Published on 21 February 2024

Survey highlights risk factors for type 2 diabetes and pre-diabetes published.

Latest figures estimate that approximately 1 million adults could be living with undiagnosed type 2 diabetes in England.

Figures recently published by the Office for National Statistics found that an estimated 7% of adults in England showed evidence of type 2 diabetes.

In addition, three in 10 (30%) of those were undiagnosed – adding up to approximately 1 million adults with undiagnosed type 2 diabetes.

The report was compiled from results of the Health Survey for England – an annual cross-sectional survey of the general population living in England.

The Health Survey for England is designed to be representative of the population living in private households in England.

The survey takes place in two stages – an interview where all participants provide demographic information and answer questions about their health. This is followed by a nurse visit, offered to a proportion of participants, during which blood and saliva samples are taken.

The statistics found that older adults were more likely to have type 2 diabetes, but younger adults were more likely to be undiagnosed if they did have type 2 diabetes.

Half of those aged 16 to 44 years with type 2 diabetes were undiagnosed compared with 27% of those aged 75 years and over.

Blood Sugar Test


Those with type 2 diabetes were also more likely to be undiagnosed if they were in better general health, and women were more likely to be undiagnosed if they had a lower body mass index (BMI), lower waist circumference, or were not prescribed antidepressants.

It is estimated that around one in nine adults in England (12%) have pre-diabetes, equal to approximately 5.1 million adults.

Groups most at risk of having pre-diabetes were those with known risk factors for type 2 diabetes, such as older age or being in the BMI categories “overweight” or “obese”.

Researchers found there was also considerable prevalence in groups typically considered “low risk”, for example, 4% of those aged 16 to 44 years and 8% of those who were not overweight or obese had pre-diabetes.

Compared with white, mixed and other ethnic groups (10%), the report found that black and Asian ethnic groups had more than double the prevalence of pre-diabetes (22%).

The overall prevalence of undiagnosed type 2 diabetes was also higher in black and Asian ethnic groups (5%) compared with white, mixed and other ethnic groups (2%).

There was no difference between ethnic groups among those who were found to have type 2 diabetes, with similar percentages of people who were undiagnosed found in both black and Asian, and white, mixed and other ethnic groups.

Type 2 diabetes occurs when the body stops producing enough insulin, or the insulin produced does not work effectively. Because of distinct differences in risk profiles and prevalence between type 1 and type 2, the study was restricted to type 2 diabetes.

Pre-diabetes, also called non-diabetic hyperglycaemia (NDH), means people have elevated blood sugar levels but do not meet the threshold for diabetes diagnosis.

People with pre-diabetes are at an increased risk of developing type 2 diabetes, however, diet and lifestyle changes can reduce this risk. In this analysis, individuals with a HbA1c value between 42 and 47mmol/mol and no previous diagnosis of diabetes were categorised as having pre-diabetes.

Read the Office for National Statistics report Risk factors for pre-diabetes and undiagnosed type 2 diabetes in England
Read more about type 2 diabetes

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