Diabetes affects roughly 830 million people worldwide, and the number keeps climbing. In the United States alone, about 40.1 million people (12% of the population) are living with the condition, and 11 million of them don’t know it yet. While anyone can develop diabetes, certain groups face significantly higher risk based on age, sex, income, where they live, and racial background.
Type 1 vs. Type 2: Different Causes, Different Groups
Over 90% of people with diabetes have type 2, which develops when the body stops using insulin effectively. Type 2 is driven by a mix of genetic, environmental, and lifestyle factors, with rising obesity rates, aging populations, and increasingly sedentary lives fueling the global surge. Type 1 diabetes is an autoimmune condition where the body attacks its own insulin-producing cells. It typically appears in childhood or adolescence, though it can develop at any age, and it isn’t preventable through lifestyle changes.
A third form, gestational diabetes, develops during pregnancy and affects 5% to 9% of U.S. pregnancies each year. It usually resolves after delivery but raises the long-term risk of type 2 diabetes for both the mother and child.
Age Is the Strongest Predictor
Your risk of diabetes rises steeply as you get older. Among U.S. adults aged 20 to 39, only 2.2% have a diagnosed case. That jumps to 12.1% for people aged 40 to 59, and reaches 20.5% for those 60 and older. One in five older adults is living with diabetes, making it one of the most common chronic conditions in that age group.
But diabetes is no longer just an adult disease. Between 2002 and 2018, new cases of type 1 diabetes in young people rose from 20 to 22 per 100,000 per year. The increase in type 2 was far more dramatic: new diagnoses among youth doubled from 9 to 18 per 100,000 over the same period. That doubling mirrors rising childhood obesity rates and more sedentary lifestyles among adolescents.
Men Face Higher Rates Than Women
In the U.S., 18% of men have diabetes compared to 13.7% of women. Men also have higher rates of diagnosed diabetes (12.9% vs. 9.7%). The gap in undiagnosed cases between men and women isn’t statistically significant, meaning both sexes are roughly equally likely to be walking around without knowing they have the condition.
Women do face a unique risk through gestational diabetes. Those of African American, Hispanic or Latino, American Indian, Alaska Native, Native Hawaiian, or Pacific Islander background are at higher risk during pregnancy. A history of gestational diabetes is one of the strongest predictors of developing type 2 diabetes later in life.
Race, Ethnicity, and Unequal Risk
Diabetes does not affect all racial and ethnic groups equally. In the U.S., American Indian, Alaska Native, Black, Hispanic, and Pacific Islander populations all experience higher rates than non-Hispanic white populations. These disparities persist even after accounting for differences in income, weight, and access to healthcare, pointing to a combination of genetic susceptibility, structural inequality, and environmental factors that compound risk over generations.
The same racial and ethnic groups at higher risk for type 2 diabetes also face elevated risk for gestational diabetes, creating a cycle where the condition can affect multiple generations within the same family.
Income and Education Create a Steep Gradient
Socioeconomic status is one of the most reliable predictors of diabetes risk. Adults without a high school diploma have about twice the prevalence of diabetes compared to college graduates. In one analysis of 2016 to 2017 data, 12.7% of adults who didn’t finish high school had type 2 diabetes, compared to 7.0% of those with education beyond high school. That gap has been widening: between 2001 and 2020, the absolute difference in diabetes prevalence between the least and most educated groups grew from 8 percentage points to 11.
What makes this finding especially notable is that the disparity doesn’t disappear when researchers account for other risk factors. Even after adjusting for age, race and ethnicity, poverty, healthcare access, and BMI, adults without a high school diploma still had a 5.8 percentage point higher prevalence of diabetes than college graduates. Lower income and less education often mean less access to fresh food, fewer safe places to exercise, more stressful living conditions, and less flexibility to attend medical appointments. All of these compound over years.
Rural Communities Are Hit Harder
Where you live matters. Diabetes prevalence is 9% to 17% higher in rural areas than in urban ones. Across 41 U.S. states analyzed in a 2021 study, 14.3% of rural adults had diabetes compared to 11.2% of urban adults. Rural residents were about 1.3 times more likely to have a diabetes diagnosis than their urban counterparts.
Rural communities tend to have fewer primary care providers, longer distances to specialty clinics, higher poverty rates, and fewer grocery stores carrying affordable fresh produce. These factors create an environment where diabetes is both more likely to develop and harder to manage once it does. In 19 of the 41 states studied, the rural-urban gap was statistically significant on its own, before adjusting for any other demographic differences.
A Global Pattern of Growth
The worldwide picture follows a consistent trajectory. In 1990, about 200 million people had diabetes and 7% of adults qualified for a diagnosis. By 2022, those numbers had exploded to 830 million people and 14% of adults. That’s a fourfold increase in total cases in just over three decades. Urbanization is a major driver: as more of the world’s population moves into cities, diets shift toward processed foods, physical activity drops, and rates of overweight and obesity climb. Aging populations in high-income countries add to the total, while younger-onset type 2 diabetes is becoming more common in lower-income regions.
The groups most affected, whether by age, income, geography, or race, share a common thread. Diabetes clusters where the conditions for healthy living are hardest to maintain. Understanding who carries the highest burden is the first step toward understanding why, and what structural changes could slow the trend.