Skopje, 14 November 2025 (MIA) - Findings of the 11th edition of the International Diabetes Federation’s (IDF) Diabetes Atlas show that diabetes is one of the fastest-growing global health challenges of the 21st century. In 2024, it is estimated that 589 million adults aged 20-79 were living with diabetes, or 11.1 percent of the world’s population in this age group. In North Macedonia, around 141.000 people live with diabetes, which is 8.9 percent of adults, or approximately one in every eleven citizens of that age group.

The Atlas shows that an estimated 43 percent of adults living with diabetes are undiagnosed. This means that around 252 million people live with diabetes without being aware of their condition, missing the opportunity for early intervention and prevention of complications. Additionally, 635 million people were estimated to have impaired glucose tolerance and 488 million were estimated to have impaired fasting glucose, which significantly increase the risk of developing type 2 diabetes and cardiovascular diseases. The IDF Diabetes Atlas 11th edition also shows that hyperglycaemia in pregnancy (HIP) affects approximately one in five pregnancies.

Diabetes is also one of the leading causes of premature death. Approximately 3.4 million adults aged 20-79 years are estimated to have died because of diabetes or its complications in 2024 (2.4 million diagnosed diabetes-related deaths and 1 million undiagnosed diabetes-related deaths). This corresponds to 9.3 percent of global deaths from all causes in this age group.

The Atlas shows that the economic burden of diabetes is also enormous – over USD 1 trillion was spent on diabetes in 2024, which represents 12 percent of global health expenditure.

According to the report, around 9.1–9.5 million people had type 1 diabetes in 2024, of whom 1.9 million children and adolescents under the age of 20. The majority (69 percent) are aged 20-59. Europe has the highest number of people with type 1 diabetes (2.7 million), which reflects the high survival rate and better access to insulin and care. 

In North Macedonia 938 deaths annually are attributable to diabetes 

The Atlas estimates around 141.000 people in North Macedonia live with diabetes, representing 8.9 percent of adults or approximately one in every eleven citizens. Of these, about one-third – roughly 47.000 people – are unaware they have the disease. The comparative prevalence of 7.4 percent is slightly below the European average of 8 percent. 

According to the International Diabetes Federation, approximately 2.292 people in the country live with type 1 diabetes. Annual healthcare costs related to diabetes are estimated at around USD 134 million, or approximately USD 953 per patient. Diabetes-related mortality is estimated at about 938 deaths per year. 

National sources estimate that between 112.000 and 135.000 individuals have been diagnosed with diabetes, including around 4.000 officially registered with type 1 diabetes, 40.000 with insulin-treated type 2 diabetes, and between 72.000 and 80.000 receiving oral treatment. 

They note that insulin is provided free of charge to all individuals with diabetes, but reimbursement for other medications is limited. Insulin pumps and continuous glucose monitoring (CGM) systems are currently free only for children and a limited number of people with type 1 diabetes who have developed serious complications such as blindness, dialysis, or amputations (approximately 330 insulin pump users and 600 CGM users). Glucometers and test strips are fully reimbursed only for people with type 1 diabetes; access is more restrictive for those with insulin-treated type 2 diabetes. 

The National Diabetes Program and the public procurement system fund insulin, glucagon, needles, test strips, pumps, and CGM sensors, with a planned budget of around USD 16.1 million for 2024. However, recent procurement issues have led to serious shortages of glucometers, test strips, needles, and pump consumables. 

To achieve better outcomes, strengthening registries, improving access to modern monitoring and multidisciplinary care, and fully activating and updating the National Diabetes Strategy are essential. Additionally, a new financing and budgeting methodology based on regional models could lay the foundation for a more functional healthcare system. 

Total number of adults living with diabetes could rise to 853 million by 2050, or 13 percent of global population 

Data shows that diabetes is increasing in all IDF Regions, though the pace of growth varies significantly. The total number of people with diabetes in the IDF Africa Region is predicted to increase by 142% to 60 million by 2050, the highest percentage increase of all IDF Regions. Western Pacific is the IDF region with the highest number of adults living with diabetes (215 million) – more than one-third of global cases. China accounts for 1 in 4 of all adults living with diabetes worldwide. 1 in 6 adults has diabetes in the IDF Middle-East and North Africa Region – 85 million. The highest proportion of all IDF Regions.  Europe has about 65.6 million cases in 2024, projected to rise to 72.4 million by 2050 – the smallest relative increase, but a significant absolute growth. The North America and Caribbean Region has the highest diabetes-related expenditure (USD 439 billion), 43 percent of global expenditure. 

The Atlas states that by 2050, the number could reach 853 million people, or 13 percent of the adult population. Across all regions, the majority of new cases and the largest increase by 2050 will occur in low and middle-income countries, where health systems are least prepared to respond to chronic diseases. 

The IDF Diabetes Atlas represents a global research and advocacy tool that provides data for 215 countries and territories. The eleventh edition of the Atlas highlights key priorities in the fight against diabetes, including early detection, prevention, strengthening healthcare systems, and protection of vulnerable groups. 

World Diabetes Day is observed annually on November 14 and represents the largest global campaign for raising awareness about this chronic disease. It was introduced by the International Diabetes Federation and the World Health Organization, and in 2006, it received official recognition from the United Nations. The day is celebrated in honor of the birthday of Sir Frederick Banting, one of the discoverers of insulin, and aims to inform the public about prevention, early diagnosis, and modern treatment. The symbol of the campaign is the blue circle, representing unity in the fight against diabetes. In North Macedonia, educational events, free blood sugar screenings, and public forums are organized to support patients. 

MIA file photo