Campaigners are warning that diabetes care in England is in "crisis" - with less than half of people getting the basic care they need.
Diabetes UK warns there are some areas where only 6% of people are getting the recommended regular checks and services.
Its head said the State of the Nation 2012 report showed people with diabetes were getting "second rate care".
Ministers said the report would encourage local NHS services to act.
Diabetes is a condition in which the amount of glucose in the blood is too high because the body cannot use it properly.
Type 1 diabetes develops if the body cannot produce any insulin and usually develops by the age of 40.
Type 2 diabetes develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly and in most cases is linked with being overweight.
Between 2006 and 2011 the number of people diagnosed with diabetes in England has increased by 25%, from 1.9m to 2.5m.
Almost all - 90% - have type 2 diabetes.
It is also estimated that up to 850,000 people have diabetes but are unaware of it.
Diabetes is now the biggest single cause of amputation, stroke, blindness and kidney failure.
Spending on the condition accounts for around 10% of the NHS budget.
Diabetes UK says that because so many people are missing out on the relevant checks, there has been a rise in complications such as amputation, blindness, kidney failure and stroke.
Such complications account for about 80% of NHS spending on diabetes, it says.
A National Service Framework for diabetes was drawn up in 2001, but the charity says its recommendations are not being followed.
Diabetes UK wants better risk assessment and early diagnosis for people with the condition.
It says a national audit found only 50% of people with diabetes get all the recommended health checks - ranging from 6% in the worst areas to 69% in the best.
For children with diabetes, just 4% have all their annual checks, they claim.
Barbara Young, Chief Executive of Diabetes UK, said: "This report shows how in exchange for this investment we are getting second rate healthcare that is putting people with diabetes at increased risk of tragic complications and early death.
"Above all, the wide variation in standards of care shows the need for a national plan to be put in place for giving people with diabetes the kind of healthcare that can help prevent complications, as well as a greater focus on preventing Type 2 diabetes.
"By taking the longer-term approach of investing in making sure people get the basic checks and services, we could save money by reducing the number of complications and make life immeasurably better for people with diabetes."
Care Services Minister Paul Burstow said there was still much to be done to tackle diabetes.
"Our focus is on prevention and education, with more done to get earlier diagnoses and to help people manage their conditions themselves.
"This report and our new strategy will help local NHS services act so that diabetics get the care they need and deserve."