Top 10 Countries with the Highest Rates of Diabetes in Africa 2025

In Summary 

• Africa now accounts for over 6% of global diabetes cases, despite the continent historically recording lower rates than Asia or the West.
• Rural populations are increasingly affected, with more than two-thirds of Africa’s diabetics undiagnosed, making prevalence higher than official figures.
• Several African nations, including Egypt, South Africa, and Tanzania, are investing in insulin access, screening, and lifestyle awareness campaigns to address the rise.

Deep Dive!!

Lagos, Nigeria, Friday, September 12 - Diabetes is steadily emerging as one of Africa’s most significant health challenges in 2025. The International Diabetes Federation estimates that over 24 million people on the continent live with the condition, a number projected to rise in the coming decade. Unlike infectious diseases that dominate Africa’s public health agenda, diabetes grows quietly in the background, yet it carries major implications for healthcare systems and national economies.

The increase is tied to multiple shifts. Urbanization has changed how people eat and live, traditional diets are being replaced with processed foods, and levels of physical activity are falling. Rising life expectancy and genetic predispositions in some populations also play a role. What makes the African situation distinct is that a large share of cases remain undiagnosed, especially in rural areas where healthcare access is limited. This creates a double burden: many live with diabetes without treatment, while health systems face pressure to manage complications that could have been prevented.

Despite the scale of the problem, progress is visible across the continent. Governments are investing in national diabetes programs, community-based screening initiatives, and greater access to insulin. Regional collaborations and global partnerships are also supporting training for healthcare workers and research into non-communicable diseases.

This ranking of the top ten African countries with the highest diabetes burden in 2025 presents not only the numbers but also the context behind them. It highlights where prevalence is concentrated, why the figures look the way they do, and how each country is addressing the challenge. 

10. Tunisia

Tunisia recorded an estimated 869,400 people living with diabetes, equal to 9.6 percent of its adult population. This figure makes diabetes one of the leading non-communicable diseases in the country, with a prevalence that sits above the continental average. The rise is tied to shifts in diet and lifestyle. While Tunisia has a long tradition of Mediterranean eating patterns that are linked to lower health risks, urbanization has changed food consumption. Processed foods and reduced levels of daily physical activity are now common in cities, contributing to rising obesity and diabetes rates.

Tunisia’s healthcare system is relatively structured compared to many African countries and offers broad access to clinics, particularly in urban centers where screening and treatment are more easily available. This access supports earlier detection and provides many patients with pathways to management through the public health system. However, challenges remain for rural populations, where consistent follow-up treatment is limited and access to specialist care is more difficult. These gaps leave a portion of the population at risk of complications that could be prevented with timely intervention.

To respond, the Ministry of Health has expanded its National Diabetes Program, which emphasizes early screening, reliable insulin supply, and education on lifestyle modification. Public awareness campaigns have been introduced to encourage healthier diets and increased physical activity, often highlighting elements of the traditional Mediterranean diet as a preventive model. Moving forward, Tunisia’s combination of healthcare infrastructure, government focus, and cultural health awareness creates a strong foundation for slowing the rise of diabetes, though rural inequalities remain an area that will require sustained investment and attention.

9. Democratic Republic of Congo 

The Democratic Republic of Congo is home to about 1.9 million people living with diabetes, with a national prevalence of 5.8 percent. While this rate is lower than in many North African countries, the DRC’s large population means that the overall number of cases is among the highest on the continent. Many of these cases remain undiagnosed because healthcare access in rural and remote regions is limited, making the real burden likely higher than reported. The rise in diabetes here is closely linked to urbanization, where shifts in diet and lifestyle have led to higher rates of obesity and reduced levels of physical activity, particularly in growing cities like Kinshasa and Lubumbashi.

The DRC faces unique challenges in managing diabetes due to its fragile healthcare system. Primary care facilities are stretched thin, and specialized services for non-communicable diseases are concentrated in urban centers, leaving much of the population underserved. Even when diagnosis occurs, access to consistent treatment can be disrupted by supply shortages and affordability issues, making long-term management difficult. This situation increases the risk of complications such as kidney disease and cardiovascular problems, which place further strain on the healthcare system.

