England 2015/16 to 2024/25
Published 21 August 2025
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Key findings
In 2024/25:
The cost of prescribed items for treating diabetes has doubled to £1.92 billion over the last ten years.
Patient numbers have increased by an average of 7% each year over the past 3 years.
Anti-diabetic drugs were the most prescribed, making up 59% of items and 75% of the total cost of diabetes treatments.
There were 77 million items prescribed for treating diabetes in England - a 56% increase from 50 million items in 2015/16, and up 9% from 71 million the year before.
The cost of diabetes treatments was £1.92 billion, accounting for 15% of the total spend on all prescribed items. This is double the £960 million spent in 2015/16, when diabetes treatments made up 10% of total prescribing costs.
Two treatments have driven much of this cost increase over the past decade:
- Dapagliflozin, branded as Forxiga
- Interstitial Fluid Sensors, such as Freestyle Libre or Dexcom
More than 58 million anti-diabetic drugs were prescribed at a cost of £1.1 billion - an 11% rise in items, and an 18% rise in cost compared to 2023/24. A new driver of cost growth this year is Tirzepatide, branded as Mounjaro, alongside Dapagliflozin.
The number of patients receiving diabetes-related prescriptions also increased. In 2024/25, an estimated 3.9 million people were identified as receiving treatment - up 7% from 3.6 million in 2023/24, and up 43% from 2.7 million in 2015/16.
The most commonly treated group was men aged 60 to 64. There are an estimated 284,000 identified patients in this group, accounting for 7% of all identified patients receiving drugs to treat diabetes.
Areas with greater deprivation had the highest number of patients prescribed items for treating diabetes. There were an estimated 349,000 more patients in the most deprived areas, compared to the least deprived.
1.Things you should know
1.1. Background
Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high. There are two main types of diabetes, type 1 diabetes where the body’s immune system attacks and destroys the cells that produce insulin, and type 2 diabetes where the body does not produce enough insulin, or the body’s cells do not react to insulin. Another form of diabetes is gestational diabetes, where diabetes develops during pregnancy and usually disappears after childbirth.
This publication aims to describe the prescribing of medicines and appliances used for the treatment of diabetes in England that are dispensed in the community. This does not include data on medicines prescribed and dispensed in secondary care, prisons, or issued by a private prescriber as this is not held by the NHSBSA.
1.2. What is in these statistics
These statistics detail:
- the total number of prescription items issued for drugs used in diabetes
- the number of identified patients that have received prescribing for these drugs
- demographic breakdowns of prescribing by age group and gender
- demographic breakdowns by gender
- demographic breakdowns by a measure of deprivation.
1.3. Classifications
These statistics use the BNF therapeutic classifications defined in the British National Formulary (BNF) using the classification system prior to BNF edition 70. Each January the NHSBSA updates the classification of drugs within the BNF hierarchy which may involve some drugs changing classification between years of this publication. Five paragraphs of the BNF are covered within these statistics:
- Insulin (060101)
- Anti-diabetic drugs (060102)
- Treatment of hypoglycaemia (060104)
- Diabetic diagnostic and monitoring agents (060106)
- Interstitial fluid glucose sensor (2148)
These medicines are classified by their primary therapeutic indication. However, it is possible that they can be prescribed for other reasons outside of this primary therapeutic indication. For example, metformin which is used to reduce blood sugar for those with type 2 diabetes is also used to treat infertility caused by polycystic ovarian syndrome (PCOS). From March 2025 - Tirzapetide, which is used to treat type 2 diabetes, can also be used for weight management in patients with, or without diabetes.
It is not possible to distinguish the type of diabetes that insulin is prescribed for between patients. It is also not suitable to use drug types as an indicator of diabetes type.
Due to these reasons, these statistics may not give an accurate estimation of the population who are receiving drugs specifically for diabetes and the diabetes type of the population, any inferences made from this data should take this into consideration.
Hypodermic needles are not included as part of this publication as these are often used for other clinical conditions and would unnecessarily skew the data.
Only data for prescribed sensors for continuous blood glucose monitoring devices is included in these statistics, as readers are usually provided to patients separately.
1.4. Definitions
Item
A single unit of medication listed separately on a prescription form. For example, in this publication, an item might be listed as Metformin 500mg tablets x28, distinct from other medications that may be prescribed on the same form.
NIC
The Net Ingredient Cost (NIC) is the basic price of a single unit of a medication multiplied by the quantity prescribed. It does not include other fees incurred by dispensing contractors, such as controlled drug fees or the single activity fee. The basic price is determined by the Drug Tariff or by the manufacturer, wholesaler, or supplier of the product.
Patient
A unique NHS number captured from a prescription form or electronic prescription service (EPS) message.
1.5. Patient identification
When the NHSBSA processes prescriptions it is not always possible to capture the NHS number of the patient. Table 1 shows the percentage of items for which a patient could be identified. This means that the data relating to patient counts represents most, but not all, patients.
Due to an increase in digital prescribing through the Electronic Prescription Service (EPS) during the COVID-19 pandemic, more patients were identified from 2020/21 onwards, when compared to previous years. The prescribing for those previously unidentified patients is included in the reported totals. Therefore, their prescribing should have no further impact on the volume of items now that they are identified. This means the observed increase in the number of patients is likely an overestimate of the actual increase in the number of new patients receiving prescribing for diabetes. Conversely, any decrease over the same period is likely to be an underestimation of the actual decrease.
Where patients are identified, to assign them to a single age band their age is calculated on the 30 September of the given financial year. For patients where date of birth has not been captured, they have been included in an unknown category.
Gender information was not available from PDS for a small number of patients in each year, typically fewer than 100. This may be because it was not disclosed by the patient or not recorded by the organisation that collected the data.
These statistics do not include any information that is personally identifiable. You can find more information about how the NHSBSA protect personal information in the confidentiality and access statement.
Table 1: The percentage of items for which an NHS number was recorded for listed BNF sections over the five most recent financial years
| Bnf paragraph name | Bnf paragraph code | 2020/2021 | 2021/2022 | 2022/2023 | 2023/2024 | 2024/2025 |
|---|---|---|---|---|---|---|
| Insulin | 060101 | 99.36% | 99.41% | 99.41% | 99.44% | 99.49% |
| Antidiabetic drugs | 060102 | 99.45% | 99.49% | 99.51% | 99.57% | 99.58% |
| Treatment of hypoglycaemia | 060104 | 99.01% | 99.16% | 99.27% | 99.36% | 99.46% |
| Diabetic diagnostic and monitoring agents | 060106 | 99.46% | 99.52% | 99.53% | 99.59% | 99.63% |
| Detection Sensor Interstitial Fluid/Gluc | 2148 | 99.02% | 99.26% | 99.39% | 99.51% | 99.58% |
Source: Prescribing for diabetes summary tables - Costs and items (Patient identification rates)
2. Results and commentary
2.1. Volume and cost
Number of diabetes items prescribed and identified patients by financial year
Chart
Figure 1: The number of items prescribed and identified patients have increased every year between 2015/16 and 2024/25
Table
Table 2: The number of items prescribed and identified patients have increased every year between 2015/16 and 2024/25
| Financial year | Measure | Value |
|---|---|---|
| 2015/2016 | Identified patients | 2,714,978 |
| 2016/2017 | Identified patients | 2,800,871 |
| 2017/2018 | Identified patients | 2,867,618 |
| 2018/2019 | Identified patients | 2,934,748 |
| 2019/2020 | Identified patients | 3,013,146 |
| 2020/2021 | Identified patients | 3,055,246 |
| 2021/2022 | Identified patients | 3,207,195 |
| 2022/2023 | Identified patients | 3,411,408 |
| 2023/2024 | Identified patients | 3,635,806 |
| 2024/2025 | Identified patients | 3,884,302 |
| 2015/2016 | Prescription items | 49,723,213 |
| 2016/2017 | Prescription items | 52,058,382 |
| 2017/2018 | Prescription items | 53,460,387 |
| 2018/2019 | Prescription items | 55,506,228 |
| 2019/2020 | Prescription items | 58,257,904 |
| 2020/2021 | Prescription items | 58,844,564 |
| 2021/2022 | Prescription items | 61,684,721 |
| 2022/2023 | Prescription items | 65,804,920 |
| 2023/2024 | Prescription items | 70,687,069 |
| 2024/2025 | Prescription items | 77,397,780 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
77 million items for drugs used in diabetes prescribed in 2024/25.
