There used to be a clear-cut way to distinguish diabetes type 1 and type 2. Medical jargon aside: Type 1 diabetes was a genetic autoimmune disease that presented in young people, and type 2 was a disease that presented in older patients in their fifties or sixties due to an unhealthy lifestyle.
But that distinction of young and old doesn’t work anymore.
More and more, younger people are being diagnosed with type 2 diabetes. In England, for example, the biggest increase in new diagnoses of type 2 diabetes is among young women.
This was revealed when a team of researchers from Imperial College London evaluated data from an English National Diabetes Audit between 2011 and 2024. They found that while the prevalence of type 2 diabetes was decreasing in adults between 60 and 79 years of age, it was rising in under-40-year-olds.
The results, published in The Lancet Regional Health Europe journal, showed the sharpest increase was among white, Asian and Black women in their 20s, and white women in their 30s.
“Much of the discussion around rising type 2 diabetes in younger people has focused on ethnic minority groups,” said Shivani Misra, the lead author of the study and a clinical associate professor for diabetes at Imperial College London.
“While these ethnic groups are disproportionately affected with early-onset type 2 diabetes, we now see that incidence is […] increasing in white populations too, showing that this public health challenge is broadening across the generation.”
Lifestyle behind rise in type 2 diabetes among young people
In Germany, the situation is similar to the UK, said Baptist Gallwitz, an endocrinologist and spokesperson for the German Diabetes Society (DDG).
“Type 2 diabetes is on the rise in many countries,” Gallwitz told DW. “It’s basically a pandemic. In Germany, we’re also seeing an increase in children and teenagers diagnosed with the disease.”
From 2014 to 2023, there was an increase in type 2 diabetes cases of 5.8% a year among youth aged 11 to 17 years, according to a 2026 health report on diabetes released by the DDG.
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While genetic disposition can play a role in the development of type 2 diabetes, the biggest factor is lifestyle.
“We live in a world where we don’t move enough and where our nutrition contains too much sugar and too many calories,” Gallwitz said. “That leads to more obesity among young people, and that in turn greatly increases the risk of type 2 diabetes.”
In people with type 2 diabetes, reduced insulin secretion or a weaker effect of insulin on its receptors lead to a higher glucose content in the blood.
Type 1 diabetes is characterized by a full loss of insulin-producing cells, leading to severe insulin deficiency.
Fighting the rise of diabetes type 2 in young people
The increase is particularly concerning because in young patients, the progression of the disease can be more serious than in older patients.
“Any diagnosis of type 2 diabetes is serious, but it can be more aggressive in younger people, increasing the risk of devastating complications and cutting lives short,” said Helen Kirrane from Diabetes UK, a charity that campaigns on the issue.
That’s why it’s important to intervene early. Gallwitz said the DDG welcomed the introduction of a tax on sugary sodas in Germany, but added that it wasn’t enough.
The DDG is calling for a tiered value-added tax (VAT) system, with fresh fruit and vegetables being sold with no tax and the VAT increasing the more the products contain saturated fats and sugars.
The organization also wants healthier food in kindergarten and school cafeterias and one hour of mandatory movement per day to be incorporated into class schedules.
Asking for more exercise during the school day is one thing. But conditions in the general environment also need to be improved to stop the increase of type 2 diabetes in young women, said Alexandra Kautzky-Willer, head of the division for endocrinology and metabolism at the Medical University of Vienna.
“More movement is important, so we need to ensure conditions in which it’s safe for women to move,” Kautzky-Willer, who is also a professor of gender medicine, told DW.
For example, a woman who fears being catcalled, ridiculed for her weight or even attacked in the dark is less likely to go running after work or join a gym.
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Diabetes type 2 underdiagnosed in women
The number of women with type 2 diabetes might be even higher than what current data show. In 2025, Kautzky-Willer and a colleague wrote a report for the Deutsches Ärzteblatt, a German medical journal, saying that the disease is underdiagnosed in women.
“Men are usually diagnosed with [type 2 diabetes] at a younger age,” they wrote in the the article. “At the point of diagnosis, more women are obese, they have hypertension more often and have gained more weight” than men when they are diagnosed.
Those factors contributed to an increased risk of stroke and heart attacks as well. So, why is it that diabetes type 2 is often only diagnosed in women when they are already this sick?
“For one, the value often tested in initial diabetes diagnosis is fasting blood sugar,” Kautzky-Willer said.
Your fasting blood sugar is your blood sugar level when you haven’t eaten for eight hours. It’s just a single snapshot in time, however, and misses blood sugar spikes after a meal.
Fasting blood sugar “is generally lower in women than it is in men,” Kautzky-Willer said. “It would make more sense to do a glucose tolerance test, but that is more work.”
More complex tests for diabetes could save lives
A glucose tolerance test involves taking blood several times in the span of two hours, during which patients need to stay at the doctor’s office.
Kautzky-Willer says it would be good if HbA1c levels were tested as well. Tests for HbA1c levels show a person’s average blood sugar level over a two or three-month period.
HbA1c refers to glycated haemoglobin, which is when glucose in your body sticks to red blood cells. This prevents the body from using the sugar properly.
A high HbA1c means you have too much sugar in your blood and are more likely to develop diabetes complications. But testing HbA1c levels requires specialized lab equipment and is more expensive than testing the fasting blood sugar.
The glucose tolerance and the HbA1c tests are not covered by health insurance in Germany and Austria, only the fasting blood sugar one is covered, and that may be influencing the options for people in those countries.
Experts who spoke to DW agreed that to bring type 2 diabetes numbers down among young people, it’s important to know when their blood values get close to the line for the disease, a condition known as being “pre-diabetic.”
People who find out they have a problem at this early stage still have a chance to turn the ship around. With lifestyle and nutrition changes, diabetes progression can be stopped in some cases, saving them from a host of health problems later on, which may require regular medication and lead to a reduced life expectancy.
Edited by: Zulfikar Abbany
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