Over recent decades, type 2 diabetes has become one of the fastest-growing chronic diseases. More than 800 million people worldwide are now living with it, four times as many as in 1990, and the WHO projects that by the 2050s the number could reach 1.5 billion. Experts stress that these figures cover only diagnosed cases, while many people remain unaware they have the disease.
Russia is following the same path. By the beginning of 2026, more than 5 million people with type 2 diabetes had been officially registered in the country, but specialists say the true number is at least 50% higher. That would mean the disease may affect up to 10–12% of the population, with hundreds of thousands of new cases added each year. The condition is also getting younger, increasingly being diagnosed in people in their 30s and 40s and even in teenagers.
Type 2 diabetes is linked to a metabolic disorder and reduced cellular sensitivity to insulin. Endocrinologist Yury Poteshkin said that in 90% of cases the disease is driven not by heredity but by lifestyle changes: physical inactivity, excess weight, and a growing share of ultra-processed food, sugar, and saturated fats in the diet.
“We cannot influence genetics, but we can influence external factors,” Yury Poteshkin says.
According to him, excess fat and lack of exercise increase insulin resistance, forcing the pancreas to work under strain for years before it begins to lose function. Modern treatment, says Yury Zhulev, co-chair of the All-Russian Patients’ Union, can significantly reduce the risks of heart attack, stroke, kidney disease, and repeat hospitalizations, but access to medicines varies widely by region.
Zhulev said patient organizations regularly receive complaints about drug supply disruptions caused by delayed procurement and limited regional budgets. Marina Shestakova, director of the Dedov Institute of Diabetes, estimates that about 1 million patients need modern glucose-lowering medicines, but funding is insufficient. A proposal to prioritize drug coverage for more than 100,000 working-age patients without disability status has so far not led to policy changes.
Specialists also point to prediabetes and obesity as a major problem. Shestakova estimates that one in five or six people in Russia has prediabetes, while one in three or four has obesity. In theory, routine medical checkups should detect such conditions, but in practice the screenings are often superficial, and fasting glucose tests are not sensitive enough. Even when prediabetes is identified, patients usually receive only general advice on weight loss and diet.
On March 1, a federal register of certain chronic diseases, including diabetes, began operating. According to Yan Vlasov, co-chair of the All-Russian Patients’ Union, it can improve care only if it is integrated with the medicine supply system. The article also argues that the problem cannot be solved without changing the surrounding environment: among the measures discussed are restrictions on advertising unhealthy food, higher prices for sugary drinks, clear food labeling, bans on junk food in schools, and better infrastructure for physical activity.