Roughly 38 million adults in the United States have type 2 diabetes. That figure comes from national survey data collected between 2021 and 2023 showing that 15.8% of all U.S. adults have some form of diabetes, with about 91% of those cases being type 2. The number has climbed steadily for decades and is projected to keep rising.
Total Prevalence and Undiagnosed Cases
Of the 15.8% of U.S. adults living with diabetes, 11.3% have been formally diagnosed and 4.5% remain undiagnosed. That means roughly one in four people with diabetes don’t know they have it. Undiagnosed diabetes is particularly concerning because elevated blood sugar causes damage to blood vessels, kidneys, and nerves even when no symptoms are obvious. People who go years without a diagnosis often already have complications by the time they’re tested.
The undiagnosed rate isn’t evenly distributed. Hispanic and Asian American adults have an undiagnosed prevalence of about 7.5%, nearly double the 3.9% rate among white adults. Black adults fall in between at 5.2%. These gaps likely reflect differences in access to routine screenings and primary care.
Who Is Most Affected
Type 2 diabetes hits certain communities harder than others. After adjusting for age and sex, the overall diabetes prevalence among white adults is 12.1%. For Black adults it’s 20.4%, for Hispanic adults 22.1%, and for Asian American adults 19.1%. Within those broad categories, the variation is even wider. Among Hispanic subgroups, Mexican Americans have the highest rate at 24.6%, while South Americans have the lowest at 12.3%. Among Asian American subgroups, South Asian and Southeast Asian adults have rates above 22%, compared to 14% for East Asian adults.
Age is the single strongest risk factor. The percentage of adults with diabetes climbs steadily through middle age and reaches 28.8% among those 65 and older, meaning nearly three in ten older adults are living with the condition.
Prediabetes: The Pipeline
Behind the 38 million people with type 2 diabetes sits a much larger group at risk. An estimated 115.2 million American adults, more than two in five, have prediabetes. That means their blood sugar is elevated but hasn’t crossed the threshold for a diabetes diagnosis. Without intervention, a significant portion of these people will develop type 2 diabetes within a few years. Losing a modest amount of weight through healthier eating and regular physical activity can cut that risk roughly in half.
Where the Numbers Are Headed
Projections from the International Diabetes Federation’s modeling estimate that the total number of Americans with diabetes (type 1 and type 2 combined) will reach roughly 55 million by 2030. That’s a 54% increase from 2015 levels. The growth is driven by an aging population, rising obesity rates, and the sheer size of the prediabetes pool feeding new diagnoses each year. Even if prevention efforts improve, the demographic math makes a significant increase nearly unavoidable.
The Financial Toll
Diabetes is one of the most expensive chronic conditions in the country. The total estimated cost of diagnosed diabetes in 2022 was $412.9 billion. Direct medical costs accounted for $306.6 billion of that, covering things like medications, hospital stays, and ongoing monitoring. The remaining $106.3 billion came from indirect costs: $35.8 billion in reduced productivity at work, $28.3 billion from disability-related job loss, and $32.4 billion from premature deaths, which totaled more than 338,000 in that year alone. On a per-person basis, people with diagnosed diabetes spend roughly two to three times more on medical care than people without the condition.