Doctors have long thought of type 2 diabetes as a condition that shows up in middle age, usually brought on by decades of metabolic wear. So when a 26-year-old is diagnosed, it still catches people off guard. The data, however, suggests it shouldn’t.
Type 2 diabetes diagnoses in women under 40 rose by 47% between 2017/18 and 2023/24, according to Diabetes UK’s own analysis – more than twice the rate seen in women aged 40 to 79, where diagnoses rose by 22%. Over the same period, diagnoses in men under 40 increased by 34%. Something is happening specifically to women in their 20s and 30s, and it’s accelerating.
The rise has largely occurred since the COVID-19 pandemic and is closely linked to increasing obesity levels, according to an analysis of NHS data from 2011 to 2024 published in The Lancet. Obesity is driving an increase in the condition among all under-40s while rates in older adults are actually falling. But obesity alone doesn’t fully explain the sex gap. Women in this age group carry a cluster of biological risks – hormonal, reproductive, and metabolic – that interact in ways that make them particularly vulnerable to early-onset type 2 diabetes. Understanding those risks matters, because the disease behaves differently when it starts young, and not in a good way.
The scale of this trend is global, not just a UK story. A study published in a peer-reviewed journal shows a remarkable increase in global type 2 diabetes burden in women of reproductive age between 1990 and 2021. The increase in prevalence was most pronounced in the 25 to 29 age group and in younger women overall. The numbers keep climbing.
Why Young Women Are Disproportionately Affected by Type 2 Diabetes
Overall, men still develop type 2 diabetes at higher rates than women. But that pattern reverses in younger age groups. Research shows that among people aged 20 to 39, the risk dynamics shift compared to those aged 40 and over. A 2023 study found that the risk of developing type 2 diabetes was greater in women than in men specifically in the 20 to 29 age group, particularly when metabolic syndrome – a cluster of conditions including high blood pressure, high blood sugar, and excess body fat – was present.
Part of the explanation lies in biology. A 2024 review published in a peer-reviewed journal identified female sex as one of several factors that contribute to a younger age of type 2 diabetes onset. Body mass index at diagnosis has been increasing more quickly among younger adults than in older age groups, hinting at a likely cause.
In 2024, 30% of adults aged 16 and over were living with obesity, and 66% were either overweight or living with obesity, according to the NHS Health Survey for England 2024. Obesity prevalence among adults aged 16 to 24 stood at 18%, rising steeply with age. These are not abstract population statistics – they are the cohort now being diagnosed with type 2 diabetes at record rates.
The PCOS Connection
No single condition does more to raise type 2 diabetes risk in young women than polycystic ovary syndrome (PCOS), a hormonal disorder that disrupts ovulation and throws multiple metabolic systems out of balance. PCOS is the most common endocrine disorder in women of reproductive age, affecting between 4% and 21% of women depending on diagnostic criteria and population.
The diabetes risk it creates is severe. PCOS is a common disorder in women of reproductive age, and over the last few decades, research has revealed it is strongly associated with metabolic disorders including insulin resistance and prediabetes, with women carrying an increased risk of developing type 2 diabetes in the future. The mechanism is insulin resistance – when the body’s cells stop responding normally to insulin, the pancreas compensates by producing more, but blood sugar eventually climbs beyond what that compensation can control.
A nationwide population-based retrospective cohort study performed in Denmark found that the hazard ratio for women with PCOS who developed type 2 diabetes was 3.5 when gestational diabetes was excluded. A 10-year retrospective cohort study found the adjusted risk of developing type 2 diabetes following a PCOS diagnosis was highest in the youngest group studied: women aged 18 to 24 had a hazard ratio of 10.4 compared to women without PCOS. That risk decreased with age – the adjusted hazard ratio was 5.28 in the 25 to 29 age group, and 4.06 in the 30 to 34 age group. PCOS diagnosed in the late teens or early 20s carries by far the greatest metabolic danger. A Danish national cohort study also found that type 2 diabetes was diagnosed four years earlier in women with PCOS compared to age-matched controls.
Gestational Diabetes: A Warning That’s Too Often Ignored
Pregnancy opens another window of vulnerability that affects women exclusively. Gestational diabetes – high blood sugar that develops during pregnancy – is one of the strongest known predictors of future type 2 diabetes. Roughly 50% of women with gestational diabetes go on to develop type 2 diabetes within five years, making annual follow-up, counseling, and treatment in primary care essential. That’s a clear, time-limited opportunity to intervene, and it’s being missed.
Diabetes UK has raised concerns about the follow-up care offered to women who have had gestational diabetes. The NHS published its first-ever national gestational diabetes audit covering England in 2024/25, which exposed worrying inconsistencies in follow-up care. According to the NHS National GDM Audit 2024/25, only 57.4% of women with gestational diabetes received an annual HbA1c measurement, despite national guidance requiring it. Only 4.5% of women had received support through the NHS Diabetes Prevention Program. HbA1c is a blood test that reflects average blood sugar levels over roughly three months – it’s the standard tool for catching diabetes early.