Despite these obstacles, progress is taking place. International partnerships and non-governmental organizations are working with the Ministry of Health to strengthen non-communicable disease programs and improve supply chains for essential medicines like insulin. Community health initiatives have begun to incorporate diabetes screening alongside programs for infectious diseases, making early detection more accessible at the grassroots level. While the DRC still faces structural challenges, the growing recognition of diabetes as a national health concern signals a shift in attention that can improve outcomes over time.

8. Ethiopia 

Ethiopia records an estimated 1.9 million people living with diabetes, representing about 5 percent of its adult population. The prevalence rate is lower than in several North African countries, yet the overall number of cases is significant due to Ethiopia’s large and growing population. Many cases remain undiagnosed, particularly in rural areas where people often have limited contact with healthcare providers. Urbanization is reshaping lifestyle patterns, with processed foods and sedentary habits contributing to rising risks, while genetic susceptibility and lack of routine health checks add to the burden.

Managing diabetes in Ethiopia is complicated by disparities in healthcare access. Public hospitals in major cities like Addis Ababa provide diagnostic services and treatment, but rural areas often lack trained staff and adequate facilities. For many patients, insulin and regular monitoring are difficult to obtain, leading to poor control of the disease and higher chances of complications. Limited awareness about non-communicable diseases also means that symptoms are often overlooked until they become severe, which increases costs for both families and the healthcare system.

In response, Ethiopia has integrated diabetes care into its broader health programs. The government has been working with international partners to improve access to essential medicines and expand training for health workers in rural areas. Screening campaigns are now more common in urban clinics, and community outreach programs promote awareness about diet, exercise, and lifestyle management. Although challenges remain, these steps reflect a growing commitment to tackling diabetes within a health system that is still heavily focused on infectious diseases but increasingly adapting to the demands of chronic conditions.

7. Algeria

Algeria is estimated to have around 2 million people living with diabetes in 2025, representing 7.1 percent of its adult population. The country has seen steady growth in diabetes cases over the past decade, linked to rapid urbanization and shifts in dietary patterns. Traditional food habits are being replaced with processed and high-calorie diets, while reduced levels of physical activity in urban areas further raise the risk. Rising obesity, especially among younger adults, has also contributed to the growing burden of diabetes across the country.

Healthcare access in Algeria is stronger than in many African countries, with public hospitals and clinics widely available, particularly in coastal urban regions where most of the population lives. Screening and diagnosis rates are relatively high compared to sub-Saharan Africa, yet access to specialized treatment is uneven. Patients in rural areas, particularly in the interior and desert regions, often face delays in diagnosis and limited access to consistent care. The cost of managing diabetes remains a concern, with many households struggling to afford medications and monitoring equipment despite government subsidies.

The Algerian government has introduced several initiatives to address the rise of non-communicable diseases, including diabetes awareness campaigns and programs promoting healthy lifestyles. Partnerships with international organizations have also supported the training of health workers and improvement of supply chains for essential medicines such as insulin. Public health campaigns emphasize nutrition education and encourage physical activity, while national policies aim to make treatment more affordable and accessible. These combined measures reflect Algeria’s effort to control a disease that continues to expand quietly within its population, adding pressure on a healthcare system already balancing both chronic and infectious disease challenges.

6. Morocco 

Morocco records an estimated 2.3 million people living with diabetes in 2025, equal to 9.1 percent of its adult population. The number reflects both the country’s demographic size and lifestyle changes that have accompanied urban growth. Shifts in eating habits, with more reliance on processed foods and sugary beverages, combined with lower levels of physical activity, are central drivers of the disease. Rising obesity rates, especially in urban centers like Casablanca and Rabat, have made diabetes one of Morocco’s most pressing non-communicable diseases.

The country has made significant progress in building a health system that addresses chronic conditions. Public hospitals and urban health centers provide screening and management services, but disparities remain between urban and rural regions. Many patients in rural Morocco struggle with delayed diagnosis and inconsistent follow-up care. Insulin and diabetes medication are generally available through public facilities, yet supply gaps and affordability issues can still disrupt long-term management. These challenges highlight the strain on the healthcare system as it works to balance both infectious and non-communicable diseases.

