England 2016/17 to 2025/26
Published 20 August 2026
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Key findings
In England in 2025/26:
The cost of prescribed items for treating diabetes more than doubled to £2.31 billion since 2016/2017.
The number of identified patients prescribed items for treating diabetes increased by 46% to 4.1 million since 2016/2017.
Anti-diabetic drugs were the most prescribed treatment, making up 77% of items and 64% of the total cost of diabetes treatments.
There were 83 million items prescribed for treating diabetes - a 60% increase from 52 million items in 2016/17, and up 8% from 77 million in 2024/2025.
The cost of diabetes treatments accounted for 20% of the total spend on all prescribed items. In 2016/17, diabetes treatments made up 11% of total prescribing costs.
Much of the cost increase over the past decade has been driven by SGLT2 inhibitors, GLP-1 receptor agonists, and improved glucose monitors:
- Dapagliflozin, branded as Forxiga
- Empagliflozin, branded as Jardiance
- Tirzepatide, branded as Mounjaro
- Semaglutide, branded as Ozempic
- Interstitial Fluid Sensors, such as Freestyle Libre or Dexcom
There were 64 million anti-diabetic drugs prescribed at a cost of £1.5 billion.
The most commonly treated group was men aged 65 to 69. There were an estimated 300,000 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 386,000 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 describes 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 data 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 sensors (2148)
The medicines included in this publication are primarily prescribed for the treatment of diabetes, but some may also be used for other conditions. For example, metformin, which is commonly used to reduce blood sugar for those with type 2 diabetes, is also used to treat infertility caused by polyendocrine metabolic ovarian syndrome (PMOS). Since March 2025, Tirzepatide, which is used to treat type 2 diabetes, has also been used for weight management in patients with and 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 type as an indicator of diabetes type.
As some medicines have multiple uses, prescribing data alone cannot be used to determine whether a patient has diabetes or to identify their diabetes type. As a result, these statistics may not provide an accurate estimate of the population who are receiving drugs specifically for diabetes and should not be used to infer diabetes type. These limitations should be considered when interpreting the findings.
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 proportion of items for which a patient could be identified. This means that the data relating to patient counts represents most, but not all, patients.
Identification rates
Due to an increase in digital prescription processing through the Electronic Prescription Service (EPS) during the COVID-19 pandemic, more patients were identified from 2020/21 onwards. As patient identification rates increase, any increase in the number of identified patients between periods is likely to be an overestimate of the actual increase in patient numbers. This is because the proportion of patients who could be identified has increased. Conversely, any decrease over the same period is likely to be an underestimate of the actual decrease.
Patient age
Where patients are identified, their age is calculated on 30 September of the given financial year to assign them to a single age band. Patients whose date of birth was not recorded have been included in an unknown category.
Patient gender
Gender information was not available from the Personal Demographic Service (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. Further information on PDS is included in Section 4.2.
Personally identifiable information
These statistics do not include any information that is personally identifiable. You can find more information about how the NHSBSA protects 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 | 2021/2022 | 2022/2023 | 2023/2024 | 2024/2025 | 2025/2026 |
|---|---|---|---|---|---|---|
| Insulin | 060101 | 99.41% | 99.41% | 99.44% | 99.49% | 99.56% |
| Antidiabetic drugs | 060102 | 99.49% | 99.51% | 99.57% | 99.58% | 99.65% |
| Treatment of hypoglycaemia | 060104 | 99.16% | 99.27% | 99.36% | 99.46% | 99.55% |
| Diabetic diagnostic and monitoring agents | 060106 | 99.52% | 99.53% | 99.59% | 99.63% | 99.69% |
| Detection Sensor Interstitial Fluid/Gluc | 2148 | 99.26% | 99.39% | 99.51% | 99.58% | 99.67% |
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 increased every year between 2016/17 and 2025/26
Table
Table 2: The number of items prescribed and identified patients increased every year between 2016/17 and 2025/26
| Financial year | Measure | Value |
|---|---|---|
| 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 |
| 2025/2026 | Identified patients | 4,098,426 |
| 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 |
| 2025/2026 | Prescription items | 83,289,130 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
In England in 2025/26:
There were 83 million items prescribed for treating diabetes.
The number of identified patients prescribed items for treating diabetes was 4.1 million
The number of prescribed items for diabetes has grown since 2016/17 - up 60% from 52 million items, and up 8% from 77 million items in 2024/25.
