Diabetes Is Rising—And Hyperglycemia May Be Rising Even Faster

Diabetes prevalence in the United States continues to increase, but a troubling pattern may be emerging alongside it. New research published in JAMA Network Open on October 28, 2026, found that diagnosed diabetes and coded hyperglycemia increased among working-age adults between 2018 and 2024. Notably, hyperglycemia diagnoses rose even among people already identified as having diabetes. These findings raise an important question: Are more Americans experiencing poor blood sugar control, or are healthcare systems simply getting better at identifying and documenting it?

Table of Contents

1. What the Latest Data Reveal About U.S. Diabetes Rates
2. Why Hyperglycemia Diagnoses Are Increasing
3. Demographic and Insurance Differences in Diabetes Trends
4. What Claims Data Can and Cannot Tell Us
5. Conclusion
6. Frequently Asked Questions

What the Latest Data Reveal About U.S. Diabetes Rates

A 2026 study published in JAMA Network Open examined insurance claims from adults aged 18 to 64 between 2018 and 2024. Researchers analyzed more than 285 million person-years of data across commercial insurance, Medicaid managed care, and Medicare Advantage populations.

The results revealed a clear increase in diagnosed diabetes. Prevalence rose from 8.99% in 2018 to 10.61% in 2024, representing a 1.62 percentage-point increase. In relative terms, that represents approximately 18% growth over six years.

Meanwhile, coded hyperglycemia among people with diagnosed diabetes increased from 33.96% to 37.32%. This represents a 3.36 percentage-point increase, suggesting a growing burden of documented high blood sugar.

However, these percentages have different denominators. Diabetes prevalence describes the proportion of insured adults with a diabetes diagnosis, while the hyperglycemia measure describes the proportion of diagnosed patients with a relevant billing code. Therefore, the figures cannot establish that actual glucose exposure increased faster than diabetes prevalence.

Broader national data reinforce concerns about diabetes burden. According to the CDC's National Diabetes Statistics Report, approximately 40.1 million Americans had diabetes in 2023, representing 12% of the population. Of these individuals, an estimated 11 million adults had undiagnosed diabetes.

Together, these findings highlight the importance of distinguishing diagnosed disease, undiagnosed disease, and glycemic control when evaluating national trends.

Why Hyperglycemia Diagnoses Are Increasing

Hyperglycemia occurs when blood glucose rises above an appropriate range. Persistent elevations can contribute to cardiovascular disease, kidney damage, nerve problems, and vision loss. Consequently, understanding changes in documented hyperglycemia has significant implications for diabetes management.

The claims analysis found that coded hyperglycemia increased across major insurance categories. Among commercially insured patients with diabetes, the proportion with a hyperglycemia diagnosis rose from 33.38% in 2018 to 37.37% in 2024.

Several explanations deserve consideration.

First, patients may be experiencing greater difficulty maintaining recommended glucose targets. Medication costs, treatment complexity, competing health needs, and inconsistent follow-up can all complicate diabetes management.

Second, more frequent glucose testing may identify previously unrecognized episodes. Expanded use of continuous glucose monitoring, or CGM, could contribute to improved recognition, although this particular study did not establish that connection.

Third, changes in clinical documentation and billing practices may influence reported rates. A hyperglycemia code reflects a recorded diagnosis rather than a direct measurement of glucose exposure.

Importantly, the study also found little overall change in coded hypoglycemia, which remained near 2.5%. Thus, the pattern was not simply a uniform increase in all glucose-related diagnoses.

For clinicians, the findings support closer examination of A1C results, glucose patterns, medication access, and individual treatment goals.

Demographic and Insurance Differences in Diabetes Trends

Diabetes rates vary considerably across demographic groups, insurance populations, and geographic regions. The new study identified meaningful differences by sex, insurance coverage, and geography.

Among men, diagnosed diabetes prevalence increased from 10.56% to 12.31% between 2018 and 2024. Among women, the corresponding increase was from 7.83% to 9.37%.