The number of patients and prescription items for drugs used in diabetes have increased at similar rates over the last 10 years.
3.9 million identified patients were prescribed a diabetes item in 2024/25.
The number of prescribed items for diabetes has grown over the past decade - up 56% from 50 million items in 2015/16, and up 9% from 71 million items in 2023/24.
The number of patients receiving drugs to treat diabetes has also grown with a similar trend - a 43% rise from 2.7 million identified patients in 2015/16, and 7% more than the 3.6 million treated in 2023/24.
Growth trends have accelerated in recent years:
- Between 2015/16 and 2020/21, the average annual growth in patient numbers was 2%. Between 2021/22 and 2024/25, that rate has tripled to 6% per year.
- A similar pattern is seen in prescribing volume, with item growth averaging 3% annually between 2015/16 and 2020/21, rising to 7% per year from 2021/22 to 2024/25.
Cost of diabetes prescribing by financial year
Chart
Figure 2: The cost of diabetes prescribing has increased every year between 2015/16 and 2024/25
Note: The y-axis does not start at zero. This is to emphasise relative changes rather than absolute values. Please consider the scale when interpreting the data.
Table
Table 3: The cost of diabetes prescribing has increased every year between 2015/16 and 2024/25
| Financial year | Total net ingredient cost (£) |
|---|---|
| 2015/2016 | 957,998,085 |
| 2016/2017 | 985,162,849 |
| 2017/2018 | 1,014,153,611 |
| 2018/2019 | 1,084,970,854 |
| 2019/2020 | 1,195,673,847 |
| 2020/2021 | 1,268,362,943 |
| 2021/2022 | 1,362,237,899 |
| 2022/2023 | 1,530,965,733 |
| 2023/2024 | 1,669,171,583 |
| 2024/2025 | 1,919,925,307 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
The cost of drugs used in diabetes has doubled over the last 10 years.
There was a 15% increase in costs from 2023/24 to 2024/25.
The cost of diabetes medications rose to £1.92 billion in 2024/25. While the average annual growth rates for items and patient numbers shifted in 2020/21, the upturn in cost began earlier, in 2018/19. From 2015/16 to 2017/18, annual cost increases remained below 3%, but from 2018/19 to 2024/25, growth rates have ranged between 6% and 15%.
Percentage of all prescription items and costs for drugs used in diabetes by financial year
Chart
Figure 3: The proportion of all prescription items accounted for by drugs to treat diabetes has increased annually from 2015/16 to 2024/25
Table
Table 4: The proportion of all prescription items accounted for by drugs to treat diabetes has increased annually from 2015/16 to 2024/25
| Financial year | Measure | Value (%) |
|---|---|---|
| 2015/2016 | Percentage of items | 4.6 |
| 2015/2016 | Percentage of costs | 10.4 |
| 2016/2017 | Percentage of items | 4.7 |
| 2016/2017 | Percentage of costs | 10.8 |
| 2017/2018 | Percentage of items | 4.8 |
| 2017/2018 | Percentage of costs | 11.2 |
| 2018/2019 | Percentage of items | 5.0 |
| 2018/2019 | Percentage of costs | 12.4 |
| 2019/2020 | Percentage of items | 5.1 |
| 2019/2020 | Percentage of costs | 13.0 |
| 2020/2021 | Percentage of items | 5.3 |
| 2020/2021 | Percentage of costs | 13.3 |
| 2021/2022 | Percentage of items | 5.4 |
| 2021/2022 | Percentage of costs | 14.2 |
| 2022/2023 | Percentage of items | 5.6 |
| 2022/2023 | Percentage of costs | 14.8 |
| 2023/2024 | Percentage of items | 5.8 |
| 2023/2024 | Percentage of costs | 15.4 |
| 2024/2025 | Percentage of items | 6.2 |
| 2024/2025 | Percentage of costs | 17.4 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
In 2024/25, the costs of prescribed drugs used in treating diabetes accounted for 17% of the total costs of all drugs prescribed.
In 2024/25, prescribed drugs used in treating diabetes accounted for 6% of all items prescribed.
The proportion of all prescription items attributed to drugs used in diabetes has risen steadily over the last 10 years - increasing from 5% in 2015/16 to 6% in 2024/25. From 2015/16 to 2022/23, the annual growth rate was approximately 0.15%, but this has accelerated over the last two years to 0.3% in 2024/25.
The rise in the percentage of cost to treat diabetes over the same period is greater than items, up 2 percentage points from 2023/24 to 2024/25 alone. Over the longer term, this is an increase of 7 percentage points from 2015/16 when drugs used in diabetes accounted for 10% of the total spend.
Number of diabetes items prescribed by BNF paragraph by financial year
Chart
Figure 4: Anti-diabetic drugs are the most prescribed treatment for diabetes
Table
Table 5: Anti-diabetic drugs are the most prescribed treatment for diabetes
| Financial year | Bnf paragraph name | Total items |
|---|---|---|
| 2015/2016 | Antidiabetic drugs | 35,462,249 |
| 2015/2016 | Diabetic diagnostic and monitoring agents | 7,078,690 |
| 2015/2016 | Insulin | 6,893,946 |
| 2015/2016 | Treatment of hypoglycaemia | 288,328 |
| 2016/2017 | Antidiabetic drugs | 37,452,946 |
| 2016/2017 | Diabetic diagnostic and monitoring agents | 7,215,710 |
| 2016/2017 | Insulin | 7,089,122 |
| 2016/2017 | Treatment of hypoglycaemia | 300,604 |
| 2017/2018 | Antidiabetic drugs | 38,778,745 |
| 2017/2018 | Detection Sensor Interstitial Fluid/Gluc | 4,900 |
| 2017/2018 | Diabetic diagnostic and monitoring agents | 7,176,882 |
| 2017/2018 | Insulin | 7,196,368 |
| 2017/2018 | Treatment of hypoglycaemia | 303,492 |
| 2018/2019 | Antidiabetic drugs | 40,411,581 |
| 2018/2019 | Detection Sensor Interstitial Fluid/Gluc | 116,192 |
| 2018/2019 | Diabetic diagnostic and monitoring agents | 7,247,849 |
| 2018/2019 | Insulin | 7,410,776 |
| 2018/2019 | Treatment of hypoglycaemia | 319,830 |
| 2019/2020 | Antidiabetic drugs | 42,462,968 |
| 2019/2020 | Detection Sensor Interstitial Fluid/Gluc | 552,399 |
| 2019/2020 | Diabetic diagnostic and monitoring agents | 7,187,764 |
| 2019/2020 | Insulin | 7,712,258 |
| 2019/2020 | Treatment of hypoglycaemia | 342,515 |
| 2020/2021 | Antidiabetic drugs | 43,099,792 |
| 2020/2021 | Detection Sensor Interstitial Fluid/Gluc | 966,166 |
| 2020/2021 | Diabetic diagnostic and monitoring agents | 6,943,433 |
| 2020/2021 | Insulin | 7,515,784 |
| 2020/2021 | Treatment of hypoglycaemia | 319,389 |
| 2021/2022 | Antidiabetic drugs | 45,250,773 |
| 2021/2022 | Detection Sensor Interstitial Fluid/Gluc | 1,429,927 |
| 2021/2022 | Diabetic diagnostic and monitoring agents | 6,846,792 |
| 2021/2022 | Insulin | 7,808,119 |
| 2021/2022 | Treatment of hypoglycaemia | 349,110 |
| 2022/2023 | Antidiabetic drugs | 48,773,197 |
| 2022/2023 | Detection Sensor Interstitial Fluid/Gluc | 1,970,165 |
| 2022/2023 | Diabetic diagnostic and monitoring agents | 6,578,716 |
| 2022/2023 | Insulin | 8,090,936 |
| 2022/2023 | Treatment of hypoglycaemia | 391,906 |
| 2023/2024 | Antidiabetic drugs | 52,845,543 |
| 2023/2024 | Detection Sensor Interstitial Fluid/Gluc | 2,775,782 |
| 2023/2024 | Diabetic diagnostic and monitoring agents | 6,269,368 |
| 2023/2024 | Insulin | 8,389,881 |
| 2023/2024 | Treatment of hypoglycaemia | 406,495 |
| 2024/2025 | Antidiabetic drugs | 58,420,688 |
| 2024/2025 | Detection Sensor Interstitial Fluid/Gluc | 3,714,789 |
| 2024/2025 | Diabetic diagnostic and monitoring agents | 6,081,597 |
| 2024/2025 | Insulin | 8,748,549 |
| 2024/2025 | Treatment of hypoglycaemia | 432,157 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 2)
Anti-diabetic drug items account for 59% of all drugs to treat diabetes.
