Diabetes mellitus is a chronic metabolic disorder and one of the most prevalent non-communicable diseases worldwide. On average, one in ten adults is affected. The number of people living with diabetes continues to rise, posing an increasing challenge for healthcare systems and entire economies. A new study reveals the global and national economic costs of diabetes and offers strategies to reduce them.
A research team including experts from IIASA and the Vienna University of Economics and Business (WU Vienna) has calculated the economic impact of diabetes across 204 countries from 2020 to 2050. The findings are striking: Excluding informal care provided by family members, global costs amount to approximately US$ 10 trillion – equivalent to 0.2% of the annual global GDP. When informal care is factored in, costs soar to as much as US$ 152 trillion, or 1.7% of GDP. This is particularly significant for diseases like diabetes.
"Caregivers often drop out of the labor market, at least partially, which creates additional economic costs," explains WU economist Klaus Prettner, one of the study authors.
The high share of informal caregiving, ranging between 85% and 90% of the total economic burden, is explained by the fact that prevalence exceeds mortality by a factor of 30-50. Although diabetes is more common in lower-income countries, the United States bears the highest absolute costs, followed by China and India.
"To some extent, these rankings reflect the size of the economies included in our analysis in terms of GDP and population, but it is interesting to note that at 0.5% the Czech Republic has the highest burden as a percentage of GDP, followed by the United States and Germany at 0.4%. Ireland, Monaco, and Bermuda face the largest per capita economic burdens at $18,000, $12,000, and $8,000 dollars respectively," notes coauthor Michael Kuhn, Acting Economic Frontiers Research Group Leader at IIASA.
One prime distinction between high- and low-income countries is the distribution of the burden across the treatment cost and lost labor channels, where the former makes up 41% of the economic burden (net of caregiving) for high-income countries as opposed to 14% for low-income countries.
"This is a stark illustration of how medical treatment regimes for chronic diseases such as diabetes are accessible to high income countries only," Kuhn adds.
Role of COVID-19
Diabetes has proved to be one of the main risk factors for mortality from COVID-19. In a side analysis the authors explored how the economic burden of diabetes has been affected when factoring in morbidity and mortality from COVID-19 that can be attributed to diabetes. The effects are sizeable, where the economic burden increases from 0.16% to 0.22% per unit of GDP for China, from 0.4% to 0.65% per unit of GDP for the US, and from 0.4% to 0.45% per unit of GDP for Germany.
"Previous estimates of diabetes-related costs were often based on overly simplified assumptions and tended to ignore economic dynamics," says Prettner. "This study's innovative approach incorporates labor market effects, such as work absences due to caregiving responsibilities. It also recognizes that healthcare spending does not necessarily reduce economic output but often represents a shift from consumer spending toward health sector spending."
Urgent need for policy action
When compared to other diseases over the same period, such as Alzheimer's, dementia, or cancer, the economic impact of diabetes is enormous. The authors emphasize that the most effective way to prevent diabetes and reduce its economic impact lies in promoting healthier lifestyles. Regular physical activity combined with a balanced diet can significantly lower the risk of developing the disease.
In addition, early detection plays a crucial role: comprehensive diabetes screening programs for the entire population, along with rapid diagnosis and timely treatment for individuals showing symptoms or risk factors, are essential steps toward mitigating both health and economic consequences.
"Such steps are particularly relevant for low-income countries, where high levels of underdiagnosis and its role in raising mortality from infectious diseases render diabetes a severe risk factor for the stability of health care systems," Kuhn concludes.
Reference
Chen, S., Cao, Z., Chen, W., Zhao, J., Jiao, L., Prettner, K., Kuhn, M., Pan, A., Bärnighausen, T.W., Bloom, D.E. (2025). The global macroeconomic burden of diabetes mellitus. Nature Medicine DOI: 10.1038/s41591-025-04027-5
About IIASA:
The International Institute for Applied Systems Analysis (IIASA) is an international scientific institute that conducts research into the critical issues of global environmental, economic, technological, and social change that we face in the twenty-first century. Our findings provide valuable options to policymakers to shape the future of our changing world. IIASA is independent and funded by prestigious research funding agencies in Africa, the Americas, Asia, and Europe. www.iiasa.ac.at