The number of patients receiving drugs to treat diabetes has also grown with a similar trend since 2016/17 - a 46% rise from 2.8 million identified patients in 2016/17, and 6% more than the 3.9 million treated in 2024/25.
Growth trends have accelerated in recent years:
- Between 2016/17 and 2020/21, the average annual growth in patient numbers was 2%. Between 2021/22 and 2025/26, that rate tripled to 6% per year.
- A similar pattern is seen in prescribing volume, with item growth averaging 3% annually between 2016/17 and 2020/21, rising to 7% per year from 2021/22 to 2025/26.
Cost of diabetes prescribing by financial year
Chart
Figure 2: The cost of diabetes prescribing increased every year between 2016/17 and 2025/26
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 increased every year between 2016/17 and 2025/26
| Financial year | Total net ingredient cost (£) |
|---|---|
| 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 |
| 2025/2026 | 2,313,601,728 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
In England in 2025/26:
The cost of drugs used in diabetes more than doubled since 2016/17.
There was a 21% increase in costs from 2024/25.
The cost of diabetes medications rose to £2.31 billion in 2025/26. While the average annual growth rates for items and patient numbers shifted in 2020/21, the upturn in cost began earlier, in 2018/19. Between 2016/17 and 2017/18, the annual cost increase was 3%, but from 2018/19 to 2025/26, growth rates ranged between 6% and 21%.
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 increased annually from 2016/17 to 2025/26
Table
Table 4: The proportion of all prescription items accounted for by drugs to treat diabetes increased annually from 2016/17 to 2025/26
| Financial year | Measure | Value (%) |
|---|---|---|
| 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 |
| 2025/2026 | Percentage of items | 6.5 |
| 2025/2026 | Percentage of costs | 20.2 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
In England in 2025/26:
The costs of prescribed drugs used in treating diabetes accounted for 20% of the total costs of all drugs prescribed.
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 2016/17. From 2016/17 to 2022/23, the annual growth rate was approximately 0.15 percentage points, but this has accelerated over the last three years to 0.3 between 2023/24 and 2025/26.
The rise in the percentage of cost to treat diabetes over the same period was greater than items, up 3 percentage points from 2024/25 to 2025/26 alone. Over the longer term, this was an increase of 9 percentage points from 2016/17, when drugs used in diabetes accounted for 11% of the total spend.
Number of diabetes items prescribed by BNF paragraph by financial year
Chart
Figure 4: Anti-diabetic drugs were the most prescribed treatment for diabetes
Table
Table 5: Anti-diabetic drugs were the most prescribed treatment for diabetes
| Financial year | Bnf paragraph name | Total items |
|---|---|---|
| 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 |
| 2025/2026 | Antidiabetic drugs | 63,918,270 |
| 2025/2026 | Detection Sensor Interstitial Fluid/Gluc | 4,468,862 |
| 2025/2026 | Diabetic diagnostic and monitoring agents | 5,718,888 |
| 2025/2026 | Insulin | 8,728,019 |
| 2025/2026 | Treatment of hypoglycaemia | 455,091 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 2)
In England in 2025/26:
Anti-diabetic drug items accounted for 77% of all drugs to treat diabetes.
Anti-diabetic drug prescribing rose 9% from 2024/25.
Anti-diabetic drugs, such as SGLT2 inhibitors and GLP-1 agonists, remain the most prescribed treatment for diabetes, with 64 million items in 2025/26. This was a 71% increase from 37 million items in 2016/17.
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 2024/25 and 2025/26:
- the prescribing of Dapagliflozin, an SGLT2 inhibitor, rose 32% to 12 million items
- Tirzepatide, a GLP-1 agonist approved by the Medicines and Healthcare products Regulatory Agency (MHRA) in November 2023, saw a 174% increase to 3.1 million items
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 had the highest costs for treatments prescribed for diabetes
Table
Table 6: Anti-diabetic drugs had the highest costs for treatments prescribed for diabetes
| Financial year | Bnf paragraph name | Total net ingredient cost (£) |
|---|---|---|
| 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 |
| 2025/2026 | Antidiabetic drugs | 1,478,427,339 |
| 2025/2026 | Detection Sensor Interstitial Fluid/Gluc | 364,188,360 |
| 2025/2026 | Diabetic diagnostic and monitoring agents | 80,830,711 |
| 2025/2026 | Insulin | 383,829,014 |
| 2025/2026 | Treatment of hypoglycaemia | 6,326,304 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 2)
In England in 2025/26:
Anti-diabetic drugs accounted for 64% of the cost of drugs to treat diabetes.
