Diabetes is a serious global health issue, and there are more than 425 million people living with diabetes worldwide. The majority of diabetes cases are in Asia, 280 million (66%) people. The numbers of people with diabetes are rising almost everywhere, but more significantly in Asia and Korea is not an exception. Over the past 17 years, the number of people living with diabetes has increased by 274 million. A further 352 million adults are at high risk of developing type 2 diabetes. There are 1 out 2 diabetes cases yet to be diagnosed, but this is higher in Asian populations, about 151 million cases (53%). The complications are common. Many people with diabetes (50% or more in some studies) already have one or more of its complications at the time of their diagnosis. Diabetes is a leading global cause of cardiovascular disease, a leading cause of blindness, kidney failure, and lower-limb amputation. Last year, diabetes and its complications caused five million deaths. Diabetes threatens to overwhelm healthcare systems as well as budgets, and this is more prevalent in Asia due mainly to low income countries. We predict the number of people with diabetes will rise to more than 629 million by 2045, and a further 532 million adults will be at high risk. In Asia alone, the prediction is 416 million people with diabetes. The highest increase will occur in India, with 78.5%, and followed by China with 37.5%. Asia will be further troubled by the high prevalence of GDM, child hood obesity, diabetes in older populations, and urbanization of Asia. Development of a standardized risk assessment model utilizing potential risk factors for early detection of diabetes are critical and urgently in need in Asia. Finally, Asian countries must invest more in health budgets to reduce diabetes related morbidity and mortality.