In recent years, the Moroccan government has expanded national strategies focused on non-communicable diseases, with diabetes at the center. Awareness campaigns have emphasized healthier dietary choices and promoted physical activity, often aligning with cultural traditions to encourage acceptance. International partnerships have supported capacity building, while local associations work to increase community knowledge and improve patient support. With continued investment in healthcare access and education, Morocco is strengthening its response to a condition that continues to grow in scale and importance within its population.

5. Tanzania 

Tanzania is home to an estimated 2.9 million people living with diabetes in 2025, representing 12.3 percent of its adult population. This figure underscores how non-communicable diseases are becoming a major health concern in East Africa. While infectious diseases such as malaria and tuberculosis remain significant, the growing burden of diabetes highlights how lifestyle shifts and urbanization are reshaping the country’s health profile. In cities such as Dar es Salaam, changes in diet, reduced physical activity, and increasing obesity have all contributed to this rise.

A key challenge in Tanzania is the high rate of undiagnosed diabetes. Many individuals live with the condition for years without medical intervention, often presenting to hospitals only after serious complications develop. Rural areas, where most of the population resides, face the greatest difficulties. Access to diagnostic tools, insulin, and consistent follow-up care is limited, which widens health inequalities between urban and rural regions. This gap contributes to late diagnoses, poor disease management, and higher rates of diabetes-related complications such as kidney failure and cardiovascular disease.

Despite these challenges, Tanzania has made notable progress in strengthening its health system. The government has incorporated diabetes management into primary healthcare programs, with initiatives to train frontline workers and extend services to rural communities. Non-governmental organizations and international health agencies have partnered with the Ministry of Health to support awareness campaigns, provide essential equipment, and subsidize treatment. Community-driven education programs, including school-based health promotion, are gradually building awareness about diet, exercise, and the dangers of unchecked diabetes. These steps reflect Tanzania’s commitment to improving outcomes despite the scale of the challenge.

4. Sudan 

Sudan has one of the highest diabetes prevalence rates in Africa, with 18.9 percent of its adult population—around 3.5 million people—living with the condition in 2025. This striking figure places Sudan at the center of Africa’s diabetes challenge. Several factors fuel these numbers, including rapid urbanization, dietary transitions, and limited access to preventive healthcare. The reliance on refined carbohydrates and sugary drinks, combined with reduced physical activity, has created conditions where diabetes is growing faster than many other non-communicable diseases in the country.

The burden of diabetes in Sudan is made more complex by the nation’s broader healthcare struggles. Years of political and economic instability have weakened the health system, leaving hospitals and clinics underfunded and often overstretched. Insulin shortages, limited diagnostic equipment, and uneven distribution of medical staff are common, especially outside Khartoum. Rural populations are disproportionately affected, with many patients unable to access consistent treatment. As a result, late diagnosis and untreated complications such as amputations, vision loss, and kidney disease remain widespread.

Still, efforts are being made to address the crisis. Sudanese health authorities, often with support from international agencies, have launched programs aimed at non-communicable disease control. Diabetes associations and community-based organizations play a crucial role in providing education, supporting patients, and advocating for better access to care. Awareness campaigns are also gradually shifting public attitudes towards healthier diets and physical activity. While challenges remain significant, Sudan’s inclusion in regional initiatives to strengthen health systems offers an avenue for improvement in managing a disease that affects nearly one in five adults.

3. Nigeria 

Nigeria, Africa’s most populous country, has an estimated 3.6 million people living with diabetes in 2025. While its prevalence rate of 3.6 percent is lower compared to other countries on this list, the absolute number is significant due to the country’s massive population. This means Nigeria carries one of the heaviest diabetes burdens on the continent. The country faces a dual challenge: dealing with long-standing infectious diseases while also contending with the steady rise of non-communicable diseases such as diabetes. Urban lifestyles, dietary changes, and rising obesity rates, particularly in major cities like Lagos and Abuja, are fueling this shift.

