Global and Regional Prediabetes Prevalence: Updates for 2024 and Projections for 2050

Prediabetes is characterized by elevations in blood glucose below the threshold for a diagnosis of diabetes. Adults with prediabetes are at high risk for developing diabetes and other cardiometabolic complications (1).

We previously reported for the International Diabetes Federation’s (IDF) Diabetes Atlas, 10th Edition, that the 2021 global prevalence of impaired glucose tolerance (IGT) was 9.1% and impaired fasting glucose (IFG) was 5.8% (1,2). However, only ∼30% of countries had data for IGT or IFG, and all of the data sources were published before 2021.

For the IDF Diabetes Atlas 11, we conducted a comprehensive review of >4,800 articles to identify high-quality, contemporary studies, and we generated global and regional prevalence estimates of IGT and IFG (3). Herein, we report our updated estimates of IGT and IFG for 2024 and provide projections for 2050.

Data sources were identified and abstracted according to established IDF methodology (Supplementary Methods) (2). We screened studies published between 2020 and 2024 along with data abstracted previously for Atlas 10 in 2021. We included estimates based on World Health Organization (WHO) criteria for IGT (2-h glucose 140–199 mg/dL [7.8–11.1 mmol/L]) and IFG (fasting glucose 110–125 mg/dL [6.1–6.9 mmol/L]). For countries/territories without original data, estimates were extrapolated from similar countries (2).

We estimated the prevalence of IGT and IFG among adults aged 20–79 years using logistic regression adjusted for age and the quadratic of age. We standardized estimates to each country’s age distribution and estimated the prevalence in 2050, incorporating midyear population projections for age distributions, sex, and urbanization ratios from the United Nations (3).

We screened 4,812 articles. For 215 countries/territories, there were 51 high-quality studies (from 46 countries/territories) for IGT and 63 high-quality studies (from 60 countries/territories) for IFG that met the selection criteria. There were 84 (∼40%) countries/territories that had studies for either IGT or IFG and 23 countries/territories (∼10%) had studies for both IGT and IFG. More than 63% of the global population was represented in the studies for IGT, and 59% was represented in the studies for IFG.

In 2024, 634.8 million adults, or 12.0% of adults, worldwide had IGT. The age-standardized prevalence of IGT in 2024 was highest in the Southeast Asia region and lowest in Europe (Fig. 1A). By 2050, 846.5 million adults, or 12.9% of the global adult population, are projected to have IGT.

Figure 1.

Regional estimates for IGT (A) and IFG (B) among adults aged 20–79 in 2024 and projections to 2050. Estimates are reported in total number of adults (age-standardized prevalence). Age standardization was based on United Nations age distribution data for each country. IGT was defined as 2-h postload glucose levels of 140–199 mg/dL (7.8–11.1 mmol/L). IFG was defined as fasting plasma glucose levels of 110–125 mg/dL (6.1–6.9 mmol/L).

In 2024, 487.7 million adults, or 9.2% of the global adult population, had IFG. The age-standardized prevalence of IFG in 2024 was highest in North America and Caribbean regions and lowest in Europe (Fig. 1B). By 2050, 647.5 million adults, or 9.8% of the global adult population, are projected to have IFG.

In 2024, the global prevalence of prediabetes was substantial. Our updated global estimates suggest a rising prevalence of IGT (from 9.1 to 12.0%) and IFG (from 5.8 to 9.2%) between 2021 and 2024 (1,2).

In the 11th edition of the IDF Diabetes Atlas, our estimates were derived using more studies for IGT and IFG, representing more countries/territories. Notably, the number of countries with IFG data sources increased by 50% (from 40 countries/territories in Atlas 10 to 60 countries/territories in Atlas 11). The inclusion of more original data with broader global representation can help to improve the accuracy of our IGT and IFG estimates.

Our study highlights the urgent need for diabetes prevention policies and interventions. This may be especially important in regions with the highest burden of IGT (Southeast Asia) and IFG (North America and Caribbean). Intervention strategies can be adapted to resource availability. Individual-level lifestyle interventions (e.g., Diabetes Prevention Program in the U.S.) and pharmacological interventions (e.g., metformin) can prevent diabetes, but can be resource-intensive. Community-based lifestyle interventions taught by lay personnel may be effective for diabetes prevention, particularly in low- and middle-income countries (4). Population-level efforts (e.g., sugar-sweetened beverage taxation) can also offer cost-effective strategies (5).

This study has limitations. Despite improvements since the last edition, only ∼40% of countries had original data on either IGT or IFG. Our estimates likely underestimate the total burden of prediabetes. We considered the prevalence of IGT and IFG separately (combined prevalence was rarely reported) and could not reliably model global prediabetes burden based on HbA_1c as few countries reported these data.

Strengths include the latest global and regional prediabetes estimates using established IDF methodology. Additionally, more countries had original data sources for IGT and IFG, resulting in fewer instances of extrapolation in this edition.

Prediabetes is common and projected to increase in prevalence by 2050, suggesting major global challenges for future diabetes risk.

This article contains supplementary material online at https://doi.org/10.2337/figshare.29922518.

Funding Statement

D.J.M. is funded by a National Health and Medical Research Council Investigator Grant Level 2 APP ID 2016668. E.S. was supported by National Institutes of Health, National Heart, Lung, and Blood Institute grant K24 HL152440 and a Merit Award from the American Heart Association. M.F. was supported by National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases grant K01 DK138273.