Anti-diabetic drug prescribing rose 11% from 2023/24 to 2024/25.
10% of patients prescribed diabetes drugs were prescribed a glucose interstitial fluid detection sensor in 2024/25.
Anti-diabetic drugs, such as SGLT-2 inhibitors and GLP-1 agonists, remain the most prescribed treatment for diabetes with 58 million items in 2024/25. This was a 65% increase from 35 million items in 2015/16, and an 11% increase from 53 million items in 2023/24. An estimated 3.5 million patients received anti-diabetic drugs in 2024/2025.
The annual growth in anti-diabetic drug prescriptions mirrors the overall trend of items used in diabetes. In the past year, the largest contributors to the rise in anti-diabetic items were Dapagliflozin, Metformin and Tirzepatide. Between 2023/24 and 2024/25:
- the prescribing of Dapagliflozin, an SGLT-2 inhibitor, has risen 44% to 8.7 million items
- Metformin is up 5% to 27 million items
- Tirzepatide, a GLP-1 agonist approved by the Medicines and Healthcare products Regulatory Agency (MHRA) in November 2023, saw a 340-fold increase to 1.1 million items
Other areas of prescribing for diabetes also saw change between 2023/24 to 2024/25:
- insulin items increased by 4%, and were prescribed to an estimated 829,000 patients
- medicines used to treat hypoglycemia increased by 6%, and were
prescribed to an estimated 111,000 patients
- prescribing of diabetic diagnostic and monitoring agents decreased
by 3%, and were prescribed to an estimated 1.2 million patients
- interstitial fluid glucose sensor items increased by 34%, and were prescribed to an estimated 396,000 patients
For additional details regarding the groups, drugs, and devices mentioned, please refer to Section 3 of this publication.
Cost of diabetes items prescribed by BNF paragraph and financial year
Chart
Figure 5: Anti-diabetic drugs have the highest costs for treatments prescribed for diabetes
Table
Table 6: Anti-diabetic drugs have the highest costs for treatments prescribed for diabetes
| Financial year | Bnf paragraph name | Total net ingredient cost (£) |
|---|---|---|
| 2015/2016 | Antidiabetic drugs | 423,469,794 |
| 2015/2016 | Diabetic diagnostic and monitoring agents | 186,690,270 |
| 2015/2016 | Insulin | 344,132,506 |
| 2015/2016 | Treatment of hypoglycaemia | 3,705,516 |
| 2016/2017 | Antidiabetic drugs | 444,410,579 |
| 2016/2017 | Diabetic diagnostic and monitoring agents | 187,102,537 |
| 2016/2017 | Insulin | 349,658,209 |
| 2016/2017 | Treatment of hypoglycaemia | 3,991,524 |
| 2017/2018 | Antidiabetic drugs | 477,387,709 |
| 2017/2018 | Detection Sensor Interstitial Fluid/Gluc | 361,690 |
| 2017/2018 | Diabetic diagnostic and monitoring agents | 181,268,491 |
| 2017/2018 | Insulin | 350,982,212 |
| 2017/2018 | Treatment of hypoglycaemia | 4,153,510 |
| 2018/2019 | Antidiabetic drugs | 540,603,207 |
| 2018/2019 | Detection Sensor Interstitial Fluid/Gluc | 9,212,069 |
| 2018/2019 | Diabetic diagnostic and monitoring agents | 177,268,748 |
| 2018/2019 | Insulin | 353,617,026 |
| 2018/2019 | Treatment of hypoglycaemia | 4,269,803 |
| 2019/2020 | Antidiabetic drugs | 615,317,141 |
| 2019/2020 | Detection Sensor Interstitial Fluid/Gluc | 43,876,474 |
| 2019/2020 | Diabetic diagnostic and monitoring agents | 166,056,187 |
| 2019/2020 | Insulin | 365,885,273 |
| 2019/2020 | Treatment of hypoglycaemia | 4,538,772 |
| 2020/2021 | Antidiabetic drugs | 685,985,437 |
| 2020/2021 | Detection Sensor Interstitial Fluid/Gluc | 76,690,040 |
| 2020/2021 | Diabetic diagnostic and monitoring agents | 148,330,013 |
| 2020/2021 | Insulin | 353,049,697 |
| 2020/2021 | Treatment of hypoglycaemia | 4,307,755 |
| 2021/2022 | Antidiabetic drugs | 745,772,768 |
| 2021/2022 | Detection Sensor Interstitial Fluid/Gluc | 112,427,455 |
| 2021/2022 | Diabetic diagnostic and monitoring agents | 139,050,332 |
| 2021/2022 | Insulin | 360,698,853 |
| 2021/2022 | Treatment of hypoglycaemia | 4,288,492 |
| 2022/2023 | Antidiabetic drugs | 876,563,184 |
| 2022/2023 | Detection Sensor Interstitial Fluid/Gluc | 155,126,748 |
| 2022/2023 | Diabetic diagnostic and monitoring agents | 124,356,741 |
| 2022/2023 | Insulin | 369,906,485 |
| 2022/2023 | Treatment of hypoglycaemia | 5,012,576 |
| 2023/2024 | Antidiabetic drugs | 962,437,455 |
| 2023/2024 | Detection Sensor Interstitial Fluid/Gluc | 214,240,212 |
| 2023/2024 | Diabetic diagnostic and monitoring agents | 108,179,549 |
| 2023/2024 | Insulin | 378,751,834 |
| 2023/2024 | Treatment of hypoglycaemia | 5,562,533 |
| 2024/2025 | Antidiabetic drugs | 1,140,242,149 |
| 2024/2025 | Detection Sensor Interstitial Fluid/Gluc | 288,426,615 |
| 2024/2025 | Diabetic diagnostic and monitoring agents | 93,235,021 |
| 2024/2025 | Insulin | 391,958,120 |
| 2024/2025 | Treatment of hypoglycaemia | 6,063,403 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 2)
Anti-diabetic drugs account for 75% of the cost for drugs to treat diabetes.
Anti-diabetic drug costs rose 18% from 2023/24 to 2024/25.
35% increase in costs of glucose interstitial fluid detection sensors prescribed from 2023/24 to 2024/25.
In 2024/25, the cost of anti-diabetic drugs reached £1.1 billion - up 169% from £423 million in 2015/16 and 18% from £962 million in 2023/24. These cost increases exceed the growth seen for the number of prescription items for diabetes.
