An estimated one million-plus people in Portugal live with diabetes, and thousands remain undiagnosed. This guide covers everything you need to know: causes, warning signs, the best treatments available today, why regular check-ups matter, and the emerging therapies that could transform diabetes care in the years ahead.
Diabetes is one of the most prevalent chronic diseases in Portugal, and one of the most underdiagnosed. It is often described as a "silent disease" because type 2 diabetes, which accounts for more than 90% of cases, can develop slowly over many years without noticeable symptoms. By the time it is diagnosed, the condition has often been present for some time.
The good news is that diabetes is highly manageable. With the right diagnosis, appropriate treatment and regular monitoring, people with diabetes can live full, healthy lives. And thanks to the remarkable advances of the past decade, especially the emergence of GLP-1 receptor agonists and SGLT2 inhibitors, the treatment options available in Portugal today are the best they have ever been.
Section 01
Diabetes in Portugal: Understanding the Scale of the Problem
According to the National Diabetes Programme Report — Challenges and Strategies 2025, published by the Directorate-General of Health (DGS), 936,987 people had diagnosed diabetes in primary care at the end of 2024 — the highest figure on record — corresponding to 8.9% of people registered with the NHS (SNS). The same report recorded 80,915 newly diagnosed cases in 2024 alone. Portugal's Official Gazette, through Order (Despacho) No. 3390/2025, estimates that diabetes affects more than one million people in Portugal in total, including undiagnosed cases, one of the highest prevalence rates in the European Union.
Source: DGS — National Diabetes Programme, Challenges and Strategies 2025; Portugal's Official Gazette, Order No. 3390/2025.
The DGS report notes that, despite the growing number of diagnoses, metabolic control has improved and both overall and premature mortality linked to the disease have declined, a sign of the positive impact of screening programmes and more modern treatments. Even so, diabetes remains present in roughly a third of acute myocardial infarction and stroke cases in Portugal.
Section 02
Types of Diabetes
Not all diabetes is the same. Understanding which type you have — or are at risk of — is the first step toward effective management.
Section 03
Causes and Risk Factors
Type 1 Diabetes
The exact cause of type 1 diabetes remains incompletely understood. It is an autoimmune disease — the body's immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. Genetic factors play a role, as does, possibly, exposure to certain viral infections. In Portugal, research in this field is carried out by centres such as APDP — the Portuguese Diabetes Association and by research groups at the University of Lisbon Faculty of Medicine and the University of Porto Faculty of Medicine.
Type 2 Diabetes
Type 2 diabetes has a more complex, modifiable set of causes, combining genetic predisposition with lifestyle and environmental factors. Its central mechanism is insulin resistance — in which the body's cells stop responding effectively to insulin — coupled with a progressive decline in the pancreas's ability to compensate by producing more.
Section 04
Signs and Symptoms
Symptoms vary considerably between type 1 and type 2 diabetes. Type 1 often presents acutely — with symptoms appearing rapidly that can signal diabetic ketoacidosis (DKA), a medical emergency. Type 2, by contrast, typically develops slowly and silently over years, with symptoms so subtle or gradual that many people put them down to ageing, stress or tiredness.
Section 05
Current Treatments for Diabetes in Portugal
Diabetes treatment has undergone a genuine revolution over the past decade. In Portugal, the DGS's National Diabetes Programme sets the national clinical guidelines, aligned with the international recommendations of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). In February 2025, insulin pumps became available through community pharmacies in Portugal — a significant milestone in access to type 1 diabetes treatment.
Lifestyle Changes — The Foundation of All Treatment
For both type 1 and type 2 diabetes, lifestyle is the foundation of disease management. For type 2 in particular, dietary changes and increased physical activity can significantly reduce HbA1c, improve insulin sensitivity and, in some cases — notably after bariatric surgery or very low-calorie diets — lead to sustained remission. APDP and the nutrition and nursing clinics at SNS health centres offer structured lifestyle support across the country.
