Diabetes mellitus is a chronic metabolic condition and one of the most prevalent non-communicable diseases worldwide. Today, roughly one in ten adults lives with diabetes, and this share continues to rise. As prevalence increases, the disease is placing a growing strain not only on healthcare systems but also on national and global economies. A recent study provides a comprehensive assessment of these impacts by estimating the economic burden of diabetes across countries and over time, while also pointing to strategies that could reduce these costs.

The analysis, conducted by an international research team including economists from IIASA and the Vienna University of Economics and Business, examines the economic consequences of diabetes in 204 countries between 2020 and 2050. The findings highlight the enormous scale of the challenge. Excluding informal care provided by family members, the global economic cost of diabetes is estimated at around US$10 trillion, equivalent to approximately 0.2% of annual global GDP. When informal caregiving is included, however, total costs rise dramatically to as much as US$152 trillion, or 1.7% of global GDP, underlining the exceptional economic significance of diabetes as a chronic disease.

A major driver of this burden is the reliance on informal care. Family members often provide long-term support to people living with diabetes, frequently reducing their working hours or leaving the labour market altogether. These lost labour contributions generate substantial indirect economic costs. According to the study, informal caregiving accounts for between 85% and 90% of the total financial burden, largely because diabetes prevalence far exceeds mortality. While the disease is widespread, people tend to live with it for many years, requiring ongoing care and support.

Although diabetes is more common in lower-income countries, the highest absolute economic costs are borne by the world’s largest economies. The United States incurs the highest total costs, followed by China and India, reflecting their large populations and economic output. Relative measures, however, tell a more nuanced story. As a share of GDP, the burden is highest in the Czech Republic, at around 0.5%, followed by the United States and Germany at roughly 0.4%. On a per capita basis, the heaviest economic burdens are observed in Ireland, Monaco, and Bermuda.

The study also reveals stark differences between high- and low-income countries in how the burden is distributed. In high-income countries, direct treatment costs account for about 41% of the economic burden once caregiving is excluded, whereas in low-income countries, treatment costs make up only around 14%. This contrast reflects unequal access to adequate medical care and highlights how comprehensive treatment regimes for chronic diseases remain concentrated mainly in wealthier nations.

The authors further show that diabetes has amplified the economic effects of the COVID-19 pandemic. As a significant risk factor for severe illness and death from COVID-19, diabetes significantly increased economic losses during the pandemic period, particularly in countries such as China, the United States, and Germany. Overall, the findings point to an urgent need for policy action. Promoting healthier lifestyles, improving early detection through widespread screening, and ensuring timely treatment are essential steps to reduce both the health and economic consequences of diabetes, especially in low-income countries where underdiagnosis remains a serious challenge.

More information: Simiao Chen et al, The global macroeconomic burden of diabetes mellitus, Nature Medicine. DOI: 10.1038/s41591-025-04027-5

Journal information: Nature Medicine Provided by International Institute for Applied Systems Analysis