costs more than my father earns in a month. The clinic is three hours away. I can’t afford the bus fare and the insulin. So I use less insulin than I need, and I know I’m slowly killing myself, but what choice do I have?”
Stories like Maria’s repeat millions of times globally.
What Actually Works
Despite challenges, effective interventions exist.
Prevention of type 2 diabetes is possible through population-wide policies and individual actions. Regular physical activity, healthy eating, maintaining healthy weight, avoiding smoking, and controlling blood pressure all reduce risk significantly. These interventions benefit everyone, not just those at high diabetes risk.
For people already living with diabetes, a series of cost-effective interventions improve outcomes regardless of diabetes type: blood glucose control through diet, physical activity, and medication when necessary; blood pressure and cholesterol management to reduce cardiovascular complications; and regular screening for eye, kidney, and foot complications to enable early treatment.
WHO established The Global Diabetes Compact to bring together governments, UN agencies, civil society, people with diabetes, and the private sector to reduce diabetes risk and ensure all people diagnosed with diabetes have access to equitable, comprehensive, affordable, quality treatment and care.
The Compact focuses on promoting healthy lifestyles, expanding access to medicines and health technologies, strengthening health systems, and improving diabetes surveillance and monitoring.
Recent WHO work includes developing recommendations on care for women with diabetes during pregnancy and assessing availability, price, and affordability of diabetes health technologies globally.
For more articles on chronic disease management, visit ObserverVoice.com.
What Must Happen
The diabetes crisis requires urgent action across multiple levels.
Governments must implement policies reducing obesity and promoting healthy lifestyles—sugar taxes, food labeling, urban planning supporting physical activity, restrictions on marketing unhealthy foods to children.
Health systems need to integrate diabetes care into primary care, ensuring early diagnosis, affordable medications including insulin, blood glucose monitoring supplies, and specialist care when needed.
The pharmaceutical industry must address insulin pricing and availability—generic insulin production should be expanded, prices reduced, and patent barriers lowered.
International organizations and donors should support diabetes programs in low-income countries where treatment gaps are largest.
Research must continue developing better treatments, prevention strategies, and ultimately cures for both type 1 and type 2 diabetes.
The Bottom Line
Diabetes affects 830 million people worldwide, with numbers rising rather than stabilizing despite global targets. More than half receive no treatment despite effective interventions existing.
This chronic metabolic disease causes devastating complications—heart disease, stroke, kidney failure, blindness, amputations—yet most complications are preventable through proper care.
Type 2 diabetes can often be prevented through healthy lifestyles and supportive policies. Type 1 diabetes requires daily insulin to survive, yet millions lack access to affordable insulin.
The treatment gap represents a massive failure of global health equity. We have the knowledge and tools to prevent, diagnose, and manage diabetes. What’s missing is political will, adequate funding, and commitment to ensuring everyone—regardless of where they live or what they can afford—has access to life-saving care.
Back to Rajesh Kumar in Mumbai: he was fortunate. The clinic connected him with subsidized medications. A community health worker taught him about diet and exercise. He borrowed a neighbor’s blood glucose meter to monitor levels. Six months later, his blood sugar approached normal. He lost weight, felt energetic again, and avoided complications.
But for every Rajesh who gets help, millions like Maria in Guatemala go without, rationing insulin, developing preventable complications, dying decades before they should.
That’s the diabetes crisis in human terms. And it’s completely unacceptable.
Frequently Asked Questions (FAQs)
Diabetes is a chronic metabolic disease characterized by elevated blood glucose levels that over time damage the heart, blood vessels, eyes, kidneys, and nerves. Type 1 diabetes occurs when the pancreas produces little or no insulin—the immune system destroys insulin-producing cells, and it cannot currently be prevented. Type 2 diabetes, accounting for ~90% of cases, occurs when the body becomes resistant to insulin or doesn’t produce enough—it’s linked to obesity, physical inactivity, and unhealthy diet, though genetics play a role. Over the past three decades, type 2 diabetes prevalence has risen dramatically globally. Learn more at WHO’s diabetes information page.
About 830 million people worldwide have diabetes, the majority living in low- and middle-income countries. More than half of people living with diabetes are not receiving treatment—over 400 million people with no care whatsoever. Both the number with diabetes and the number with untreated diabetes have been steadily increasing over recent decades despite a globally agreed target to halt the rise by 2025. The increasing prevalence represents a major public health crisis. See WHO’s fact sheet on diabetes for detailed statistics.
Type 1 diabetes symptoms include frequent urination, excessive thirst, constant hunger, weight loss, vision changes, and fatigue—these may occur suddenly. Type 2 diabetes has similar but often less marked symptoms, so the disease may be diagnosed years after onset, after complications have developed. Early diagnosis is critical—the longer someone lives with undiagnosed and untreated diabetes, the worse their health outcomes. Easy access to blood glucose testing should be available in primary care settings. Risk factors include family history, obesity, physical inactivity, age over 45, and previous gestational diabetes. WHO recently released guidelines on diabetes during pregnancy.
Type 1 diabetes cannot currently be prevented. Type 2 diabetes can often be prevented through regular exercise, healthy eating, maintaining healthy weight, avoiding smoking, and controlling blood pressure. For people already with diabetes, cost-effective interventions improve outcomes: blood glucose control through diet, physical activity, and medication when necessary; blood pressure and cholesterol management; and regular screening for eye, kidney, and foot complications enabling early treatment. For type 1 diabetes and some type 2 cases, insulin is essential for survival. Access to affordable insulin and diabetes medications is critical but remains inadequate globally.
WHO established The Global Diabetes Compact bringing together governments, UN agencies, civil society, people with diabetes, and the private sector to reduce diabetes risk and ensure access to equitable, comprehensive, affordable, quality treatment and care. The Compact focuses on promoting healthy lifestyles, expanding access to medicines and health technologies, strengthening health systems, and improving surveillance. WHO also develops clinical guidelines, including recent recommendations on care for women with diabetes during pregnancy, assesses availability and affordability of diabetes technologies, and added key diabetes treatments to the Essential Medicines List.
- WHO Diabetes Information Hub
- WHO Fact Sheet on Diabetes
- The WHO Global Diabetes Compact
- WHO Recommendations on Care for Women with Diabetes During Pregnancy
- WHO Technical Advisory Group on Diabetes
- Availability, Price and Affordability of Diabetes Health Technologies
- WHO Essential Medicines List Update on Diabetes Treatments
- World Diabetes Day 2025 Campaign
Disclaimer: This article is an adaptation of publicly available information from WHO’s Diabetes
health topic page (WHO, Geneva. Licence: CC BYNC-SA 3.0 IGO). WHO is not responsible for the
content or accuracy of this adaptation. This content is for informational and educational purposes
only and does not constitute medical advice. ObserverVoice.com is a news and information platform
— not a healthcare provider.
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