The substances having the greatest impact on the increase in anti-diabetic drug cost in the last year are Tirzepatide, Dapagliflozin, Semaglutide and Empagliflozin. From 2023/24 to 2024/25:
- Tirzepatide has increased 340-fold to £120 million
- Dapagliflozin is up 42% to £333 million
- Semaglutide has risen 33% to £147 million
- Empagliflozin is up 19% to £171 million
Other areas of prescribing for diabetes also saw cost changes between 2023/24 to 2024/25:
- costs of insulin items increased by 3%
- costs of medicines used to treat hypoglycemia increased by 9%
- costs of prescribing diabetic diagnostic and monitoring agents decreased by 14%
- costs of glucose interstitial fluid detection sensor items increased by 35%, with the vast majority of the increase attributed to Freestyle Libre sensors
Average number of diabetes items per patient by financial year
Chart
Figure 6: In the five years to 2023/24 the average number of diabetes items per patient remained consistent but 2024/25 saw a 2.5% rate of growth
Note: The y-axis does not start at zero. This is to emphasise relative changes rather than absolute values. Please consider the scale when interpreting the data.
Table
Table 7: In the five years to 2023/24 the average number of diabetes items per patient remained consistent but 2024/25 saw a 2.5% rate of growth
| Financial year | Total identified patients | Total items | Items per patient |
|---|---|---|---|
| 2015/2016 | 2,714,978 | 47,513,431 | 17.5 |
| 2016/2017 | 2,800,871 | 50,799,087 | 18.1 |
| 2017/2018 | 2,867,618 | 52,575,803 | 18.3 |
| 2018/2019 | 2,934,748 | 54,786,491 | 18.7 |
| 2019/2020 | 3,013,146 | 57,614,011 | 19.1 |
| 2020/2021 | 3,055,246 | 58,510,254 | 19.2 |
| 2021/2022 | 3,207,195 | 61,360,700 | 19.1 |
| 2022/2023 | 3,411,408 | 65,472,596 | 19.2 |
| 2023/2024 | 3,635,806 | 70,368,910 | 19.4 |
| 2024/2025 | 3,884,302 | 77,066,771 | 19.8 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
Between 2015/16 and 2019/20, the number of items per patient increased by 2.3% per year on average. From 2020/21 to 2023/24, the rate remained consistent, with an average annual growth rate of 0.3%. However, in 2024/25, the rate of annual growth increased to 2.5% with an average of 19.8 items per patient.
This measure only includes prescribing of drugs used in diabetes and does not include any items prescribed from other BNF sections.
Cost of diabetes prescribing per patient by Integrated Care Board (ICB)
Chart
Figure 7: The median cost per patient by ICB has increased year on year for the last 10 years
Table
Table 8: The median cost per patient by ICB has increased year on year for the last 10 years
| Financial year | Minimum (£) | Lower quartile (£) | Median (£) | Upper quartile (£) | Maximum |
|---|---|---|---|---|---|
| 2015/2016 | 267.12 | 303.65 | 331.56 | 346.97 | 364.30 |
| 2016/2017 | 280.07 | 312.68 | 339.64 | 357.10 | 376.58 |
| 2017/2018 | 288.43 | 316.47 | 344.11 | 363.53 | 381.92 |
| 2018/2019 | 300.44 | 336.55 | 360.80 | 383.54 | 408.32 |
| 2019/2020 | 325.56 | 364.08 | 387.87 | 417.32 | 444.87 |
| 2020/2021 | 349.13 | 388.81 | 414.58 | 437.05 | 475.96 |
| 2021/2022 | 354.70 | 395.72 | 424.46 | 446.31 | 483.52 |
| 2022/2023 | 378.75 | 423.83 | 447.76 | 468.71 | 507.32 |
| 2023/2024 | 387.38 | 432.97 | 460.20 | 481.23 | 508.01 |
| 2024/2025 | 393.42 | 465.21 | 501.59 | 519.25 | 557.06 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 4)
The median cost per patient by ICB in 2024/25 was £502.
The costs per patient by ICB in 2024/25 range from £393 to £557.
See section 4.7. Interpretation of a box plot for guidance on interpreting this chart.
The median cost per patient has increased by 9% since 2023/24. Whilst there were no ICBs that were outliers for cost per patient in 2024/25, the distribution across ICBs is wider than previous years.
2.2. Treatment for Diabetes
Number of identified patients receiving prescribing for diabetes by treatment type
Chart
Figure 8: The proportion of patients by treatment type has remained stable from 2015/16 to 2024/25
Table
Table 9: The proportion of patients by treatment type has remained stable from 2015/16 to 2024/25
| Financial year | Treatment type | Total identified patients | Percent identified patients |
|---|---|---|---|
| 2015/2016 | Antidiabetic Drugs Only | 1964419 | 72.4 |
| 2015/2016 | Insulin Only | 321227 | 11.8 |
| 2015/2016 | Both | 358858 | 13.2 |
| 2015/2016 | None | 70474 | 2.6 |
| 2016/2017 | Antidiabetic Drugs Only | 2033237 | 72.6 |
| 2016/2017 | Insulin Only | 323306 | 11.5 |
| 2016/2017 | Both | 373212 | 13.3 |
| 2016/2017 | None | 71116 | 2.5 |
| 2017/2018 | Antidiabetic Drugs Only | 2089016 | 72.8 |
| 2017/2018 | Insulin Only | 325412 | 11.3 |
| 2017/2018 | Both | 384853 | 13.4 |
| 2017/2018 | None | 68337 | 2.4 |
| 2018/2019 | Antidiabetic Drugs Only | 2145525 | 73.1 |
| 2018/2019 | Insulin Only | 326399 | 11.1 |
| 2018/2019 | Both | 394907 | 13.5 |
| 2018/2019 | None | 67917 | 2.3 |
| 2019/2020 | Antidiabetic Drugs Only | 2210282 | 73.4 |
| 2019/2020 | Insulin Only | 328740 | 10.9 |
| 2019/2020 | Both | 406979 | 13.5 |
| 2019/2020 | None | 67145 | 2.2 |
| 2020/2021 | Antidiabetic Drugs Only | 2239485 | 73.3 |
| 2020/2021 | Insulin Only | 333037 | 10.9 |
| 2020/2021 | Both | 414436 | 13.6 |
| 2020/2021 | None | 68288 | 2.2 |
| 2021/2022 | Antidiabetic Drugs Only | 2371080 | 73.9 |
| 2021/2022 | Insulin Only | 333510 | 10.4 |
| 2021/2022 | Both | 432316 | 13.5 |
| 2021/2022 | None | 70289 | 2.2 |
| 2022/2023 | Antidiabetic Drugs Only | 2558224 | 75.0 |
| 2022/2023 | Insulin Only | 332803 | 9.8 |
| 2022/2023 | Both | 449509 | 13.2 |
| 2022/2023 | None | 70872 | 2.1 |
| 2023/2024 | Antidiabetic Drugs Only | 2757366 | 75.8 |
| 2023/2024 | Insulin Only | 332194 | 9.1 |
| 2023/2024 | Both | 473511 | 13.0 |
| 2023/2024 | None | 72735 | 2.0 |
| 2024/2025 | Antidiabetic Drugs Only | 2979141 | 76.7 |
| 2024/2025 | Insulin Only | 332335 | 8.6 |
| 2024/2025 | Both | 497032 | 12.8 |
| 2024/2025 | None | 75794 | 2.0 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 1)
Patients are generally prescribed either anti-diabetic drugs or insulin to treat their diabetes - but a smaller group of patients may receive both, or even neither (diet controlled).
In 2024/25, 77% of patients required only anti-diabetic drugs to treat their diabetes.
The estimated number of patients receiving anti-diabetic drugs has increased from 1.96 million in 2015/16 to 2.98 million in 2024/25. Over the same period the proportion of patients receiving only anti-diabetic drugs has increased 5%, up from 72%.
