Type 2 Diabetes Mellitus in Afghanistan (2015–2025): A Systematic Review of Prevalence and Determinants

Abstract

Background: Type 2 Diabetes Mellitus (T2DM) is a rapidly growing public health concern in Afghanistan, reflecting global trends in the increase of non-communicable diseases. However, the country’s fragile healthcare infrastructure, prolonged socioeconomic instability, and limited preventive strategies make a unique epidemiological context that may worsen disease burden and outcomes.

Objective: This systematic review aims to synthesize available evidence on the prevalence, temporal trends, and key determinants of T2DM in Afghanistan between 2015 and 2025.

Methods: A systematic review with narrative synthesis was conducted using studies retrieved from PubMed, Google Scholar, Scopus, Web of Science, and relevant grey literature. Eligible studies included observational studies on adult populations in Afghanistan that reported T2DM prevalence and associated risk factors. Due to methodological heterogeneity, findings were synthesized thematically rather than through meta-analysis.

Results: Evidence indicates a rising and consistently high prevalence of T2DM, generally ranging from approximately 9% to over 20%, with higher rates observed in urban populations. Major determinants include physical inactivity, dietary transitions toward high-calorie and low-fiber foods, obesity, and socioeconomic constraints. Health system limitations—particularly inadequate screening, delayed diagnosis, and poor continuity of care—contribute substantially to undiagnosed and poorly controlled cases. Additionally, gender disparities and rural–urban differences significantly affect disease distribution and management outcomes.

Conclusion: T2DM in Afghanistan is a growing and multifactorial health challenge driven by both modifiable lifestyle factors and systemic healthcare weaknesses. Addressing this burden requires integrated national strategies focused on early detection, strengthening primary healthcare systems, improving public awareness, and promoting preventive interventions. Without coordinated action, the prevalence and complications of T2DM are likely to continue increasing.