Diabetes could drain up to INT$78.8 trillion from the global economy by 2050, study finds

By Priyanjana Pramanik, MSc.Reviewed by Susha Cheriyedath, M.Sc.Jan 5 2026

A large international modelling study reveals that the hidden cost of unpaid caregiving, not healthcare alone, drives the staggering long-term economic impact of diabetes across countries and income levels.

Study: The global macroeconomic burden of diabetes mellitus. Image Credit: Proxima Studio / Shutterstock

In a recent study published in the journal Nature Medicine, researchers estimated the global economic burden of diabetes mellitus using a long-term macroeconomic modeling approach with a baseline discount rate of 2%. They estimated that diabetes could cost the global economy INT$10.2 trillion between 2020 and 2050, increasing to INT$78.8 trillion when accounting for the burden of informal caregiving under baseline assumptions, with estimates varying widely depending on caregiving time assumptions.

Rising Global Prevalence and Economic Consequences

Diabetes mellitus is a major and growing global health challenge, affecting more than one in ten adults worldwide and disproportionately impacting low- and middle-income countries (LMICs).

Population ageing, rising obesity, unhealthy diets, and environmental risks have driven a sharp increase in diabetes prevalence, with projections suggesting that nearly 800 million adults will be living with the disease by 2045. The coronavirus disease 2019 (COVID-19) pandemic has further intensified this burden by increasing both the severity of outcomes among people with diabetes and the risk of developing the disease after infection, although pandemic-related burden estimates were analysed separately from the main projections and were not incorporated into the baseline results.

Beyond its health consequences, diabetes places a substantial strain on national economies. Global healthcare spending on diabetes already exceeds $900 billion annually and continues to increase.

However, existing estimates of the economic burden are incomplete, particularly in LMICs, due to limited data and reliance on traditional cost-of-illness approaches. These methods often fail to capture broader economic effects, such as changes in labour supply, capital accumulation, and productivity, as well as the extensive unpaid care provided by families over long periods of chronic illness and the resulting long-term macroeconomic adjustments.

Macroeconomic Modeling of Diabetes Burden

Researchers applied a macroeconomic model that simulates how diabetes affects economic growth over time, from 2020 to 2050, across 204 countries and territories. By incorporating morbidity, mortality, treatment costs, and informal caregiving, they aimed to provide the most comprehensive global assessment to date of the long-term economic impact of diabetes mellitus.

The model compared a status quo scenario, in which diabetes persists, with a counterfactual scenario in which diabetes is assumed to be fully eliminated for modelling purposes rather than as a realistic policy scenario. The difference in projected gross domestic product (GDP) between these scenarios represents the burden of the disease.

The model incorporated multiple pathways through which diabetes affects the economy. These included losses in effective labour supply due to diabetes-related mortality and reduced productivity from morbidity, as well as diversion of savings and investment toward healthcare treatment costs that would otherwise contribute to physical capital accumulation.

Importantly, the model also accounted for informal caregiving, estimating reductions in labour force participation among family members who provide unpaid care to people with diabetes and assigning economic value to lost work time at prevailing country-specific wage levels.

Country-specific data on diabetes prevalence, mortality, treatment costs, education, and workforce composition were used where available. For countries with incomplete data, values were imputed using regression methods. All estimates were converted to 2017 international dollars (INT$), a purchasing-power-adjusted currency that enables economic comparisons across countries and over time.

Global and Regional Economic Losses

Globally, diabetes mellitus is projected to cost the world economy INT$10.2 trillion between 2020 and 2050, excluding informal caregiving. This represents an annual loss of approximately 0.22% of global GDP. When informal care is included, the economic burden increases dramatically to INT$78.8 trillion, with sensitivity analyses indicating a wide plausible range from approximately INT$5.5 trillion to over INT$150 trillion depending on caregiving assumptions, highlighting caregiving as the dominant source of economic loss.

In absolute terms, the largest economic burdens occur in the United States (US), India, and China, reflecting their large populations and economies. However, when measured relative to GDP or on a per-capita basis, the burden is highest in small island states and high-income countries, including American Samoa, Australia, and Brunei Darussalam.

Across regions, North America experiences the highest per-capita losses, while Sub-Saharan Africa shows lower per-capita costs but a growing future burden as diabetes prevalence continues to rise.

Treatment costs account for a substantial share of economic losses in high-income countries, whereas productivity losses dominate in lower-income settings. Informal caregiving contributes between 85% and 90% of the burden across all regions, reflecting the chronic nature of diabetes and long-term care needs rather than premature mortality alone.

Comparisons with disability-adjusted life years show that economic losses are disproportionately higher in wealthier countries for the same health burden, reflecting higher average wages and productivity per worker rather than greater disease severity.

Implications, Limitations, and Policy Relevance

This study provides the most comprehensive global estimate to date of the macroeconomic burden of diabetes mellitus by incorporating productivity losses, treatment costs, and informal caregiving across 204 countries.

The burden is unevenly distributed, with the highest absolute costs in the US, China, and India, and the highest relative and per-capita burdens in countries such as American Samoa and Australia.

A key strength is the use of a dynamic macroeconomic model that accounts for economic adjustments and long-term effects on human and physical capital. The findings reveal that informal caregiving is the most significant and underestimated contributor to diabetes-related economic losses worldwide.

However, the results likely underestimate the true burden because undiagnosed diabetes, indirect mortality, and some healthcare costs were not fully captured. Data limitations necessitated imputation for a small number of countries, and estimates of caregiving time remain uncertain, even under conservative assumptions.

Overall, the study highlights diabetes as a major threat to global economic sustainability. The unequal distribution of costs underscores the need for prevention, early diagnosis, improved care, and support for caregivers, particularly in LMICs, to reduce both health and economic consequences.