In 2024/25:
- an estimated 11,000 more patients received insulin only when compared to 2015/16
- the percentage of patients receiving both anti-diabetic drugs and insulin has remained stable at 13% since 2015/16
- 2% of patients receive no insulin or anti-diabetic drugs but are prescribed glucose monitoring tools or hypoglycaemia treatments - likely for diet-controlled diabetes, gestational diabetes, or other conditions requiring glucose tracking
Prescribing of GLP-1 receptor agonists
Chart
Figure 9: In 2024/25, GLP-1 receptor agonists account for 5% of the total items prescribed for diabetes, and 17% of the total cost
Table
Table 10: In 2024/25, GLP-1 receptor agonists account for 5% of the total items prescribed for diabetes, and 17% of the total cost
| Financial year | Chemical substance | Total identified patients | Total items | Total net ingredient cost (£) |
|---|---|---|---|---|
| 2015/2016 | Dulaglutide | 2,235 | 7,724 | 637,491.9 |
| 2015/2016 | Exenatide | 30,543 | 226,944 | 18,425,619 |
| 2015/2016 | Liraglutide | 60,113 | 416,623 | 42,610,965 |
| 2015/2016 | Lixisenatide | 12,831 | 86,132 | 5,493,765 |
| 2016/2017 | Dulaglutide | 13,904 | 76,375 | 5,968,978 |
| 2016/2017 | Exenatide | 26,929 | 212,385 | 17,278,384 |
| 2016/2017 | Liraglutide | 61,469 | 464,261 | 47,813,391 |
| 2016/2017 | Lixisenatide | 11,177 | 80,624 | 5,304,530 |
| 2017/2018 | Dulaglutide | 31,601 | 219,245 | 17,400,098 |
| 2017/2018 | Exenatide | 22,235 | 177,370 | 15,099,251 |
| 2017/2018 | Liraglutide | 62,416 | 470,526 | 49,641,190 |
| 2017/2018 | Lixisenatide | 9,165 | 67,609 | 4,494,137 |
| 2018/2019 | Dulaglutide | 52,052 | 393,358 | 31,564,210 |
| 2018/2019 | Exenatide | 17,812 | 145,947 | 12,969,333 |
| 2018/2019 | Liraglutide | 66,185 | 504,278 | 54,536,890 |
| 2018/2019 | Lixisenatide | 7,254 | 54,621 | 3,643,144 |
| 2018/2019 | Semaglutide | 905 | 1,251 | 135,732.2 |
| 2019/2020 | Dulaglutide | 72,228 | 579,783 | 47,006,187 |
| 2019/2020 | Exenatide | 13,845 | 113,006 | 10,121,941 |
| 2019/2020 | Liraglutide | 64,695 | 512,102 | 56,465,026 |
| 2019/2020 | Lixisenatide | 5,636 | 42,759 | 2,916,660 |
| 2019/2020 | Semaglutide | 28,554 | 137,322 | 13,500,927 |
| 2020/2021 | Dulaglutide | 81,266 | 691,884 | 56,358,963 |
| 2020/2021 | Exenatide | 10,006 | 85,933 | 7,729,236 |
| 2020/2021 | Liraglutide | 54,664 | 449,484 | 50,218,554 |
| 2020/2021 | Lixisenatide | 3,947 | 31,862 | 2,182,984 |
| 2020/2021 | Semaglutide | 54,702 | 374,385 | 34,967,410 |
| 2021/2022 | Dulaglutide | 109,159 | 917,172 | 74,689,759 |
| 2021/2022 | Exenatide | 8,060 | 65,813 | 5,919,373 |
| 2021/2022 | Liraglutide | 48,217 | 381,327 | 43,183,502 |
| 2021/2022 | Lixisenatide | 3,033 | 23,544 | 1,620,644 |
| 2021/2022 | Semaglutide | 101,596 | 726,830 | 65,944,316 |
| 2022/2023 | Dulaglutide | 129,227 | 1,177,582 | 96,046,419 |
| 2022/2023 | Exenatide | 6,765 | 52,106 | 4,667,307 |
| 2022/2023 | Liraglutide | 46,644 | 336,763 | 38,697,272 |
| 2022/2023 | Lixisenatide | 2,042 | 15,869 | 1,106,719 |
| 2022/2023 | Semaglutide | 152,011 | 1,165,191 | 105,704,757 |
| 2022/2023 | Tirzepatide | 1 | 1 | 196 |
| 2023/2024 | Dulaglutide | 136,783 | 1,212,562 | 98,864,749 |
| 2023/2024 | Exenatide | 8,864 | 61,863 | 5,297,327 |
| 2023/2024 | Liraglutide | 45,693 | 216,517 | 24,414,304 |
| 2023/2024 | Lixisenatide | 1,463 | 9,201 | 644,602.8 |
| 2023/2024 | Semaglutide | 184,934 | 1,197,380 | 111,812,217 |
| 2023/2024 | Tirzepatide | 2,242 | 2,595 | 279,412 |
| 2024/2025 | Dulaglutide | 97,521 | 741,078 | 61,635,607 |
| 2024/2025 | Exenatide | 5,318 | 40,558 | 3,374,724 |
| 2024/2025 | Liraglutide | 6,072 | 16,604 | 2,021,012 |
| 2024/2025 | Lixisenatide | 202 | 421 | 32,233.5 |
| 2024/2025 | Semaglutide | 216,607 | 1,592,277 | 145,891,245 |
| 2024/2025 | Tirzepatide | 188,065 | 1,100,165 | 118,506,112 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 2)
The volume and cost of GLP-1 items prescribed has increased nearly five-fold over the last ten years.
Around 1 in 10 patients who received drugs used to treat diabetes were prescribed a GLP-1 receptor agonist.
In 2024/25, over 3.5 million GLP-1 items were prescribed at a total cost of £331 million, to an estimated 430,000 patients. Notably, around one in five patients received more than one type of GLP-1 during the year.
Since 2015/16, the use of GLP-1 receptor agonists has increased dramatically:
- prescription items are up by 373%
- costs have risen by 393%
- patient numbers have grown by 386%
- and the range of available GLP-1 receptor agonists has expanded from four to six
In 2015/16, only Dulaglutide, Exenatide, Liraglutide, and Lixisenatide were available. Semaglutide and Tirzepatide became available in 2018/19 and 2022/23 — and combined, they now account for 77% of all GLP-1 items prescribed. These are 2 of the products having the greatest influence on rising volume and cost for prescribing for diabetes since their introduction.
This rapid growth is driven by evolving NICE guidelines recommending GLP-1 receptor agonists as part of the Type 2 diabetes care regime, In addition, in March 2025 NICE announced Tirzepatide could be used for weight loss in non-diabetic patients, increasing media attention and public awareness. These factors continue to shape prescribing trends and demand across the NHS.