Anti-diabetic drug costs rose 30% from 2024/25.
There was a 26% increase in the cost of glucose interstitial fluid detection sensors compared to 2024/25.
In 2025/26, the cost of anti-diabetic drugs reached £1.5 billion - up 233% from £444 million in 2016/17. This cost increase exceeded the growth of diabetes prescription items.
The increase in anti-diabetic drug costs over the last year was largely driven by Tirzepatide. Between 2024/25 and 2025/26, Tirzepatide costs rose by 377% to £574 million.
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 has increased substantially in the years since
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 has increased substantially in the years since
| Financial year | Total identified patients | Total items | Items per patient |
|---|---|---|---|
| 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 |
| 2025/2026 | 4,098,426 | 82,994,905 | 20.3 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 1)
This measure only includes prescribing of drugs used in diabetes and does not include any items prescribed from other BNF sections.
Between 2016/17 and 2019/20, the number of items per patient increased by 1.8% per year on average. From 2020/21 to 2023/24, the rate remained consistent, with an average annual growth rate of 0.3%. However, between 2024/25 and 2025/26, the average annual growth rate increased again to 2.3%”
Cost of diabetes prescribing per patient by Integrated Care Board (ICB)
Chart
Figure 7: The median cost per patient by ICB increased each year
Table
Table 8: The median cost per patient by ICB increased each year
| Financial year | Minimum (£) | Lower quartile (£) | Median (£) | Upper quartile (£) | Maximum |
|---|---|---|---|---|---|
| 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 |
| 2025/2026 | 442.51 | 519.51 | 573.37 | 609.13 | 666.23 |
Source: Prescribing for diabetes summary tables - Costs and items (Table 4)
In England in 2025/26:
The median cost per patient by ICB was £573.
The cost per patient by ICB ranged from £443 to £666.
See Section 4.7. Interpretation of a box plot for guidance on interpreting this chart.
The median cost per patient across ICBs increased by 14% between 2024/25 and 2025/26. Although no ICB was identified as an outlier in 2025/26, the variation in cost per patient across ICBs was greater than in previous years.
2.2. Treatment for Diabetes
Note
Item counts and costs in this section may vary slightly from those in Section 2.1, as this analysis is restricted to identified patients only.
Number of identified patients receiving prescribing for diabetes by treatment type
Chart
Figure 8: The proportion of patients receiving antidiabetic drugs only increased by 5 percentage points from 2016/17 to 2025/26
Table
Table 9: The proportion of patients receiving antidiabetic drugs only increased by 5 percentage points from 2016/17 to 2025/26
| Financial year | Treatment type | Total identified patients | Percentage of identified patients |
|---|---|---|---|
| 2016/2017 | Antidiabetic Drugs Only | 2,033,237 | 72.6 |
| 2016/2017 | Insulin Only | 323,306 | 11.5 |
| 2016/2017 | Both | 373,212 | 13.3 |
| 2016/2017 | None | 71,116 | 2.5 |
| 2017/2018 | Antidiabetic Drugs Only | 2,089,016 | 72.8 |
| 2017/2018 | Insulin Only | 325,412 | 11.3 |
| 2017/2018 | Both | 384,853 | 13.4 |
| 2017/2018 | None | 68,337 | 2.4 |
| 2018/2019 | Antidiabetic Drugs Only | 2,145,525 | 73.1 |
| 2018/2019 | Insulin Only | 326,399 | 11.1 |
| 2018/2019 | Both | 394,907 | 13.5 |
| 2018/2019 | None | 67,917 | 2.3 |
| 2019/2020 | Antidiabetic Drugs Only | 2,210,282 | 73.4 |
| 2019/2020 | Insulin Only | 328,740 | 10.9 |
