What the Data Misses: Undiagnosed Diabetes in Africa and Low-Resource Settings

Global diabetes statistics often tell us who is living with the condition—but what about the millions who aren’t even counted? The reality across many parts of Africa and other low-resource settings is that diabetes is not only rising—it’s also going largely undiagnosed.

According to the International Diabetes Federation’s 2025 Atlas, over 72.6% of people with diabetes in Africa remain undiagnosed, the highest rate across any global region. This means the majority of individuals affected are unaware, unmonitored, and untreated.

A Hidden Crisis Behind the Numbers

While global headlines often focus on lifestyle-driven diabetes in wealthier countries, the picture in lower-income nations is different—and arguably more urgent. In Mali, for example, nearly 60% of adults with diabetes were unaware of their condition. In Ethiopia, surveys report that up to 78% of adults have never had their blood sugar tested, not even once.

Yet the absence of a diagnosis doesn’t mean the disease isn’t progressing. Many people continue with undetected hyperglycemia until complications like stroke, kidney failure, or vision loss bring them to a clinic—often too late for effective prevention.

Why So Many Cases Go Undiagnosed

Several factors contribute to underdiagnosis in low-resource areas:

• Limited screening programs: Routine glucose testing is still not standard in many public health systems. Blood sugar checks are often only offered to those with visible symptoms—by which point damage may already be underway.
• Lack of awareness: In many communities, diabetes is misunderstood or minimized. Few people recognize the early signs—like fatigue, thirst, or frequent urination—as warning flags.
• Urban bias in research: Most diabetes data comes from city-based health centers or hospital records. In rural communities, where healthcare access is limited, cases go undocumented and uncounted.
• Testing limitations: Even when screening exists, commonly used tests like HbA1c may miss some forms of diabetes in African populations due to genetic and biochemical variations.

What This Means for Public Health and Practice

Undiagnosed diabetes has ripple effects. Without clear data, national health systems under-budget for diabetes education, medication, and lifestyle support. Individuals miss out on early intervention—when lifestyle changes can be most effective—and instead face complications that are harder and more expensive to treat.

But this is not just a clinical oversight—it’s a health equity issue. Failing to diagnose people simply because of where they live or what systems they’re part of reflects deeper imbalances in care access, infrastructure, and global priority.

What We Can Do—Even Without a Lab

As a nutritionist working in this space, I believe we can take practical steps to close the gap:

• Raise awareness: Start with symptoms—fatigue, unintentional weight loss, and vision changes—and empower people to seek testing.
• Normalize screening: Advocate for point-of-care glucose checks in community events, local clinics, and wellness programs.
• Train professionals to detect patterns: A nutritionist may be the first person to suspect diabetes based on dietary recalls, weight patterns, or client fatigue.

Diagnosis doesn’t require high-end technology—it starts with vigilance, conversation, and culturally relevant education.

A Final Thought

Data may guide policy—but real change begins with action on the ground. If we want to address diabetes in Africa and low-resource settings, we must recognize the silent burden of the undiagnosed.

Because behind every “unreported case” is a person whose story—and health—matters.

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