On This Page – Quick Medical Summary
About 40.1 million people in the United States have diabetes, roughly 12% of the population, according to the CDC. State-level rates vary widely around that national figure, and the gap between the highest and lowest states is wide enough to alarm anyone who reads it without context.
A state rate describes a population. It does not describe you.
Where to go next:
- Want the ranking? Section 2 has it, with the dataset and year attached.
- Wondering why states differ so much? Section 4 explains what is actually driving the gap.
- Just had a borderline blood sugar or A1C result? Sections 6 and 7 matter most.
ℹ️ Medical Disclaimer: This article explains population-level statistics and general screening guidance. It does not diagnose diabetes, interpret your individual test results, recommend medication, or advise on insurance coverage. Decisions about testing, diagnosis, and treatment belong to a licensed clinician who knows your history. Speak with a board-certified primary care physician or endocrinologist before acting on anything here.
Which states have the highest and lowest diabetes rates
West Virginia has the highest reported diagnosed diabetes rate in the country, at 18.4% of adults, based on America’s Health Rankings’ analysis of CDC survey data collected in 2024. The national figure is 12.0%.
The states at the top of the list
Five more states sit at or above 15%, all of them in the South or Appalachia.
| State | Adults with diagnosed diabetes | Rank (of 49) |
|---|---|---|
| West Virginia | 18.4% | 49 |
| Kentucky | 16.2% | 48 |
| Louisiana | 15.4% | 47 |
| Arkansas | 15.3% | 46 |
| Mississippi | 15.2% | 45 |
| Alabama | 15.1% | 44 |
Source: America’s Health Rankings analysis of CDC Behavioral Risk Factor Surveillance System, 2024. Crude rates, not age-adjusted.
The states at the bottom
Colorado reports the lowest rate at 8.4%, followed by Montana and Utah at 8.7% and Vermont at 8.9%. The District of Columbia also reports 8.4% but sits outside the state ranking, and Tennessee was missing from the 2024 source files.
You can look up your own state in CDC’s Diabetes State Burden Toolkit. The number you find there will probably not match the table above.
Why your state’s diabetes rate is different on every website
Search this topic and you will find your state listed with several different numbers. That is not sloppiness on anyone’s part. It reflects real reporting choices that change the answer.
Crude rate versus age-adjusted rate
The CDC publishes two figures for the same population in the same survey year.
📊 Clinical Data Point: Diagnosed diabetes among US adults, 2021 — 11.3% crude, 10.1% age-adjusted. Source: CDC Diabetes State Burden Toolkit, 2021 Behavioral Risk Factor Surveillance System.
🔬 How It Works: Older people have more diabetes. Age-adjustment recalculates each state as though it had the same age structure as everyone else, so a state with many retirees is not marked down for that alone. A crude rate skips this step and reports the raw percentage.
Diagnosed cases versus everyone who has it
State figures come from a telephone survey asking whether a health professional has ever told you that you have diabetes. Response rates in 2021 ranged from 23.5% to 60.5% depending on the state, and CDC notes that self-reported status may undercount the true total.
Two figures can even share a number and mean different things. America’s Health Rankings reports 12.0% for diagnosed adults in 2024, while CDC reports 12.0% of the entire population with diagnosed or undiagnosed diabetes in 2023.
CDC’s state-level diagnosed diabetes dataset is the source most other pages are quoting. An individual result such as a fasting glucose in the 100–125 range carries none of this ambiguity.
What actually drives the gap between states
State diabetes rates track income, age, and education more closely than geography itself.
Income and education track diabetes more closely than geography
Among US adults in 2021, 16.4% of those with household income under $35,000 had diagnosed diabetes, against 7.7% of those at $75,000 or above. Education splits the same way: 17.5% among adults without a high school diploma, 9.8% among those with more than high school.
📊 Clinical Data Point: Diagnosed diabetes by age, US adults, 2021 — 3.3% at ages 18–44, rising to 23.0% at age 75 and over. Source: CDC Diabetes State Burden Toolkit, 2021 BRFSS.
Why rural areas show higher rates
Rural adults reported 14.2% against 11.1% in urban areas. In a CDC analysis of rural and urban diabetes prevalence across 41 states, that national gap stopped being statistically significant once age, sex, race, ethnicity, income, education, and obesity were accounted for.
Does living in a high-rate state raise your own risk?
Not on its own. Mississippi and West Virginia both report adult obesity at 40% or higher, and a state’s rate largely reflects who lives there rather than where they live. A higher earner with a normal BMI in West Virginia does not carry West Virginia’s rate, so check your BMI rather than your zip code.
The diabetes belt, and what living there does and doesn’t mean
The diabetes belt is a CDC-identified region of 644 counties across 15 mostly southern states where diagnosed diabetes clustered when the analysis was run.