Pharmacological Treatment
The following drug classes are available in Portugal. Treatment decisions are individualised — DGS, ADA 2025 and EASD guidelines all emphasise a patient-centred approach that weighs cardiovascular risk, kidney function, weight and personal preferences.
Section 06
Why Regular Check-ups Matter
Diabetes is a chronic disease that evolves over time, and its complications — if left undetected — can be serious and irreversible. Diabetic retinopathy is one of the leading causes of blindness among adults in Portugal. Diabetic nephropathy is one of the biggest drivers of end-stage chronic kidney disease. Peripheral neuropathy leads to foot complications that, in the most severe cases, can result in amputation. The rate of diabetic foot amputations in Portugal remains high, according to the DGS's 2025 report, despite foot screening having been carried out in 83% of patients with diabetes.
Decades of research show that all of these complications are largely preventable — or significantly delayed — through good glycaemic control, blood pressure management and regular monitoring. The structured annual diabetes review is one of the most cost-effective interventions in all of medicine.
What Your Annual Diabetes Review Should Include
- HbA1c assessment (average blood sugar over the past 3 months)
- Blood pressure measurement and review of blood pressure medication
- Kidney function — estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio
- Cholesterol and full lipid profile
- Weight and BMI assessment
- Foot examination — including pulse and sensation checks
- Diabetic retinopathy screening — through the National Screening Programme coordinated by the DGS
- Medication review and adjustment, if needed
- Assessment of adherence to your diabetes self-management plan
- Smoking status check and support to quit, if applicable
- Flu vaccination (strongly recommended for people with diabetes)
Screening for Those Not Yet Diagnosed
If you have risk factors for type 2 diabetes and have never been tested, your family doctor can order a fasting glucose or HbA1c test — simple tests done at SNS laboratories. This is especially important if you are over 45, have a family history of diabetes, high blood pressure, or were overweight during pregnancy. Early detection of prediabetes offers a real opportunity to prevent or delay the onset of type 2 diabetes through lifestyle changes.
Section 07
The Future of Diabetes Treatment
The pace of innovation in diabetes medicine is unprecedented. Several areas of research — some already in advanced clinical trials — have the potential to fundamentally transform what it means to live with diabetes over the next decade.
Research into stem cell therapy for type 1 diabetes is examined in detail in a 2025 publication in PMC (PMID: PMC12689004), which concludes that "stem cell therapy offers a dual strategy: regeneration of insulin-producing beta cells and regulation of immune responses." While a definitive cure remains a future goal, the direction of research has never been more promising.
Section 08
Key Institutions and Resources in Portugal
If you live with diabetes in Portugal, or are concerned about your risk of developing it, the following organisations and services are your key points of reference for clinical care, education and support.
DGS — National Diabetes Programme
The Directorate-General of Health's National Diabetes Programme is the national reference point for diabetes policy and clinical guidelines in Portugal. Its annual report — with the 2025 edition presenting data through 2024 — is the most comprehensive diabetes monitoring document in Portugal, covering prevalence, screening, treatment and mortality. National clinical guidelines, aligned with European and international recommendations, are available on the DGS portal.
APDP — the Portuguese Diabetes Association
Founded in 1926, APDP is the leading reference institution for people with diabetes in Portugal. It offers specialist consultations, therapeutic education programmes, nutritional support, diabetic retinopathy screening and clinical research. APDP has run community diabetic retinopathy screening in partnership with the Lisbon and Tagus Valley Regional Health Administration for around 20 years, playing a decisive role in preventing avoidable blindness in Portugal.
SNS 24 Helpline — 808 24 24 24
The SNS 24 helpline (808 24 24 24) is available 24 hours a day and offers health triage, clinical guidance and referral to appropriate services. For emergencies, always call 112.
