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Proposed solutions include national NCD and diabetes policies, guidelines and protocols, trained workforce coverage, insurance benefits, affordable quality-assured diagnostic devices and consumables, and performance monitoring indicators. WHO initiatives such as the Global Diabetes Compact and coverage targets aim to expand equitable diagnosis and treatment.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/bridging-the-diagnostic-gap-in-diabetes-action-to-improve-diagnosis-and-care/407245/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/bridging-the-diagnostic-gap-in-diabetes-action-to-improve-diagnosis-and-care/407245.png","ImageObject",300,407,{"name":42,"@type":43},"Hazel","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",9,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"How large is the diagnostic gap in diabetes?","Question",{"text":63,"@type":64},"In 2022, an estimated 445 million adults with diabetes aged 30+ were not receiving glucose-lowering pharmacological treatment, and undiagnosed cases accounted for 84–97% of untreated diabetes.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What are the main health system challenges behind the gap?",{"text":68,"@type":64},"The gap reflects three major challenges: limited access to diagnostic technologies, limited familiarity of health workers with diagnostic devices and algorithms, and low public awareness of diabetes.",{"name":70,"@type":61,"acceptedAnswer":71},"What actions can health systems and policymakers take to bridge the gap?",{"text":72,"@type":64},"Actions include national health policies and diabetes guidelines, ensuring a trained workforce at all levels, providing insurance benefit packages covering diagnosis and treatment, guaranteeing access to insulin and treatments, ensuring availability and affordability of quality-assured diagnostic devices and consumables, and using data monitoring systems and indicators to track performance.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},407245,1790683435,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & 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Manne-Goehlerb & Adriana Velazquez Berumenc  \nIn 2022, an estimated 828 million people aged 18 years and older, about 14% of the global adult population, were living with diabetes, raising from a prevalence of 7% in 1990.1 This alarming figure underscores the growing burden of diabetes on health systems worldwide. Notably, the largest increases in prevalence were observed in low- and middle-income countries, highlighting the considerable challenge for health systems with fewer resources. In 2022, an estimated 445 million adults aged 30 years or older with diabetes (representing about 59% of this population) were not receiving any glucose-lowering pharmacological treatment. Most of the people with untreated diabetes had not been diagnosed, with undiagnosed cases accounting for 84–97% of untreated diabetes. 1 This diagnostic gap is particularly large in low- and middle-income countries, where access to health-care services and diagnostic tools is limited.  \nThis gap reflects three major health systems challenges: limited access to diagnostic technologies; limited familiarity of health workers with diagnostic devices and testing algorithms for diabetes; and low public awareness of diabetes. First, several studies have shown limited access to diagnostic technologies relevant for the optimal care of diabetes. For instance, a systematic review about the availability and affordability of essential diagnostics for diabetes (mainly in the World Health Organization (WHO) African Region) found that glucometers were only available in about half of the clinics included in the study, and Haemoglobin A1c (HbA1c) diagnostics were available in about one quarter of the clinics, with data collection undertaken in a mix of public and private facilities.2 Diabetes is a condition for which point-of-care diagnostics could speed the scale-up of care. Positively, the development of accurate, robust point-of-care diagnostic technologies has continued to evolve. For instance,  \na prospective, quantitative, accuracy study evaluated the performance of two leading point-of-care diagnostic systems for HbA1c in rural Nepal, compared with local standard laboratory-based HbA1c tests.3 The study found robust accuracy in these conditions but highlighted ongoing usability challenges such as the need for substantial training on how to use it; a similar study recently completed in Indonesia demonstrated comparable findings.4 Hence, further testing and refinement of point-of-care diagnostic tests are needed, including implementation studies across a wider range of settings.  \nThe second driver of the diagnostic gap is the limited training of key health workers in the principles of diabetes diagnosis and its complications. Prior research has shown the relatively weak understanding of diabetes diagnosis and management in certain low- and middle-income settings.5–7 For instance, a study of diabetes knowledge among health workers in Indonesia showed low scores in the range of 29–37% on diabetes clinical vignettes.7 A similar study in Islamic Republic of Iran revealed a lack of familiarity with common diagnostic thresholds for diabetes, including those based on HbA1c.5  \nThe third challenge involves the low public awareness of diabetes, which has been well documented across multiple contexts. For example, in a survey of over 12 100 adults older than 30 years in Bangladesh, only one third were able to correctly identify a cause of diabetes and only approximately 15% had ever been tested.8 Similar findings regarding awareness of diabetes have been observed in other settings: for instance, in a survey in Poland, only about 17%(182/1051) of those surveyed reported a good level of knowledge about diabetes.6 This awareness gap likely contributes to the low rates of diagnosis.  \nKey actions to bridge these gaps include implementing national health  \npolicies that address noncommunicable diseas","cbCairjbTe6iZZzW","https://ap.wps.com/l/cbCairjbTe6iZZzW","pdf",710726,"English","# Diabetes diagnostic gap\n## Drivers of the gap\n## Key actions to bridge gaps\n## WHO responses and coverage targets","[{\"question\":\"How large is the diagnostic gap in diabetes?\",\"answer\":\"In 2022, an estimated 445 million adults with diabetes aged 30+ were not receiving glucose-lowering pharmacological treatment, and undiagnosed cases accounted for 84–97% of untreated diabetes.\"},{\"question\":\"What are the main health system challenges behind the gap?\",\"answer\":\"The gap reflects three major challenges: limited access to diagnostic technologies, limited familiarity of health workers with diagnostic devices and algorithms, and low public awareness of diabetes.\"},{\"question\":\"What actions can health systems and policymakers take to bridge the gap?\",\"answer\":\"Actions include national health policies and diabetes guidelines, ensuring a trained workforce at all levels, providing insurance benefit packages covering diagnosis and treatment, guaranteeing access to insulin and treatments, ensuring availability and affordability of quality-assured diagnostic devices and consumables, and using data monitoring systems and indicators to track performance.\"}]","Bridging the Diagnostic Gap in Diabetes - Action to Improve Diagnosis and Care | PDF",1790572215]