OBJECTIVES: Rising rates of diabetes in Africa have triggered increased demand for affordable medical solutions. This analysis sought to quantify the burden of diabetes in Africa, and identify regions where disease burden creates opportunity for pharmaceutical and medical device interventions. METHODS: Data from the International Diabetes Federation was used to estimate the prevalence of diabetes mellitus and the mean national expenditure in 53 African countries. A systematic literature search was conducted to capture current disease management protocols and practice in Africa. RESULTS: In 2013, there were an estimated 33.2 million adult (ages 20-79) diabetes patients in Africa, ~1.5 times the prevalence in 2003. The continent-wide expenditure on diabetes in 2013 was ~$7.06 billion, compared to $2.72 billion in 2010, accounting for ~1% of global expenditures despite a prevalence burden of nearly 10% of global figures. The highest proportion of diabetes cases and spending were from northern Africa (40.4% of cases, 41.8% expenditures in 2013). However, eastern Africa (23.2% cases, 7.1% expenditures), western Africa (19.3% cases, 10.9% expenditures), and central Africa (8.6% cases, 4.2% expenditures), shoulder higher burdens of disease than their share of expenditures. In contrast, southern Africa (8.4% cases, 36% expenditures) has a lower percentage of overall patients, but spends significantly more than other regions. Data indicate that access to diabetes treatment is highly variable by region, and that disease management programs are infrequently available. Drug therapies are more broadly available, though costs can be a significant barrier to utilization. CONCLUSIONS: Rising disease prevalence will continue to stimulate demand for medical solutions in Africa. Northern and southern Africa present a noteworthy market opportunity due to high disease prevalence and/or relatively high mean spending per patient. Affordable solutions that account for the variability in local market economics and implementation infrastructure are needed to support the growing diabetes burden in Africa.