The stakes are especially high for certain ethnic groups. Diabetes UK has called for inequities in care to be addressed, particularly for women from deprived and minority ethnic communities who face disproportionate gestational diabetes rates and faster conversion to type 2 diabetes afterward.
Women with previous gestational diabetes, non-diabetic raised blood sugar, or PCOS are advised to seek early antenatal advice for consideration of early gestational diabetes screening in future pregnancies. All women with a history of gestational diabetes should be offered referral to the NHS Diabetes Prevention Program. Most women aren’t receiving even the basics of that pathway.
COVID-19’s Lasting Metabolic Shadow
The pandemic years appear to have accelerated this trend in ways that researchers are still unpacking. Pandemic-era lifestyle changes – less movement, disrupted eating patterns, increased stress – drove rapid weight gain in younger adults at a critical window. But the virus itself may also have played a direct role.
A large population-based study from the British Columbia Center for Disease Control, covered by the University of Minnesota’s CIDRAP in early 2026, found that COVID-19 infection is associated with an increased risk of type 2 diabetes in unvaccinated and severely ill patients, with elevated risk persisting for up to three years after infection. No increased diabetes risk was observed among people who were partially or fully vaccinated.
Young women, who in many cases delayed healthcare visits during the pandemic, may have also missed early screening opportunities that would have caught rising blood sugar before it crossed into diabetes territory. The combination of biological vulnerability, post-pandemic lifestyle disruption, and reduced healthcare access has created a near-perfect environment for early-onset type 2 diabetes to take hold.
Why Early-Onset Diabetes Is More Dangerous
A type 2 diabetes diagnosis at 27 is not medically equivalent to a diagnosis at 57, even if the blood sugar numbers look similar. Type 2 diabetes is a serious, lifelong condition that can lead to severe complications including heart attacks, strokes, kidney disease, and sight loss – and when it develops at a younger age, patients face a longer lifetime exposure to those complications.
A landmark study published in The New England Journal of Medicine found that 60.1% of young people with type 2 diabetes developed at least one microvascular complication – affecting small blood vessels in the eyes, kidneys, and nerves – early in the course of the disease. Complications that typically take decades to appear in older-onset patients were showing up within years.
A 2024 review found that younger individuals with type 2 diabetes have a higher body mass index, more adverse lipid profiles, and higher HbA1c levels at the time of diagnosis than those diagnosed later in life. These markers suggest the disease is starting from a more metabolically compromised baseline.
Young women with type 2 diabetes also show a greater relative risk of cardiovascular disease and death compared to men, and a 2023 study published in Diabetologia found they are less likely to receive guideline-recommended treatment. The sex gap in care quality compounds the already higher biological risk.
There is also the question of what early-onset diabetes does to the pancreas over time. Early-onset type 2 diabetes is associated with rapid deterioration in the function of pancreatic beta cells – the cells that produce insulin – leading to an earlier need for insulin therapy compared with those diagnosed in middle age or later.
Read More: Many Diagnosed With Type 2 Diabetes May Actually Have a Different Form of the Disease
What This Means for You
The clearest risk factors are now well-established: severe obesity, a family history of diabetes, ethnicity, a mother who had diabetes, and a personal history of gestational diabetes all contribute to earlier onset of type 2 diabetes in women. PCOS belongs on that list too, particularly when diagnosed in the teens or early 20s. If you have one or more of these factors, ask your GP to check your HbA1c and fasting glucose – standard blood tests available on the NHS and through most primary care providers. You don’t need symptoms to justify the request.
For women who have had gestational diabetes, don’t wait for your doctor to follow up. Annual follow-up is essential given that roughly 50% of women with gestational diabetes go on to develop type 2 diabetes within five years, and all women with a history of gestational diabetes should be offered referral to the NHS Diabetes Prevention Program. If you haven’t had annual blood sugar testing since your pregnancy, request it now.
The Long Game: Prevention Is Still Possible
Lifestyle interventions remain the most powerful tools available for women at elevated risk. Maintaining a healthy weight, regular physical activity (particularly after meals to blunt post-meal glucose spikes), and a diet that reduces refined carbohydrates and ultra-processed foods can all meaningfully reduce diabetes risk. Type 2 diabetes can sometimes be put into remission by eating a healthy diet and keeping a healthy weight without needing to rely on glucose-lowering medications. That window is narrowest at the beginning – the earlier a rising blood sugar trend is caught, the more reversible it is.
Diabetes UK has warned that poor follow-up care for women who have had gestational diabetes is contributing directly to the rising rates of type 2 diabetes in young women. The 47% rise in diagnoses didn’t happen because the biology of type 2 diabetes changed. It happened because the environment changed, and the healthcare system hasn’t kept pace. Knowing that gap exists is the first step to not becoming part of the statistic.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.
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