Diabetes mellitus, which affects more than one in ten adults worldwide, is projected to impose a substantial global economic burden of over $10 trillion between 2020 and 2050, according to a new modelling study published in Nature Medicine.¹ The analysis highlights the immense cost of the disease, particularly when accounting for informal care, and reveals a significant disparity in the economic impact across different world regions.
Methodology
Researchers used a health-augmented macroeconomic model to estimate the economic impact of diabetes in 204 countries and territories. The model projected the macroeconomic burden from 2020 to 2050 by comparing a 'status quo' scenario with a counterfactual scenario in which diabetes was eliminated. The analysis incorporated several key factors: losses in effective labour supply due to mortality and morbidity, the diversion of economic resources for treatment costs, and the financial impact of informal caregiving. Data were sourced from the Global Burden of Disease (GBD) 2021 study, the World Bank, and the International Labour Organization.
Results
Excluding the cost of informal care, the global macroeconomic burden of diabetes is estimated to be $10.2 trillion in 2017 international dollars (INT$), equivalent to an annual tax of 0.22% on the global gross domestic product (GDP).¹ The absolute costs are highest in the United States (INT$2.5 trillion), India (INT$1.6 trillion), and China (INT$1.0 trillion).
The burden increases dramatically when informal caregiving is included, rising to INT$78.8 trillion, or 1.72% of the annual global GDP. Informal care was found to account for over 84% of the total economic burden in all regions.
The economic impact is unevenly distributed. North America faces the highest relative burden, at 0.39% of its GDP. Treatment costs contribute a larger proportion of the total burden in high-income countries (40.5%) compared to lower-middle-income countries (14.0%), where productivity losses have a greater relative impact.
In Practice/Interpretation
The study underscores the profound and unequally distributed economic consequences of diabetes. The findings particularly draw attention to the often-overlooked cost of informal care, which constitutes the vast majority of the financial burden. According to the authors, Dr Simiao Chen and colleagues, "These findings highlight the uneven distribution of diabetes’ economic impact and underscore the urgent need for effective global interventions."¹ The results suggest that policies aimed at mitigating diabetes should also consider support for informal caregivers to reduce the overall economic strain.
Next Steps
The authors suggest that strengthening public health interventions is essential to protect global health and economic well-being. Key strategies include promoting lifestyle interventions, enhancing cost-effective screening for prediabetes and undiagnosed diabetes, and ensuring early diagnosis and treatment to reduce the long-term health and economic consequences of the disease.²
This study was funded by Horizon Europe, the China Medical Board, and the Ministry of Science and Technology of the People’s Republic of China.
References
1. Chen S, Cao Z, Chen W, et al. The global macroeconomic burden of diabetes mellitus. Nat Med (2025). https://doi.org/10.1038/s41591-025-04027-5
2. Bommer C, Heesemann E, Sagalova V, et al. The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study. Lancet Diabetes Endocrinol. 2017;5:423–430. https://doi.org/10.1016/S2213-8587(17)30097-9
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