Global estimates of undiagnosed diabetes in adults: findings from the 2025 IDF Diabetes Atlas

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Objective: Undiagnosed diabetes leads to delayed treatment and increased risk of complications, exacerbating global disease burdens. In this study, we estimated the prevalence and absolute numbers of undiagnosed diabetes globally and across regions, and quantified gaps in national diabetes detection efforts. Research Design and Methods: We systematically compiled estimates of biomarker-based diabetes prevalence and self-reported diabetes diagnosis using 2003–2024 data from all eligible population-based studies and grey literature. We calculated proportions with undiagnosed diabetes and case numbers among adults aged 20-79 years. For countries without data, we extrapolated estimates using available data within the same geographic region and country-income group. Country-level estimates were benchmarked against the World Health Organization 80%-diagnosis target. Results: We identified 193 data sources on undiagnosed diabetes from 109 countries. Across all 215 countries/territories, 42.8% of individuals with diabetes were undiagnosed, equating to 251.7 million [95%-uncertainty interval (UI): 250.8–252.6 million] adults. Proportions undiagnosed ranged from 16.2% in Colombia to 90.4% in Burkina Faso, and 29.1% in North America and the Caribbean to 72.6% in Africa. A larger proportion of individuals were undiagnosed in low-income (58.7%) compared to high-income countries (28.9%). Middle-income countries accounted for 206.0 million [95%-UI: 202.3–209.7 million] adults with undiagnosed diabetes (81.8% of all cases), including 127.1 million [95%-UI: 121.2–133.0 million; or 50.5%] adults in China, India, and Indonesia alone. Under 5% of all countries attained diabetes diagnosis levels above 80%. Conclusions: Substantial variability in undiagnosed diabetes globally indicates opportunities to close existing care gaps, likely requiring context-specific solutions and investments.