Approximately 36 to 38 million Americans have type 2 diabetes. That estimate comes from the CDC’s finding that 40.1 million people in the U.S. have diabetes overall, with 90% to 95% of those cases being type 2. That works out to roughly 1 in every 8 Americans, and the number has been climbing steadily for more than two decades.
How the Numbers Break Down
The 40.1 million figure includes both people who know they have diabetes and those who don’t. More than 1 in 4 adults with diabetes have not been diagnosed, meaning they are living with elevated blood sugar without knowing it. Across all U.S. adults aged 20 and older, about 15.8% have diabetes (diagnosed or undiagnosed), while 4.5% have undiagnosed diabetes specifically. Applied to the type 2 share, that puts roughly 8 to 10 million Americans in the position of having type 2 diabetes without being aware of it.
Why does undiagnosed diabetes matter? Type 2 diabetes often develops gradually, and blood sugar can stay high for years before symptoms become obvious. During that time, excess glucose is already damaging blood vessels, nerves, and organs. Many people first learn they have the condition only after a complication surfaces, like vision changes, slow-healing wounds, or kidney problems.
Who Is Most Affected
Type 2 diabetes does not hit all communities equally. Diagnosed diabetes rates among U.S. adults for 2021 to 2023 vary sharply by race and ethnicity:
- American Indian or Alaska Native: 15.7%
- Black, non-Hispanic: 12.2%
- Hispanic: 11.8%
- Asian, non-Hispanic: 9.7%
- White, non-Hispanic: 7.1%
American Indian and Alaska Native adults are diagnosed at more than twice the rate of white adults. These disparities reflect a mix of factors: unequal access to healthcare and healthy food, historical and ongoing socioeconomic disadvantages, and in some cases genetic predisposition. Black and Hispanic communities also carry a disproportionate burden, with rates that are roughly 60% to 70% higher than those of white Americans.
Rising Rates Over Time
The U.S. has seen a significant, sustained increase in diabetes prevalence since the early 2000s. Between 2001 and 2004, the age-adjusted prevalence of total diabetes among adults was 11.2%. By 2021 to 2023, it had risen to 13.5%. That climb tracks closely with rising rates of obesity and sedentary lifestyles over the same period.
The trend is especially concerning among young people. In 2002, about 9 out of every 100,000 young Americans were newly diagnosed with type 2 diabetes each year. By 2018, that figure had doubled to 18 per 100,000, representing roughly a 5% annual increase in new cases. Type 2 diabetes was once considered an adult disease, but it is now a growing reality for adolescents and young adults, particularly in communities that already face higher rates.
The Prediabetes Pipeline
Behind the 40 million Americans with diabetes sits an even larger group on the path toward it. An estimated 115.2 million U.S. adults, more than 2 in 5, have prediabetes. Their blood sugar is higher than normal but hasn’t crossed the diabetes threshold yet. The staggering part: 8 in 10 people with prediabetes don’t know they have it.
Prediabetes is not a guaranteed sentence. Losing 5% to 7% of body weight and getting regular physical activity can cut the risk of progressing to type 2 diabetes by more than half. But that only works if people know their status in the first place, which is why routine blood sugar screening matters so much, especially after age 35 or for anyone with risk factors like excess weight, a family history of diabetes, or membership in a higher-risk racial or ethnic group.
The Financial Toll
Diabetes is the most expensive chronic condition in the United States. The combined costs of healthcare, lost work, and reduced wages total $413 billion a year, based on 2022 data. On an individual level, medical costs for someone with diabetes are roughly double those of someone without it. That includes not just diabetes medications and supplies but also the downstream costs of managing complications like heart disease, kidney failure, and nerve damage, which are far more common in people with poorly controlled blood sugar.
These costs fall unevenly, too. The same communities with the highest diabetes rates often face the steepest financial barriers to managing it, creating a cycle where late diagnosis and inadequate treatment lead to more expensive complications down the road.