| 2019/2020 | Both | 406,979 | 13.5 |
| 2019/2020 | None | 67,145 | 2.2 |
| 2020/2021 | Antidiabetic Drugs Only | 2,239,485 | 73.3 |
| 2020/2021 | Insulin Only | 333,037 | 10.9 |
| 2020/2021 | Both | 414,436 | 13.6 |
| 2020/2021 | None | 68,288 | 2.2 |
| 2021/2022 | Antidiabetic Drugs Only | 2,371,080 | 73.9 |
| 2021/2022 | Insulin Only | 333,510 | 10.4 |
| 2021/2022 | Both | 432,316 | 13.5 |
| 2021/2022 | None | 70,289 | 2.2 |
| 2022/2023 | Antidiabetic Drugs Only | 2,558,224 | 75.0 |
| 2022/2023 | Insulin Only | 332,803 | 9.8 |
| 2022/2023 | Both | 449,509 | 13.2 |
| 2022/2023 | None | 70,872 | 2.1 |
| 2023/2024 | Antidiabetic Drugs Only | 2,757,366 | 75.8 |
| 2023/2024 | Insulin Only | 332,194 | 9.1 |
| 2023/2024 | Both | 473,511 | 13.0 |
| 2023/2024 | None | 72,735 | 2.0 |
| 2024/2025 | Antidiabetic Drugs Only | 2,979,141 | 76.7 |
| 2024/2025 | Insulin Only | 332,335 | 8.6 |
| 2024/2025 | Both | 497,032 | 12.8 |
| 2024/2025 | None | 75,794 | 2.0 |
| 2025/2026 | Antidiabetic Drugs Only | 3,182,387 | 77.6 |
| 2025/2026 | Insulin Only | 331,016 | 8.1 |
| 2025/2026 | Both | 510,573 | 12.5 |
| 2025/2026 | None | 74,450 | 1.8 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 1)
In England in 2025/26:
Patients are generally prescribed either anti-diabetic drugs or insulin to treat their diabetes, but a smaller group of patients may receive both, or neither if their diabetes is controlled through diet.
78% of patients required only anti-diabetic drugs to treat their diabetes.
The estimated number of patients receiving only anti-diabetic drugs increased from 2.0 million in 2016/17 to 3.2 million in 2025/26.
In England in 2025/26:
- an estimated 7,700 more patients received insulin only when compared to 2016/17
- the percentage of patients that received both anti-diabetic drugs and insulin remained stable, at between 12% and 14% since 2016/17
- 2% of patients received no insulin or anti-diabetic drugs but were 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 2025/26, GLP-1 receptor agonists accounted for 6% of the total items prescribed for diabetes and 33% of the total cost
Table
Table 10: In 2025/26, GLP-1 receptor agonists accounted for 6% of the total items prescribed for diabetes and 33% of the total cost
| Financial year | Bnf chemical substance name | Total identified patients | Total items | Total net ingredient cost (£) |
|---|---|---|---|---|
| 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 |
| 2025/2026 | Dulaglutide | 64,111 | 557,489 | 45,601,178 |
| 2025/2026 | Exenatide | 2,601 | 13,609 | 1,121,354 |
| 2025/2026 | Liraglutide | 3,188 | 15,707 | 1,211,234 |
| 2025/2026 | Lixisenatide | 13 | 29 | 1,969.62 |
| 2025/2026 | Semaglutide | 199,298 | 1,542,791 | 137,124,768 |
| 2025/2026 | Tirzepatide | 344,668 | 3,042,799 | 569,982,126 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 2)
In England in 2025/26:
The volume of GLP-1 items prescribed increased by 520% since 2016/17.
The cost of GLP-1 items prescribed increased by 889% since 2016/17.
Around 14% of patients who received drugs used to treat diabetes were prescribed a GLP-1 receptor agonist.
In 2025/26, 5.2 million GLP-1 items were prescribed at a total cost of £755 million, to an estimated 562,000 patients.
In 2016/17, only Dulaglutide, Exenatide, Liraglutide, and Lixisenatide were available. Semaglutide and Tirzepatide became available in 2018/19 and 2022/23, respectively, and combined, they now account for 89% of all GLP-1 items prescribed. Since their introduction, these two products have been among the main drivers of growth for both volume and cost of prescribing for diabetes.