Prescribing of SGLT-2 inhibitors
Chart
Figure 10: In 2024/25, SGLT-2 inhibitors account for 18% of the total items prescribed for diabetes, and 28% of the total cost
Table
Table 11: In 2024/25, SGLT-2 inhibitors account for 18% of the total items prescribed for diabetes, and 28% of the total cost
| Financial year | Chemical substance | Total identified patients | Total items | Total net ingredient cost (£) |
|---|---|---|---|---|
| 2015/2016 | Canagliflozin | 28,093 | 162,479 | 7,213,303 |
| 2015/2016 | Dapagliflozin | 73,799 | 518,301 | 21,945,910 |
| 2015/2016 | Empagliflozin | 11,334 | 44,802 | 1,783,815 |
| 2016/2017 | Canagliflozin | 42,124 | 323,742 | 14,036,609 |
| 2016/2017 | Dapagliflozin | 90,310 | 705,339 | 29,917,089 |
| 2016/2017 | Empagliflozin | 37,447 | 233,641 | 9,511,789 |
| 2017/2018 | Canagliflozin | 46,995 | 391,108 | 16,992,288 |
| 2017/2018 | Dapagliflozin | 105,514 | 849,878 | 36,095,867 |
| 2017/2018 | Empagliflozin | 75,797 | 526,083 | 21,682,092 |
| 2018/2019 | Canagliflozin | 49,971 | 422,488 | 18,439,638 |
| 2018/2019 | Dapagliflozin | 119,871 | 993,451 | 42,211,387 |
| 2018/2019 | Empagliflozin | 124,383 | 942,223 | 38,962,628 |
| 2018/2019 | Ertugliflozin | 5 | 6 | 235.2 |
| 2019/2020 | Canagliflozin | 60,559 | 508,344 | 22,226,082 |
| 2019/2020 | Dapagliflozin | 139,586 | 1,168,131 | 49,553,786 |
| 2019/2020 | Empagliflozin | 180,343 | 1,436,252 | 59,700,942 |
| 2019/2020 | Ertugliflozin | 537 | 2,107 | 64,205.4 |
| 2020/2021 | Canagliflozin | 69,866 | 602,350 | 26,054,085 |
| 2020/2021 | Dapagliflozin | 155,055 | 1,325,905 | 55,680,584 |
| 2020/2021 | Empagliflozin | 212,446 | 1,821,531 | 75,181,830 |
| 2020/2021 | Ertugliflozin | 895 | 6,226 | 203,657 |
| 2021/2022 | Canagliflozin | 80,692 | 728,491 | 31,120,444 |
| 2021/2022 | Dapagliflozin | 249,058 | 1,913,065 | 77,811,811 |
| 2021/2022 | Empagliflozin | 262,008 | 2,258,077 | 92,954,842 |
| 2021/2022 | Ertugliflozin | 1,284 | 9,726 | 324,339.8 |
| 2022/2023 | Canagliflozin | 85,672 | 800,123 | 34,068,907 |
| 2022/2023 | Dapagliflozin | 451,716 | 3,564,876 | 139,822,913 |
| 2022/2023 | Empagliflozin | 332,373 | 2,859,295 | 117,012,250 |
| 2022/2023 | Ertugliflozin | 1,769 | 13,837 | 468,354.6 |
| 2023/2024 | Canagliflozin | 87,429 | 829,701 | 35,184,690 |
| 2023/2024 | Dapagliflozin | 709,834 | 6,027,585 | 232,927,306 |
| 2023/2024 | Empagliflozin | 400,449 | 3,557,910 | 144,771,925 |
| 2023/2024 | Ertugliflozin | 1,811 | 14,598 | 519,753.2 |
| 2024/2025 | Canagliflozin | 86,303 | 847,236 | 35,479,829 |
| 2024/2025 | Dapagliflozin | 956,359 | 8,701,577 | 331,445,661 |
| 2024/2025 | Empagliflozin | 461,968 | 4,230,190 | 170,305,960 |
| 2024/2025 | Ertugliflozin | 1,306 | 11,865 | 417,994.5 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 3)
The number of SGLT-2 items prescribed in 2024/25 is nearly 20 times greater than was prescribed in 2015/16.
Around 3 in 10 patients who received drugs used to treat diabetes were prescribed an SGLT-2 inhibitor.
There are four SGLT-2 inhibitors currently available. Canagliflozin, Dapagliflozin, and Empagliflozin were already on the market by 2015/16, while Ertugliflozin was introduced later in 2018/19. By 2024/25, Dapagliflozin and Empagliflozin together account for 94% of all SGLT-2 prescriptions. These products are 2 of the products having the greatest influence on rising volume and cost for prescribing for diabetes since 2015/16.
The most significant annual growth in volume, cost, and patient numbers has occurred since 2021/22, coinciding with the publication of updated NICE guidelines that formally recommended SGLT-2 inhibitors as a treatment option for type 2 diabetes. This growth also reflects a broader rise in the number of patients receiving diabetes-related prescriptions.
Dapagliflozin has shown the largest increase. In 2024/25, 8.7 million items were prescribed to an estimated 960,000 patients, at a total cost of £331 million. Compared to 2023/24, this represents an increase of 2.7 million items, an additional £99 million in cost, and an estimated 250,000 more patients.
Prescribing of Interstitital fluid/glucose detection sensors to monitor glucose levels
Chart
Figure 11: In 2024/25, Interstitial fluid glucose sensors account for 5% of the total items prescribed for diabetes, and 15% of the total cost
Table
Table 12: In 2024/25, Interstitial fluid glucose sensors account for 5% of the total items prescribed for diabetes, and 15% of the total cost
| Financial year | Product | Total identified patients | Total items | Total net ingredient cost (£) |
|---|---|---|---|---|
| 2017/2018 | FreeStyle Libre | 1,894 | 4,079 | 278,670 |
| 2018/2019 | FreeStyle Libre | 18,904 | 108,028 | 8,059,975 |
| 2019/2020 | FreeStyle Libre | 73,334 | 536,057 | 41,865,950 |
| 2020/2021 | FreeStyle Libre | 105,258 | 956,730 | 75,635,700 |
| 2021/2022 | FreeStyle Libre | 150,753 | 1,419,358 | 111,417,145 |
| 2022/2023 | FreeStyle Libre | 217,569 | 1,943,407 | 153,066,585 |
| 2022/2023 | Dexcom | 5,290 | 14,346 | 988,781 |
| 2022/2023 | GlucoMen | 46 | 63 | 3,149 |
| 2022/2023 | GlucoRx | 136 | 357 | 17,400.95 |
| 2023/2024 | FreeStyle Libre | 298,090 | 2,612,259 | 204,838,466 |
| 2023/2024 | Dexcom | 17,124 | 149,201 | 8,317,276 |
| 2023/2024 | GlucoMen | 84 | 136 | 7,537.5 |
| 2023/2024 | GlucoRx | 165 | 555 | 30,490.48 |
| 2024/2025 | FreeStyle Libre | 380,352 | 3,474,703 | 273,591,070 |
| 2024/2025 | Dexcom | 25,969 | 223,993 | 13,619,188 |
| 2024/2025 | GlucoMen | 21 | 28 | 1,574.5 |
| 2024/2025 | GlucoRx | 97 | 316 | 16,112.61 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 4)
The first Interstitial fluid glucose sensor became available on the NHS in 2017/18.
Around 1 in 10 patients receiving drugs used to treat diabetes were prescribed an interstitial fluid glucose sensor.
There are currently four manufacturers supplying eleven distinct interstitial fluid glucose products. The FreeStyle Libre was the first interstitial fluid glucose sensor to be available on the NHS in 2017/18. Dexcom, GlucoMen and GlucoRx became available in 2022/23, which aligns with the NICE guidelines recommending all type 1 patients should be offered Continuous Glucose Monitoring (CGM) as part of their routine NHS care.
In 2024/25, over 3.7 million interstitial fluid glucose sensor items were prescribed across England, at a total cost of £288 million, reaching an estimated 396,000 patients - approximately 10% of all individuals receiving treatment for diabetes.
2.3. Patient demographics
Estimated number of identified patients receiving diabetes prescribing by gender and financial year
Chart
Figure 12: The overall split of male and female patients has remained consistent between 2015/16 and 2024/25
Table
Table 13: The overall split of male and female patients has remained consistent between 2015/16 and 2024/25
| Financial year | Patient gender | Total identified patients |
|---|---|---|
| 2015/2016 | Female | 1,227,944 |
| 2015/2016 | Male | 1,481,280 |
| 2016/2017 | Female | 1,268,227 |
| 2016/2017 | Male | 1,529,401 |
| 2017/2018 | Female | 1,296,228 |
| 2017/2018 | Male | 1,569,636 |
| 2018/2019 | Female | 1,325,384 |
| 2018/2019 | Male | 1,607,886 |
| 2019/2020 | Female | 1,361,110 |
| 2019/2020 | Male | 1,650,850 |
| 2020/2021 | Female | 1,381,554 |
| 2020/2021 | Male | 1,673,200 |
| 2021/2022 | Female | 1,454,013 |
| 2021/2022 | Male | 1,752,693 |
| 2022/2023 | Female | 1,539,629 |
| 2022/2023 | Male | 1,871,223 |
| 2023/2024 | Female | 1,638,157 |
| 2023/2024 | Male | 1,997,160 |
| 2024/2025 | Female | 1,752,787 |
| 2024/2025 | Male | 2,130,987 |
Source: Prescribing for diabetes summary tables - Patient demographics (Table 2)
In 2024/25, 55% of identified patients were male.