SPEDM — the Portuguese Society of Endocrinology, Diabetes and Metabolism
The SPEDM is the scientific society that brings together endocrinology and diabetes specialists in Portugal. It publishes clinical guidelines, organises continuing medical education and represents Portugal in European and international diabetes research networks.
Section 09
Frequently Asked Questions
How many people have diabetes in Portugal?
According to the DGS's National Diabetes Programme Report — Challenges and Strategies 2025, 936,987 people had diagnosed diabetes in primary care at the end of 2024, corresponding to 8.9% of people registered with the SNS. 80,915 new cases were recorded in 2024. Portugal's Official Gazette (Order No. 3390/2025) estimates that diabetes affects more than one million people in Portugal in total, one of the highest prevalence rates in the European Union.
What are the first signs of diabetes?
The most common signs include excessive thirst, frequent urination (especially at night), persistent fatigue, blurred vision, slow-healing wounds, constant hunger even after eating, and tingling or numbness in the hands and feet. Type 2 diabetes can develop slowly and silently — many people have no symptoms for years before diagnosis. If you have risk factors, talk to your family doctor about a fasting glucose or HbA1c test even in the absence of symptoms.
What is the difference between type 1 and type 2 diabetes?
Type 1 diabetes is an autoimmune disease in which the immune system destroys the insulin-producing beta cells in the pancreas, requiring lifelong insulin therapy and usually appearing in childhood or early adulthood. Type 2 diabetes occurs when the body becomes resistant to insulin or doesn't produce enough of it — it is strongly linked to lifestyle factors such as diet, inactivity and excess weight, and accounts for more than 90% of cases in Portugal. The two conditions have different causes, treatments and clinical courses, though both require careful management to avoid complications.
What are the best treatments for type 2 diabetes in Portugal?
First-line treatment usually includes metformin combined with lifestyle changes. The newer drug classes — particularly GLP-1 agonists (such as semaglutide/Ozempic) and SGLT2 inhibitors (such as empagliflozin/Jardiance) — have revolutionised treatment by lowering blood sugar while also protecting the heart and kidneys and promoting weight loss. DGS and 2025 ADA guidelines recommend these classes for patients with established cardiovascular disease, heart failure or chronic kidney disease. Treatment is always individualised — your doctor will tailor it to your specific profile.
How often should I see a doctor if I have diabetes in Portugal?
If you have diagnosed diabetes, you should have at least one structured annual review with your family doctor — covering HbA1c, blood pressure, kidney function, cholesterol, weight, a foot examination and diabetic retinopathy screening. More frequent HbA1c checks (every 3 to 6 months) are recommended if glycaemic control hasn't been achieved or if treatment has recently changed. Retinopathy screening is available free of charge through the DGS's National Screening Programme.
Can diabetes go into remission?
Type 2 diabetes can, in some cases, go into remission — defined as achieving near-normal blood sugar levels without medication — through significant weight loss, often with very low-calorie diets or bariatric surgery. The DiRECT trial showed remission in around 50% of participants after one year on a structured dietary programme. This doesn't mean the underlying tendency is eliminated — remission requires sustained lifestyle changes to maintain. Type 1 diabetes currently has no cure, though stem cell therapies in clinical trials hold promise for restoring insulin production in the coming years.
Can I see a doctor about diabetes online in Portugal?
Yes. Global Health offers online family and general medicine consultations with doctors registered with the Portuguese Medical Council — including diabetes review appointments, symptom assessment, medication review and lab test requests (including HbA1c, fasting glucose and a full metabolic panel). Electronic prescriptions are issued via PEM and IMED when clinically indicated, directly accepted at any pharmacy in Portugal. Book your consultation at myglobalhealth.online or contact globalhealth@myglobalhealth.online.
Have questions about diabetes? Talk to a doctor today.
Online family and general medicine consultations with doctors registered with the Portuguese Medical Council. Electronic prescriptions via PEM and IMED. Available in Portuguese, English, Arabic and more.