This rapid growth was likely 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 that 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 SGLT2 inhibitors
Chart
Figure 10: In 2025/26, SGLT2 inhibitors accounted for 20% of the total items prescribed for diabetes and 21% of the total cost
Table
Table 11: In 2025/26, SGLT2 inhibitors accounted for 20% of the total items prescribed for diabetes and 21% of the total cost
| Financial year | Bnf chemical substance name | Total identified patients | Total items | Total net ingredient cost (£) |
|---|---|---|---|---|
| 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 |
| 2025/2026 | Canagliflozin | 84,205 | 833,381 | 34,696,756 |
| 2025/2026 | Dapagliflozin | 1,260,794 | 11,519,620 | 259,884,749 |
| 2025/2026 | Empagliflozin | 492,666 | 4,704,659 | 186,538,720 |
| 2025/2026 | Ertugliflozin | 1,167 | 11,073 | 379,151.8 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 3)
In England in 2025/26:
The number of SGLT2 items prescribed was nearly 14 times greater than was prescribed in 2016/17.
Around 43% of patients who received drugs used to treat diabetes were prescribed an SGLT2 inhibitor.
There are four SGLT2 inhibitors currently available. Canagliflozin, Dapagliflozin, and Empagliflozin were already on the market by 2016/17, while Ertugliflozin was introduced later, in 2018/19. By 2025/26, Dapagliflozin and Empagliflozin together accounted for 95% of all SGLT2 prescription items. Since 2016/17, these two products have also been among the main drivers of growth for both volume and cost of prescribing for diabetes.
The most significant annual growth in volume, cost, and patient numbers occurred from 2021/22 onwards, coinciding with the publication of updated NICE guidelines that formally recommended SGLT2 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 2025/26, 11.5 million items were prescribed to an estimated 1.3 million patients, at a total cost of £260 million. Compared to 2024/25, this represents an increase of 2.8 million items, a reduction of £72 million in cost, and an estimated 304,000 more patients. Forxiga, the branded presentation of Dapagliflozin, came off patent and was made a generic in 2025.
Prescribing of Interstitital fluid/glucose detection sensors to monitor glucose levels
Chart
Figure 11: In 2025/26, Interstitial fluid glucose sensors accounted for 5% of the total items prescribed for diabetes and 16% of the total cost
Table
Table 12: In 2025/26, Interstitial fluid glucose sensors accounted for 5% of the total items prescribed for diabetes and 16% of the total cost
| Financial year | Bnf presentation name | 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 |
| 2025/2026 | FreeStyle Libre | 452,138 | 4,137,612 | 340,682,989 |
| 2025/2026 | Dexcom | 39,041 | 315,802 | 22,289,399 |
| 2025/2026 | GlucoMen | 69 | 94 | 4,805.25 |
| 2025/2026 | GlucoRx | 52 | 138 | 6,220.83 |
| 2025/2026 | Accu-Chek | 33 | 36 | 1,540 |
| 2025/2026 | CareSens | 98 | 284 | 14,978.9 |
Source: Prescribing for diabetes summary tables - Treatment for Diabetes (Table 4)
In England in 2025/26:
The first Interstitial fluid glucose sensor became available on the NHS in 2017/18.
Around 12% of patients receiving drugs used to treat diabetes were prescribed an interstitial fluid glucose sensor.
There are currently six 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. Accu-Chek and CareSens became available in 2025/26. This aligns with the NICE recommendation that all type 1 patients should be offered Continuous Glucose Monitoring (CGM) as part of their routine NHS care.
In 2025/26, 4.5 million interstitial fluid glucose sensor items were prescribed across England, at a total cost of £363 million, reaching an estimated 478,000 patients.
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 remained consistent between 2016/17 and 2025/26
Table
Table 13: The overall split of male and female patients remained consistent between 2016/17 and 2025/26
| Financial year | Patient gender | Total identified patients |
|---|---|---|
| 2016/2017 | Female | 1,268,240 |
| 2016/2017 | Male | 1,529,415 |
| 2017/2018 | Female | 1,296,242 |
| 2017/2018 | Male | 1,569,639 |
| 2018/2019 | Female | 1,325,397 |
| 2018/2019 | Male | 1,607,892 |
| 2019/2020 | Female | 1,361,126 |
| 2019/2020 | Male | 1,650,848 |
| 2020/2021 | Female | 1,381,560 |
| 2020/2021 | Male | 1,673,196 |
| 2021/2022 | Female | 1,454,022 |
| 2021/2022 | Male | 1,752,681 |
| 2022/2023 | Female | 1,539,643 |
| 2022/2023 | Male | 1,871,215 |
| 2023/2024 | Female | 1,638,171 |
| 2023/2024 | Male | 1,997,164 |
| 2024/2025 | Female | 1,752,815 |
| 2024/2025 | Male | 2,131,022 |
| 2025/2026 | Female | 1,848,213 |
| 2025/2026 | Male | 2,249,762 |
Source: Prescribing for diabetes summary tables - Patient demographics (Table 2)
In England in 2025/26:
55% of identified patients were male.