In 2024/25, 45% of identified patients were female.
While the overall number of identified patients receiving drugs used in diabetes prescribing has increased year-on-year, the overall split of male and female patients has remained consistent between 2015/16 and 2024/25.
In 2024/25 there were an additional 520,000 female identified patients than there were in 2015/16, and an additional 650,000 males.
Identified patients where their gender was unknown or indeterminate have been grouped together and can be found in the summary tables that accompany this release.
Estimated number of identified patients receiving diabetes prescribing by age and gender
Chart
Figure 13: Male patients aged 60 to 64 was the largest prescribing group for drugs used in diabetes in 2024/25
Table
Table 14: Male patients aged 60 to 64 was the largest prescribing group for drugs used in diabetes in 2024/25
| Age band | Patient gender | Total identified patients |
|---|---|---|
| 00-04 | Female | 1,299 |
| 00-04 | Male | 1,501 |
| 05-09 | Female | 3,490 |
| 05-09 | Male | 3,776 |
| 10-14 | Female | 7,747 |
| 10-14 | Male | 7,709 |
| 15-19 | Female | 12,520 |
| 15-19 | Male | 11,184 |
| 20-24 | Female | 24,559 |
| 20-24 | Male | 13,347 |
| 25-29 | Female | 49,962 |
| 25-29 | Male | 19,822 |
| 30-34 | Female | 72,704 |
| 30-34 | Male | 31,148 |
| 35-39 | Female | 77,823 |
| 35-39 | Male | 50,715 |
| 40-44 | Female | 79,165 |
| 40-44 | Male | 81,311 |
| 45-49 | Female | 91,977 |
| 45-49 | Male | 118,587 |
| 50-54 | Female | 131,180 |
| 50-54 | Male | 180,772 |
| 55-59 | Female | 171,032 |
| 55-59 | Male | 243,621 |
| 60-64 | Female | 194,582 |
| 60-64 | Male | 283,874 |
| 65-69 | Female | 193,254 |
| 65-69 | Male | 279,810 |
| 70-74 | Female | 183,457 |
| 70-74 | Male | 258,160 |
| 75-79 | Female | 184,446 |
| 75-79 | Male | 248,729 |
| 80-84 | Female | 135,546 |
| 80-84 | Male | 163,129 |
| 85-89 | Female | 90,433 |
| 85-89 | Male | 94,427 |
| 90+ | Female | 42,961 |
| 90+ | Male | 35,329 |
Source: Prescribing for diabetes summary tables - Patient demographics (Table 6)
In 2024/25, an estimated 284,000 identified patients were male aged 60 to 64, which is 7% of all identified patients where a gender was known. This was the most common group to receive prescribing for drugs used in diabetes. However, males aged 55 to 79 make up the top 5 categories by gender and age group, with an estimated 1.3 million male patients accounting for more than a third of all identified patients receiving prescribing for diabetes.
More information on how we calculate a patient’s age can be found in section 4 of this summary.
Table 15: Number of child and adult identified patients receiving diabetes prescribing (millions of patients)
| Age Band | 2020/2021 | 2021/2022 | 2022/2023 | 2023/2024 | 2024/2025 |
|---|---|---|---|---|---|
| 17 and under | 0.0348 | 0.0367 | 0.0376 | 0.0381 | 0.0389 |
| 18 and over | 3.01 | 3.16 | 3.36 | 3.59 | 3.84 |
Source: Prescribing for diabetes summary tables - Patient demographics (Table 8)
There were 39,000 identified patients aged 17 and under that received prescribing for drugs used in diabetes in 2024/25. This was 1% of all identified patients with a captured age.
Estimated number of identified patients receiving diabetes prescribing by IMD quintile
Chart
Figure 14: More people were prescribed drugs used in diabetes in more deprived areas
Table
Table 16: More people were prescribed drugs used in diabetes in more deprived areas
| IMD Quintile | Total identified patients |
|---|---|
| 1 - Most deprived | 986,708 |
| 2 | 907,887 |
| 3 | 797,598 |
| 4 | 722,000 |
| 5 - Least deprived | 637,293 |
Source: Prescribing for diabetes summary tables - Patient demographics (Table 9)
In 2024/25, 24% of patients were from the most deprived areas in England.
In 2024/25, 16% patients were from the least deprived areas in England.
In 2024/25, the general trend shows more patients were prescribed drugs used in diabetes as deprivation increased - with 637,000 patients living in the least deprived areas, rising to an estimated 987,000 patients living in the most deprived areas. This pattern has remained consistent since 2015/16.
The English Indices of Deprivation have been used in this publication to provide a measure of patient deprivation. The patient’s postcode has been used to assigned them to an IMD quintile. You can find more information about this in section 4 of this summary.
3. Background
3.1. Anti-diabetic drugs
Anti-diabetic drugs are medications designed to lower blood glucose levels and are primarily used to treat type 2 diabetes. These drugs work through various mechanisms, targeting different organs and pathways to improve glucose regulation. Patients may be prescribed a single anti-diabetic drug or may be prescribed several to work together to achieve the desired control of their diabetes in combination with diet, exercise and lifestyle advice and interventions. Generally, patients are likely to receive anti-diabetic drugs from at least one of the following categories:
3.1.1 Biguanides
Metformin is the only biguanide prescribed in the UK. It is usually the first anti-diabetic drug a patient with type 2 diabetes will be prescribed. Metformin suppresses the liver from generating glucose, and makes muscle and fat cells more responsive to insulin.
Depending on the response to treatment, additional anti-diabetic drugs may be added, and the patient may be prescribed insulin further into treatment if the desired control of the diabetes is not achieved with anti-diabetic drugs and diet and lifestyle management alone.
3.1.2 GLP-1 receptor agonists
GLP-1 receptor agonists are injectable medications originally developed for type 2 diabetes. They mimic the hormone glucagon-like peptide-1 released after eating. They regulate blood sugar by stimulating insulin, suppressing glucagon, slowing gastric emptying, and reducing appetite - leading to improved glucose control and weight loss.
NICE approved GLP-1 receptor agonists to treat type 2 diabetes in May 2009, recommending their use when metformin alone fails or isn’t suitable. Since February 2021, NICE has also endorsed some GLP-1 receptor agonists for weight management in non-diabetic adults - the most recent being Tirzepatide in March 2025.
3.1.3 SGLT-2 inhibitors
SGLT-2 inhibitors are a class of oral medications that lower blood glucose by preventing glucose reabsorption in the kidneys, causing it to be excreted in urine - leading to improved glucose control, modest weight loss and blood pressure reduction. They are primarily used to treat type 2 diabetes, but they’ve also shown significant benefits for non-diabetic patients with heart failure and chronic kidney disease (CKD).
NICE first incorporated SGLT-2 inhibitors into its guidelines for type 2 diabetes in 2015. They can be used as first-line therapy alongside metformin or as part of combination therapy, depending on individual risk profiles. NICE has also approved SGLT-2 inhibitors, like dapagliflozin and empagliflozin, for heart failure and CKD in people without diabetes.
You can find out more information on type 2 diabetes medications on the NHS website.
