- A modelling study across 204 countries estimates diabetes could cost about US$10 trillion from 2020 to 2050 even before counting unpaid family care
- When unpaid care is included, the total rises sharply, with informal caregiving making up most of the burden
- Researchers argue prevention, earlier diagnosis and better access to care are key to reducing both health impact and economic damage
Diabetes is already one of the most common long-term conditions worldwide and prevalence keeps rising.
A new analysis suggests the knock on impact is not just clinical, it is macroeconomic too.
Researchers linked to the International Institute for Applied Systems Analysis and Vienna University of Economics and Business modelled the economic burden of diabetes across 204 countries from 2020 to 2050.
They estimated that, excluding unpaid care provided by family members, diabetes would cost the global economy around US$10 trillion over the period.
That works out at roughly 0.2% of annual global GDP, averaged across the time window.
The numbers climb dramatically when unpaid care is counted. Factoring in informal care, the total cost estimate rises to as much as US$152 trillion, around 1.7% of global GDP.
The researchers argue this matters for chronic conditions like diabetes because the day to day support needs can be substantial and often fall on families, not formal services.
- Type 2 diabetes is linked to weaker heart muscle in people with ACF
- Common type 2 diabetes tablets may affect insulin producing cells
One reason unpaid care dominates is that diabetes is far more common than it is fatal.
The study team estimates informal caregiving accounts for about 85% to 90% of the total economic burden in their modelling, largely because people may live with diabetes for decades.
In absolute terms, the United States carries the largest total costs in the model, followed by China and India.
That partly reflects population size and economic size.
Looking instead at the burden relative to the size of the economy, some countries rank differently.
The researchers highlight the Czech Republic as having the highest burden as a share of GDP in their analysis at around 0.5%, with the United States and Germany next at roughly 0.4%.
They also looked at costs per person. In their estimates, Ireland, Monaco and Bermuda have the highest per capita burden, with figures in the thousands to tens of thousands of dollars per person across the modelling period.
The breakdown of where the burden falls also differs by income level.
In higher income countries, treatment costs make up a much larger share of the non caregiving burden than in lower income settings.
The researchers interpret this as a reflection of access, with more intensive treatment regimes available in wealthier countries, while lower income countries see a bigger share of costs through lost labour and productivity.
The paper also explored how COVID-19 changed the picture, because diabetes is a major risk factor for severe outcomes.
When the authors attributed some COVID-19 illness and deaths to diabetes, the estimated GDP burden rose in several major economies, including China, the United States and Germany.
So what would actually reduce these costs? The authors point to two big levers.
First is prevention through healthier diets and regular physical activity, which can lower the risk of developing type 2 diabetes. Second is earlier detection and timely treatment.
They argue for stronger screening and faster diagnosis, particularly in lower income countries where underdiagnosis is common and diabetes can worsen outcomes from infectious diseases.
Study details: Simiao Chen et al. The global macroeconomic burden of diabetes mellitus. Nature Medicine (2025). DOI: 10.1038/s41591-025-04027-5