45% of identified patients were female.
In 2025/26, there were an additional 580,000 female identified patients than there were in 2016/17, and an additional 720,000 males.
Data for identified patients with unknown or indeterminate gender has 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 65 to 69 was the largest prescribing group for drugs used in diabetes in 2025/26
Table
Table 14: Male patients aged 65 to 69 was the largest prescribing group for drugs used in diabetes in 2025/26
| Age band | Patient gender | Total identified patients |
|---|---|---|
| 00-04 | Female | 1,271 |
| 00-04 | Male | 1,465 |
| 05-09 | Female | 3,509 |
| 05-09 | Male | 3,715 |
| 10-14 | Female | 7,823 |
| 10-14 | Male | 7,830 |
| 15-19 | Female | 13,349 |
| 15-19 | Male | 11,624 |
| 20-24 | Female | 25,888 |
| 20-24 | Male | 13,698 |
| 25-29 | Female | 53,036 |
| 25-29 | Male | 20,612 |
| 30-34 | Female | 75,997 |
| 30-34 | Male | 32,315 |
| 35-39 | Female | 80,760 |
| 35-39 | Male | 53,251 |
| 40-44 | Female | 81,635 |
| 40-44 | Male | 83,714 |
| 45-49 | Female | 97,303 |
| 45-49 | Male | 123,537 |
| 50-54 | Female | 132,350 |
| 50-54 | Male | 182,000 |
| 55-59 | Female | 175,975 |
| 55-59 | Male | 251,061 |
| 60-64 | Female | 204,336 |
| 60-64 | Male | 298,996 |
| 65-69 | Female | 205,471 |
| 65-69 | Male | 299,706 |
| 70-74 | Female | 192,235 |
| 70-74 | Male | 272,032 |
| 75-79 | Female | 197,983 |
| 75-79 | Male | 266,423 |
| 80-84 | Female | 146,954 |
| 80-84 | Male | 179,449 |
| 85-89 | Female | 99,136 |
| 85-89 | Male | 103,711 |
| 90+ | Female | 49,029 |
| 90+ | Male | 41,171 |
Source: Prescribing for diabetes summary tables - Patient demographics (Table 6)
In 2025/26, males aged 65 to 69 were the largest identified patient group, with an estimated 300,000 patients, accounting for 7% of all identified patients of known gender. However, males aged 55 to 79 made up the top 5 categories by gender and age group, with an estimated 1.4 million patients. This was more than a third of all identified patients of known gender that received 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 | 2021/2022 | 2022/2023 | 2023/2024 | 2024/2025 | 2025/2026 |
|---|---|---|---|---|---|
| 17 and under | 0.0367 | 0.0376 | 0.0381 | 0.0389 | 0.0394 |
| 18 and over | 3.16 | 3.36 | 3.59 | 3.84 | 4.05 |
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 2025/26. 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 | 1,060,266 |
| 2 | 962,596 |
| 3 | 824,093 |
| 4 | 748,929 |
| 5 - Least deprived | 674,280 |
Source: Prescribing for diabetes summary tables - Patient demographics (Table 9)
In England in 2025/26:
25% of patients were from the most deprived areas.
16% of patients were from the least deprived areas.
In 2025/26, the general trend shows more patients were prescribed drugs used in diabetes as deprivation increased - with 674,000 patients living in the least deprived areas, rising to an estimated 1.1 million patients living in the most deprived areas. This pattern has remained consistent since 2016/17.
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 SGLT2 inhibitors
SGLT2 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 SGLT2 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 SGLT2 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 recommend 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 drug categories 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 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 2025 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 living conditions.
The reported IMD quintile is derived from the postcode of the patient an item has been prescribed to. Quintile 1 represents the 20% most deprived areas and quintile 5 represents 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 to a postcode in the National Statistics Postcode Lookup (NSPL) - February 2026.
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.
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 February 2026 National Statistics Postcode Lookup (NSPL) file for 2021 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. 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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