3.2. Insulin
Insulin is a hormone that plays a key role in the body’s metabolism, including regulating blood glucose levels. In those with type 1 diabetes, the body produces insufficient insulin to undertake this role effectively. For those with type 2 diabetes, the body does not respond effectively to insulin (known as insulin resistance) or the body does not make enough insulin. People with type 1 diabetes will be prescribed insulin, while only a proportion of those with type 2 diabetes will be prescribed this.
Insulin can be injected or delivered by an insulin pump which regularly infuses insulin into the body. Synthetic insulin or non-synthetic animal insulin are available depending on the needs of the patient. Insulin preparations also vary in how quickly they act and are often used in combinations, depending on the individual requirements of a patient.
You can find out more about insulin on the NHS website.
3.3. Diabetes diagnostic and monitoring agents
Diabetes diagnostic and monitoring agents cover a range of monitoring equipment and testing strips that can be used by a person with diabetes to check their diabetic control. Self-monitoring is not routinely suggested for type 2 diabetes, but it is an integral part of treatment for people with type 1 diabetes. This can be monitoring blood glucose levels or monitoring ketones (a by-product of the breakdown of fats) in either the blood or urine.
By being able to monitor blood glucose levels, patients can manage their health effectively and prevent hypoglycaemia or hyperglycaemia.
Diabetic patients can be at risk of diabetic ketoacidosis, a serious condition, where the body starts to run out of insulin and ketones build up in the body. Checking ketone levels can be an important early warning of this and monitoring agents allow people to check these levels themselves.
3.4. Treatment of hypoglycaemia
Hypoglycaemia is a lower than normal blood glucose concentration. It is the most common side effect of insulin treatment and can cause acute symptoms such as feeling tired and sweating, drowsiness and confusion. This can progress to seizures or unconsciousness if untreated.
Hypoglycaemia can be treated with a sugary drink or snack, though this is not always enough. Fast-acting carbohydrates are prescribed for patients to keep at hand in case of hypoglycaemia, these can be oral liquids and gels, capsules or even injectables.
The NHS website has additional information on symptoms and treatment of hypoglycaemia.
3.5 Glucose interstitial fluid detection sensors
Glucose interstitial fluid detection sensors are a specific type of diabetic monitoring equipment that allow for real time testing of glucose levels without finger pricks or test strips.
NICE guidance was updated in March 2022 to recommended the use of real-time continuous glucose monitoring (CGM) for all adults and children living with type 1 diabetes.
Instead of using blood, the test monitors the amount of glucose in the fluid surrounding a patient’s cells. This is called interstitial fluid. This measurement is done using a sensor on the body that can be read using a specific reader or with a smart phone.
The readings from interstitial fluid can lag behind blood sugar by up to 15 minutes so the use of sensors does not entirely replace other diabetic monitoring such as testing strips though it would usually reduce the requirements for such.
Only data for prescribed sensors is included in this report as readers are usually provided separately.
The NHS website has additional information on continuous glucose monitoring.
4. About these statistics
Further information on the methodology used in this publication and further background information is available in our Background Information and Methodology supporting document.
4.1. Patient counts
The patient counts shown in these statistics should only be analysed at the level at which they are presented. Adding together any patient counts is likely to result in an overestimate of the number of patients. A person will be included, or counted, in each category or time period in which they received relevant prescriptions. For example, if a patient received a prescription item for a diabetes product in 2018/19 and another in 2019/20, then adding together those totals would count that patient twice. For the same reason, data on patient counts for different BNF paragraphs should not be added together.
4.2. Patient age and gender
The age and gender of patients used in these statistics is derived from data provided by the NHS Personal Demographics Service (PDS) for NHS numbers that have been successfully verified by them. A patient’s age, used to assign them to an age group, has been calculated on 30 September for the given financial year. It is possible that a patient’s PDS information may change over the course of the year, in these cases patients may be subject to multiple counting in these analyses.
4.3. Index of deprivation
The English Indices of Deprivation 2019 have been used to provide a measure of patient deprivation. The English Indices of Deprivation are an official national measure of deprivation that follows an established methodological framework to capture a wide range of individuals living conditions.
IMD deciles are calculated by ranking census lower-layer super output areas (LSOAs) from most deprived to least deprived and dividing them into 10 equal groups. These range from the most deprived 10% (decile 1) of small areas nationally to the least deprived 10% (decile 10) of small areas nationally. We have aggregated these deciles into quintiles in this publication, for use alongside the NHS Core20PLUS5 approach.
The reported IMD quintile is derived from the postcode of the patient an item has been prescribed to. When a patient postcode is unknown but we hold a postcode for the prescribing practice, this will be used instead. Quintile 1 represents the 20% most deprived areas and quintile 5 is the 20% least deprived areas. There are a small number of items each year that we have reported as having an unknown IMD quintile. These are items where we have been unable to match the patient postcode or practice postcode to a postcode in the NSPL May 2024 edition.
4.4. Geographies included in this publication
The patient deprivation measures in these statistics are based on the patient’s postcode. Each postcode is linked to a Lower Layer Super Output Area (LSOA) using the August 2024 National Statistics Postcode Lookup (NSPL) file for 2011 census LSOAs. This allows deprivation to be measured using standard geographical boundaries.
Unlike LSOAs, the higher-level geographies shown in the statistical summary tables, such as Integrated Care Boards (ICBs), are based on NHS Business Services Authority (NHSBSA) administrative records rather than geographical boundaries. This approach better reflects how GP practices are organised and managed in practice, rather than strictly following geographical definitions.
4.5. Changes made to this publication
A new section - treatment for diabetes - is incorporated into the ‘results and commentary’ section of the report. It includes four new charts investigating treatment type at patient level, and the prescribing of GLP-1 receptor agonists, SGLT-2 inhibitors and interstitial fluid glucose sensors.
4.6. Interpretation of a box plot
Box plots are used to help visualise not just averages, but also how data is spread out. If all data points were arranged from the smallest to the biggest, halfway along this line in the middle would be the median. The middle line in the box is the median. The top section of the box includes the 25% of numbers directly above the median, the bottom includes the 25% directly below the median.
The remaining lowest 25% and highest 25% are usually captured by the whiskers; the whiskers are set to have a maximum length of 1.5 interquartile ranges (the length of the box), the end of each whisker is the most extreme value within this range. Any points that are further than 1.5 interquartile ranges from the top or bottom of the box are classified as statistical outliers and are shown as small circles on the box plot.
The length of the whiskers away from the median show how similar the data is compared to the average; short whiskers indicate that there are no areas extremely different to the average whereas long whiskers show the data is much more spread out and there are bigger differences between the highest and lowest numbers.
5. Rounding
The high-level figures in this statistical summary have been rounded as per the table below:
| From | To | Round to nearest |
|---|---|---|
| 0 | 1,000 | 1 |
| 1,001 | 10,000 | 100 |
| 10,001 | 100,000 | 1,000 |
| 100,001 | 1,000,000 | 10,000 |
| 1,000,001 | 10,000,000 | 100,000 |
| 10,000,001 | 100,000,000 | 1,000,000 |
| 100,000,001 | 10,000,000,000 | 10,000,000 |
| 10,000,000,001 | 100,000,000,000 | 100,000,000 |
All changes and totals are calculated prior to rounding. Percentage changes are calculated prior to rounding and then are rounded to the nearest whole number. As all figures within this statistical summary have been rounded, they may not match totals elsewhere when aggregated.
The summary tables released with this publication allow users to investigate this data at lower levels of granularity. Figures in the supplementary tables have not been rounded.
6. Statistical disclosure control
Statistical disclosure control has been applied to these statistics. Patient count, items, and net ingredient cost (NIC) have been redacted in the supporting summary tables if they relate to fewer than 5 patients. Further information about our statistical disclosure control protocol can be found on our website.
The high-level figures in this statistical summary have been rounded where appropriate for clarity. This is to make this narrative as accessible as possible to all readers. The summary tables released with this publication allow users to investigate this data at lower levels of granularity. Figures in the supplementary tables have not been rounded.
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