An analysis of NHS data from the English National Diabetes Audit between 2011 and 2024 has recorded a clear rise in the age-standardised incidence of type 2 diabetes among adults aged 20 to 39 in England. The increase has been particularly pronounced among women, with annual rate ratios of 1.030 for those in their twenties and the same figure for those in their thirties.
Incidence fell among people aged 60 to 79 over the same period. The rise occurred across most ethnic and sex groups, the principal exception being Asian males aged 20 to 39. Highest rates were seen in white females aged 30 to 39 and black females aged 20 to 29.
Body mass index at the point of diagnosis climbed across all ages, yet the annual increase was approximately double in younger adults. By 2024 the median BMI for females aged 20 to 29 stood at 37.4. Trends in incidence moved in close parallel with these changes in BMI at diagnosis.
Post-pandemic acceleration
A temporary reduction in recorded incidence appeared in 2022, mirroring the drop seen in 2020 during lockdown. Yet cumulative incidence from 2022 to 2024 exceeded levels predicted from pre-pandemic trends. Obesity rates in England worsened after the Covid pandemic, with nearly one in three people now affected. The largest increases in new obesity cases occurred among younger adults: a 16 percent rise in those aged 20 to 29 and almost 20 percent in those aged 30 to 39 between 2019 and 2025. Rates fell among adults aged 60 to 79.
Approximately 12,000 people under the age of 30 are now living with type 2 diabetes in England, women making up a growing share of the younger cases. Type 2 diabetes diagnosed at a younger age tends to run a more aggressive course, carrying higher risks of complications including heart attacks and strokes.
We think that the earlier onset of severe obesity in young people is increasing their type 2 diabetes risk in early life and pulling down their age at diagnosis. This is really worrying given the poor health outcomes from early-onset type 2 diabetes.
Those are the words of Dr Shivani Misra, lead researcher. She added that incidence is now also increasing in white populations, showing the public health challenge is broadening across generations.