Which states the belt covers
All of Mississippi falls inside it. Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and West Virginia each have some counties in and some out.
Why the designation is older than most articles admit
CDC researchers defined the belt in 2011 using survey data from 2007 and 2008. Prevalence inside the belt was reported at 11.7% against 8.5% outside it at that time, figures now well over a decade old.
🩺 Physician Note: The belt maps where population burden clustered during one survey period. It is a public health planning tool, not a property of the land and not a prediction for any individual who lives there.
The number no state ranking shows: undiagnosed diabetes
About 27.6% of US adults with diabetes have never been diagnosed, which works out to roughly 11.0 million people, according to CDC’s National Diabetes Statistics Report.
More than a quarter of adults with diabetes don’t know
Of the 40.1 million people with diabetes, 29.1 million have a diagnosis. State rankings count only that second group, because the survey question asks whether a professional has ever told you.
Which means a low state rate can reflect less testing rather than less disease. That inference follows from the two figures above; it is not a finding CDC has published as such.
And 115 million more adults have prediabetes
115.2 million US adults, more than two in five, have prediabetes, and eight in ten of them do not know it. The fuller breakdown sits in our prediabetes statistics for US adults.
⚠️ Clinical Warning: Type 2 diabetes and prediabetes often produce no symptoms at all, so blood glucose can stay elevated for years while a person feels well. A favourable state ranking tells you nothing about whether you personally have been tested.
What to do with your state’s number
Your state’s rate is a planning figure for public health departments. Your own result is the number that describes you.
When to ask about testing
CDC advises an A1C test for adults over 45, and earlier for younger adults with overweight plus another risk factor. The US Preventive Services Task Force lowered its recommended screening start age from 40 to 35 in 2021 for adults with overweight or obesity, which we cover in diabetes screening under 35.
What lowers the risk
The lifestyle change program run through CDC’s National Diabetes Prevention Program reduced the risk of developing type 2 diabetes by 58% in a randomised controlled trial, and by 71% among participants aged 60 and older.
✅ Patient Action: Ask your primary care physician: “Given my age, BMI, and family history, should I have an A1C or fasting glucose test now, and how often after that?”
If you already have a result in hand, start with what your own glucose numbers mean.
Common questions about diabetes rates by state
1. Which state has the highest diabetes rate?
West Virginia, at 18.4% of adults, based on America’s Health Rankings analysis of CDC survey data collected in 2024.
2. Which state has the lowest diabetes rate?
Colorado, at 8.4% of adults in 2024. The District of Columbia also reports 8.4% but sits outside the state ranking.
3. Why do diabetes rates differ so much between states?
State diabetes rates track income, age, education, and obesity more closely than geography. Population composition drives most of the gap.
4. What is the diabetes belt?
A CDC-identified region of 644 counties across 15 mostly southern states, defined in 2011 using survey data from 2007 and 2008.
5. What percentage of Americans have diabetes?
About 40.1 million people, roughly 12% of the US population, have diagnosed or undiagnosed diabetes according to CDC figures.
6. Are diabetes rates higher in rural areas?
Yes. Rural adults reported 14.2% against 11.1% in urban areas, though that gap narrows once income, age, and obesity are accounted for.
7. How many people have diabetes and don’t know it?
About 27.6% of US adults with diabetes are undiagnosed, which is roughly 11.0 million people nationwide.
8. How many Americans have prediabetes?
About 115.2 million US adults, more than two in five, have prediabetes, and eight in ten do not know it.
9. Does living in a high-diabetes state raise my personal risk?
Not by itself. State rates reflect population income, age, and weight. Ask your physician which of your own risk factors matter.
10. At what age should I be tested for diabetes?
CDC advises an A1C test after 45, or earlier with overweight plus a risk factor. Your physician sets your schedule.
11. Can you lower your risk of type 2 diabetes?
Yes. A CDC lifestyle change program cut type 2 diabetes risk by 58% in trial participants. Discuss eligibility with your physician.
Your state’s diabetes rate describes the people around you: their ages, their incomes, and how many of them have been tested. It does not describe your blood sugar.
The most useful number in this article is not on the state table. It is the one on your own lab result, and getting it takes a single blood draw.
About this content
How this article was put together: researched from recognised health sources, drafted with the help of AI tools, and edited by hand, with sources linked throughout.
Sameer Patel is the founder and editor of My Medicine Advisor. He is not a doctor or medical professional — before starting this site he worked in banking,…
Medical disclaimer
The content on MyMedicineAdvisor is provided for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Health information on this website should not be used to diagnose, treat, cure, or prevent any condition without guidance from a qualified healthcare professional. Always seek the advice of your doctor, physician, or another licensed healthcare provider with any questions you may have regarding a medical condition, symptoms, medications, or treatment decisions.