Insurance differences were equally notable. Commercially insured adults experienced the largest increase in diagnosed prevalence, rising from 7.49% to 9.46%. Conversely, Medicaid managed care patients had a higher starting prevalence of 14.08%, which increased modestly to 14.30%.

These differences should not automatically be attributed to insurance coverage itself. Age, health status, eligibility rules, healthcare access, and population composition may influence comparisons.

Geographic variation was also substantial. In 2024, diagnosed diabetes prevalence ranged from 6.01% in Montana to 14.88% in Mississippi within the analyzed claims populations.

Additionally, hyperglycemia coding differed considerably across states. Such variation could reflect differences in patient characteristics, clinical practice, or documentation.

For healthcare professionals, these findings emphasize the value of targeted screening, accessible follow-up, and attention to populations facing barriers to consistent treatment.

What Claims Data Can and Cannot Tell Us

Large insurance claims databases provide valuable insights into healthcare utilization and diagnosed disease. However, they cannot fully describe the biological burden of diabetes.

The study relied on diagnostic codes rather than direct laboratory measurements. Therefore, researchers could not determine whether patients experienced more frequent glucose spikes, higher average A1C levels, or longer periods above their recommended glucose range.

Furthermore, claims data may overlook individuals without insurance, people who rarely seek medical care, and patients whose diabetes remains undiagnosed.

Changes in insurance enrollment also matter. The researchers noted that one commercial insurance plan was removed from the dataset in 2024, potentially affecting some state-level estimates.

Another concern involves changes in healthcare utilization during the COVID-19 pandemic. Reduced medical visits may have influenced diagnostic patterns around 2020.

These limitations do not erase the study's findings. Instead, they clarify what the results actually measure.

For a more complete assessment of glycemic control, clinicians need laboratory A1C measurements and, when appropriate, CGM data. Measures such as time in range can provide insight that diagnostic codes cannot capture.

As discussed in Diabetes in Control's practical guide to using time in range, glucose monitoring can complement A1C when clinicians evaluate treatment effectiveness.

Ultimately, combining claims information with clinical measurements may offer a clearer understanding of diabetes trends and opportunities to improve care.

Conclusion

The latest claims analysis provides important evidence that diagnosed diabetes and documented hyperglycemia increased among working-age U.S. adults from 2018 through 2024.

Although the increase in hyperglycemia coding raises concerns about glycemic management, it does not prove that actual blood glucose exposure worsened at the same rate. Differences in screening, documentation, and insurance populations remain important considerations.

For healthcare professionals, the central takeaway is clear: diabetes surveillance should extend beyond counting diagnoses. Better outcomes require accurate glucose assessment, individualized treatment, and consistent access to care.

Frequently Asked Questions

1. Are diabetes rates continuing to rise across the United States?

Yes. The 2026 claims study found diagnosed prevalence increased from 8.99% in 2018 to 10.61% in 2024 among insured adults aged 18 to 64.

2. Is hyperglycemia increasing faster than diabetes?

Coded hyperglycemia increased from 33.96% to 37.32% among diagnosed patients. However, these figures use different denominators from diabetes prevalence and cannot establish a faster increase in actual glucose exposure.

3. Which groups showed the greatest increase in diabetes diagnoses?

Commercially insured adults showed the largest percentage-point increase among the insurance categories studied. Men also experienced higher diagnosed diabetes prevalence than women.

4. Can insurance claims accurately measure blood sugar control?

Not directly. Claims identify documented diagnoses but cannot reliably measure A1C, glucose variability, or time above range. Clinical testing provides more complete information.

5. What can healthcare professionals do about rising hyperglycemia diagnoses?

Clinicians can review glucose measurements, assess medication access and adherence, individualize treatment goals, and address barriers to follow-up. Appropriate use of CGM may also support better treatment decisions.

This content is not medical advice. For any health issues, always consult a healthcare professional. In an emergency, call 911 or your local emergency services.