One of the key issues in Nigeria’s diabetes landscape is underdiagnosis. Studies suggest that many people living with diabetes remain undiagnosed, often seeking medical help only after severe complications arise. Access to healthcare is highly unequal across the country. While urban centers offer specialized clinics, diagnostic facilities, and pharmacies stocked with insulin and other treatments, rural areas often lack even basic screening services. Out-of-pocket healthcare costs remain a barrier, forcing many families to forgo consistent treatment. These gaps result in poor management outcomes and high rates of preventable complications such as neuropathy and cardiovascular disease.

Despite these challenges, Nigeria is actively addressing diabetes as part of its non-communicable disease response. Federal and state health agencies have launched initiatives aimed at early detection, community awareness, and integration of diabetes care into primary healthcare. Civil society groups and professional associations also play an important role, providing patient education and lobbying for better healthcare policies. Awareness campaigns are increasingly focused on promoting healthier diets, encouraging exercise, and dispelling myths about diabetes. While the path forward is complex, Nigeria’s sheer size means that improvements in its diabetes response will have a major impact on Africa’s overall fight against the disease.

2. South Africa

South Africa has an estimated 4.2 million people living with diabetes in 2025, representing 10.8 percent of its adult population. This makes it one of the countries carrying the heaviest diabetes burden in Africa. Urban lifestyles, dietary shifts, and rising obesity have all contributed to the condition’s rapid growth. In South Africa, diabetes is often described as part of a “double epidemic,” as it exists alongside high rates of hypertension and cardiovascular disease. The situation has reached a point where diabetes is now among the leading causes of death in the country.

Healthcare services in South Africa are relatively advanced compared to much of the continent, with both public and private systems in place to manage chronic conditions. However, disparities remain clear. While urban populations often have access to specialists, screening tools, and modern treatment facilities, rural communities face shortages of doctors, diagnostic equipment, and regular access to medication. Even within cities, economic inequality shapes how people experience healthcare, as poorer households struggle with costs associated with long-term treatment. These challenges have made diabetes not just a medical issue but also a social and economic one.

In response, South Africa has implemented several strategies to manage the disease. Public health campaigns have raised awareness about obesity, unhealthy diets, and the dangers of sugar consumption. The government also introduced a tax on sugary beverages in 2018, one of the first in Africa, aimed at reducing excessive sugar intake and improving public health outcomes. Non-governmental organizations and medical associations have strengthened community-level awareness and patient support programs. Together, these steps highlight how South Africa is balancing the weight of a large diabetes burden with policy-driven actions designed to slow its growth and improve the lives of those affected.

1. Egypt

Egypt leads Africa in both the number and prevalence of diabetes cases, with 10.9 million people living with the condition in 2025. This represents 20.9 percent of its adult population, one of the highest rates on the continent. Egypt’s large population combined with rapid urbanization, dietary changes, and rising obesity has created conditions where diabetes has grown into a public health crisis. The widespread consumption of refined carbohydrates, sugary foods, and low levels of physical activity, especially in urban areas, has made diabetes one of the country’s leading health challenges.

The strain of this disease is evident across the healthcare system. Hospitals and clinics are working to manage the growing number of patients, but gaps remain. Insulin and medication are generally available, yet affordability and consistent access remain concerns for low-income families. Rural areas face even greater challenges, where diagnostic delays and limited follow-up care contribute to high rates of complications. With diabetes already placing pressure on kidney dialysis units, cardiovascular services, and ophthalmology clinics, Egypt is experiencing firsthand how a chronic disease reshapes the entire health sector.

Egypt has taken visible steps to confront the issue. The government has launched nationwide initiatives targeting non-communicable diseases, including free screening campaigns for millions of citizens. Educational programs in schools and communities highlight the importance of healthy eating and regular exercise. Partnerships with international organizations and local medical associations have supported research, training, and public awareness campaigns. These measures show that Egypt is not only grappling with a significant diabetes burden but also working to implement strategies that can curb the disease’s impact over time. The country’s experience underscores how large-scale action is needed when a fifth of the population is at risk.