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May 2024

Preventable complications of diabetes costing £6.2 billion a year

Devastating and largely preventable complications are causing ‘untold hardship’ for people with diabetes and costing the NHS £6.2 billion a year, a leading charity has warned.   

The new research1, commissioned by Diabetes UK and carried out by the York Health Economics Consortium, University of York, also examined how costs will rise over time if action is not taken to reduce the number of people developing type 2 diabetes and improve outcomes for everyone living with diabetes. It estimates that, by 2035, the cost to the NHS alone could be nearly £18bn.   

Diabetes UK say the findings not only highlight the seriousness of diabetes, but also the huge opportunity to transform lives through a greater focus on early care and support, with fewer people developing complications. The charity is calling on all political parties to ensure that the next government moves the balance of investment in diabetes over time, shifting the dial from crisis to preventative care. 

There are estimated to be more than 5.6 million people living in the UK with diabetes. With the right treatment and support, it is possible to live well with the condition. But diabetes can be a gateway to ill health, and it can lead to people developing multiple long-term health issues. Every week, diabetes leads to 2,990 cases of heart failure, more than 930 strokes and 660 heart attacks, and 184 amputations.

To reduce the risk of complications, people living with diabetes need a series of routine checks, including blood glucose measurements (HbA1c), foot checks, and blood pressure monitoring. However, this vital diabetes care is not being delivered to everyone who needs it and, in 2022/23, approximately 1.6 million people living with diabetes in England did not receive all eight of their essential health checks

Following the publication of the research today, Diabetes UK is calling for:

  • More attention and resource to ensure people with diabetes get all their routine checks and follow-up care, including access to technologies and treatments. This would reduce the number of people going on to develop devastating and costly complications.
  • A greater focus on support and education at diagnosis to help people with diabetes manage their condition effectively.
  • Bold action from the next UK Government to reduce the number of people developing type 2 diabetes – including measures to tackle the promotion of unhealthy food and drink.

Nick Hex is Associate Director for the NHS and Public Sector at the York Health Economics Consortium, University of York. He said:  ‘Diabetes remains very costly to the NHS, and the majority of those costs are still spent on potentially preventable complications. 

‘Increased investment in new medicines and technologies that help people better manage their condition contribute to some of the high ongoing costs, but the rise in type 2 diabetes in under 40s is a particular concern and there needs to be continued focus on prevention strategies.’ 

The research found the NHS spends £10.7bn a year on diabetes, about 6% of the UK health budget. Approximately £4.4bn goes on routine diabetes care, which includes diagnosis, GP and nurse appointments, eye screening, blood tests, medications, diabetes technology, education and support programmes, and specialist diabetes teams.   

The remainder, £6.2bn – about 60% of the overall costs of diabetes – is spent on dealing with diabetes-related complications. Similar research in 2012 found complications accounted for 80% of the overall cost. Since then, there has been a reduction in complication rates, alongside improvements in routine diabetes care, at least prior to the pandemic.  

Diabetes UK adds that, despite the progress that has been made, these figures show spending on complications is still far too high and much of it is avoidable with the right care. Despite evidence that there were improvements in routine diabetes care, and a corresponding reduction in complications up until 2020, this has still not recovered fully across the country since a big downturn during and immediately after the COVID-19 pandemic. 

This all comes against the backdrop of a worrying rise in the prevalence of diabetes, with diagnoses of type 2 diabetes among under 40s up by almost 40% across the past six years according to a Diabetes UK report published last month (May).

1. Hex N, MacDonald R, Pocock J, et al. Estimation of the direct health and indirect societal costs of diabetes in the UK using a cost of illness model. Diabet Med. 2024; 00:e15326.

Practice Nurse 2024;54(3): online only