Nearly one in five Mauritians lives with diabetes – one of the highest rates in the world –, a statistic that has climbed steadily despite a sugar tax first introduced in 2013 and expanded and doubled since. The policy was meant to be a turning point but, as sugar remains woven into everything from festive cakes to processed snacks lining supermarket shelves, taxing sugar content cannot be enough on its own.

The narrative

Non-communicable diseases have emerged as one of the defining public-health challenges of the 21st century, with Type 2 diabetes standing out because of its growing prevalence, potentially life-threatening complications and the long-term burden it places on families, healthcare systems and national economies. For Mauritius, the challenge is particularly serious. According to the International Diabetes Federation, around 20.1% (218,000 people) of Mauritians aged 20 to 79 live with diabetes. It also ranks Mauritius as the 12th highest disease-burdened country in the world for diabetes.

The Mauritius Non-Communicable Diseases (NCD) Survey 2021 similarly found that 19.9% of adults aged 25 to 74 had Type 2 Diabetes – a crisis that extends far beyond individual patients, affecting productivity, household finances, caregivers and social welfare, while placing sustained pressure on hospitals and specialised services. In that context, the government has adopted a multi-pronged strategy combining prevention, clinical care, specialist services and fiscal measures, with the expansion of the sugar tax under the 2026-2027 Budget aimed at reducing sugar consumption and encouraging healthier food choices.

Changing lifestyle, growing burden

Mauritius’ diabetes epidemic is closely linked to the country’s social and economic transformation. Rapid urbanisation has changed traditional dietary patterns, with refined carbohydrates, processed foods and sugar-sweetened beverages becoming increasingly common, while physical activity has declined as lifestyles have become more sedentary. Genetic factors also contribute: research on Mauritius’ multi-ethnic population shows significant susceptibility to insulin resistance and metabolic syndrome within certain groups.

Diabetes rarely exists in isolation – it frequently occurs alongside obesity, hypertension and dyslipidaemia, raising cardiovascular risk. The 2021 NCD Survey found more than a third of adults obese or overweight, with hypertension and high cholesterol also widespread, while prevalence rises sharply with age, affecting nearly one in two adults aged 50 and above. Type 2 Diabetes develops primarily through insulin resistance and is strongly linked to excess weight, inactivity, diet and genetic susceptibility. It accounts for 98% to 99% of diagnosed adult cases in Mauritius. Its gradual progression is concerning because people can remain undiagnosed for years while high blood sugar silently damages blood vessels, nerves, kidneys and eyes.

The relationship between sugar and diabetes is complex. Eating sugar does not, on its own, cause diabetes, but excessive consumption of added sugars can contribute to a sustained calorie surplus, weight gain and increased visceral fat, all of which raise the risk of insulin resistance. Fructose – found naturally in fruits but also in sucrose and sweetened products – is metabolised primarily in the liver and excessive intake can contribute to fat accumulation there and wider metabolic dysfunction. Over time, blood sugar remains elevated. The issue, then, is not simply the presence of sugar in the diet, but the combination of excessive sugar and calorie intake, poor dietary quality, inactivity and other metabolic risk factors.

Socioeconomic costs

Poorly controlled Type 2 Diabetes can progressively damage almost every major organ system: diabetic retinopathy in the eyes causing irreversible blindness; diabetic nephropathy can progress to chronic kidney disease and dialysis; atherosclerosis raises the risk of hypertension, heart attacks and strokes; and diabetic neuropathy can reduce sensation in the feet, so an unnoticed small cut or ulcer becomes infected and, in severe cases, require amputation.

Moreover, the consequences of diabetes extend well beyond hospitals and clinics. Although public healthcare and essential antidiabetic medicines are free in Mauritius, families still face indirect expenses – transportation, monitoring strips, homecare equipment and additional care for complications – that can be especially hard for lower-income households to absorb. Complications such as vision loss, kidney failure and amputations may force patients to leave employment prematurely, increasing dependence on social assistance. The psychological impact should not be underestimated: chronic illness and visible complications can bring anxiety, stigma and social withdrawal while deepening existing inequalities.

Public health response

Mauritius has developed a broad public healthcare response, with NCD clinics across regional hospitals and community health centres providing regular monitoring, consultations and medication, alongside specialised services such as diabetic foot care, retinal screening and podiatry and reference to hospital cardiac units.

To complement medical care, in the 2026-2027 Budget, the excise duty on sugar-sweetened beverages rose from 12 to 15 cents per gram of sugar, effective June 20, 2026, and extended to processed food categories – biscuits, waffles, sweets, confectionery, jams, fruit jellies and chewing gum – as from October 1, 2026. The objective is twofold: discourage excessive sugar consumption and encourage manufacturers to reformulate products with lower sugar content.

Beyond this fiscal measure, the 2026-2027 Budget is investing in recruiting 2,220 additional medical and paramedical personnel, specialised training in diabetes care, and Rs 40 million for the Visiting Doctor Scheme, allowing international specialists to contribute to the public system. This further reflects the growing recognition that diabetes, obesity and cardiovascular disease are interconnected rather than separate health challenges.

The biggest challenge

Mauritius has seen diabetes prevalence fall from the 2015 levels – but the overall burden remains exceptionally high. The next stage of the national response must therefore focus strongly on prevention and early intervention: encouraging healthier diets, increasing physical activity, reducing excessive sugar consumption, strengthening screening and support for those diagnosed.

It also means addressing the wider environment of health decisions – healthier food must be accessible and affordable and public education must move beyond simply telling people what not to eat. The sugar tax should be viewed as one element of a broader strategy. Type 2 diabetes is a national public-health and socioeconomic challenge, visible in dialysis units, diabetic foot clinics and retinal screening services, but also in households dealing with lost income and reduced quality of life.

The government’s response represents an attempt to tackle the problem on several fronts. Yet, the ultimate measure of success will not be the number of policies introduced, but whether fewer people develop Type 2 diabetes, whether those diagnosed achieve better control, and whether fewer progress to preventable complications such as blindness, kidney failure, cardiovascular disease and amputation.

For Mauritius, the fight against diabetes is therefore a fight for healthier families, a more productive workforce and a more sustainable healthcare system. Prevention is not simply an option – it has become an essential public-health priority.