Diabetes mellitus has emerged as one of the most pressing public health challenges in the United States. Characterized by insulin production or insulin action that causes chronic hyperglycemia, diabetes affects millions of Americans and places a tremendous burden on individuals, families, and the American healthcare system.
According to recent estimates, over 35 million Americans are living with diabetes. Additionally, nearly 100 million adults are considered to have prediabetes, a condition that significantly increases the risk of developing type 2 diabetes. The prevalence continues to rise, driven largely by lifestyle factors such as sedentary behavior, unhealthy diets, and increasing rates of obesity. Type 2 diabetes remains the most common form, though type 1 diabetes also contributes significantly to the disease burden 1–3.
The development of type 2 diabetes is strongly linked to modifiable risk factors, including obesity, poor nutrition, and physical inactivity. However, non-modifiable factors such as genetics, family history, and age also play a role. Importantly, social determinants of health, including socioeconomic status, education, neighborhood environment, and access to healthcare, profoundly shape diabetes risk and outcomes. Communities with limited access to healthy food or safe places for exercise face higher rates of disease 4–6.
The American landscape of diabetes is marked by stark disparities across racial and ethnic groups. Hispanic/Latino, African American, Native American, and certain Asian American populations experience disproportionately high rates of both diabetes and its complications. Barriers such as limited healthcare access, underinsurance, and cultural or language differences often exacerbate these disparities. Addressing equity in diabetes prevention and treatment is therefore a critical national priority 2,7,8.
Uncontrolled diabetes can lead to a wide range of complications, including cardiovascular disease, kidney failure, neuropathy, vision loss, and amputations. These complications significantly reduce quality of life and contribute to premature mortality. Mental health is also deeply intertwined with diabetes, as depression, anxiety, and diabetes distress are common among those managing the disease. Effective communication, patient education, and psychosocial support are essential components of comprehensive care 9–11.
The American Diabetes Association estimates the total annual cost of diabetes at around $400 billion, including both direct medical costs and indirect costs related to lost productivity. Hospitalizations, emergency care, and long-term treatment of complications account for the majority of expenditures, placing strain on patients, families, employers, and the healthcare system 12,13.
Addressing the diabetes epidemic requires a multifaceted approach. Public health initiatives promoting healthier diets, increased physical activity, and early screening for prediabetes are crucial. Policy interventions that improve access to affordable medications, healthy foods, and preventive care are equally important. Advances in technology, like continuous glucose monitors, insulin pumps, and telehealth platforms, continue to transform diabetes management 14–16.
The American landscape of diabetes reflects both progress and persistent challenges. While innovations in treatment and care have improved outcomes for many, rising prevalence and deep health disparities highlight the urgent need for comprehensive, equity-focused strategies.
1. CDC. National Diabetes Statistics Report. Diabetes https://www.cdc.gov/diabetes/php/data-research/index.html (2024).
2. Neupane, S., Florkowski, W. J. & Dhakal, C. Trends and Disparities in Diabetes Prevalence in the United States from 2012 to 2022. American Journal of Preventive Medicine 67, 299–302 (2024). DOI: 10.1016/j.amepre.2024.04.010
3. Rowley, W. R., Bezold, C., Arikan, Y., Byrne, E. & Krohe, S. Diabetes 2030: Insights from Yesterday, Today, and Future Trends. Popul Health Manag 20, 6–12 (2017). DOI: 10.1089/pop.2015.0181
4. Cooper, Z. W., Mowbray, O. & Johnson, L. Social determinants of health and diabetes: using a nationally representative sample to determine which social determinant of health model best predicts diabetes risk. Clinical Diabetes and Endocrinology 10, 4 (2024). DOI: 10.1186/s40842-023-00162-5
5. Hill, J., Nielsen, M. & Fox, M. H. Understanding the Social Factors That Contribute to Diabetes: A Means to Informing Health Care and Social Policies for the Chronically Ill. Perm J 17, 67–72 (2013). DOI: 10.7812/TPP/12-099
6. Hill-Briggs, F. et al. Social Determinants of Health and Diabetes: A Scientific Review. Diabetes Care 44, 258–279 (2021). DOI: 10.2337/dci20-0053
7. Diabetes in America: Prevalence, Statistics, and Economic Impact. https://diabetes.org/about-diabetes/statistics/about-diabetes.
8. Khavjou, O. Rural–Urban Disparities in State-Level Diabetes Prevalence Among US Adults, 2021. Prev. Chronic Dis. 22, (2025). DOI: 10.5888/pcd22.240199
9. Lloyd, A., Sawyer, W. & Hopkinson, P. Impact of long-term complications on quality of life in patients with type 2 diabetes not using insulin. Value Health 4, 392–400 (2001). DOI: 10.1046/j.1524-4733.2001.45029.x
10. AbuAlhommos, A. K. et al. The Health-Related Quality of Life of Patients with Type 2 Diabetes in Saudi Arabia. PPA 16, 1233–1245 (2022). DOI: 10.2147/PPA.S353525
11. Diabetes – Symptoms and causes – Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444.
12. CDC. Health and Economic Benefits of Diabetes Interventions. National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) https://www.cdc.gov/nccdphp/priorities/diabetes-interventions.html (2025).
13. Parker, E. D. et al. Economic Costs of Diabetes in the U.S. in 2022. Diabetes Care 47, 26–43 (2024). DOI: 10.2337/dci23-0085
14. Afable, A. & Karingula, N. S. Evidence based review of type 2 diabetes prevention and management in low and middle income countries. World J Diabetes 7, 209–229 (2016). DOI: 10.4239/wjd.v7.i10.209
15. Preventing and Treating Diabetes | American Heart Association. https://www.heart.org/en/health-topics/diabetes/prevention–treatment-of-diabetes.
16. Bowen, S.-A. Public Health Research and Program Strategies for Diabetes Prevention and Management. Prev. Chronic Dis. 22, (2025). DOI: 10.5888/pcd22.240501
