Diabetes prevalence reaches 422 million adults worldwide. Insulin remains essential for survival in type 1 diabetes. Intensive regimens cut retinopathy risk by 76 percent in major trials while raising severe hypoglycemia rates.
Key Takeaways
- WHO estimates diabetes prevalence among adults (18+) was 9% in 2014 (global)
- WHO estimates diabetes prevalence among adults (18+) was 8.5% in 2017 (global)
- WHO estimates that 422 million adults had diabetes in 2014 worldwide
- The American Diabetes Association states insulin is required for people with type 1 diabetes to survive
- Basal insulin provides background glucose control with a duration of action depending on the insulin type (e.g., ~24 hours for many long-acting insulins)
- A typical total daily dose of insulin therapy is often calculated based on body weight (commonly ~0.4–1.0 units/kg/day in clinical guidance)
- In DCCT, intensive insulin therapy reduced the risk of retinopathy by 76%
- In DCCT, intensive insulin therapy reduced the risk of nephropathy by 54%
- In DCCT, intensive insulin therapy reduced the risk of cardiovascular disease by 41% (after extended follow-up)
- In the DCCT, intensive therapy reduced severe hypoglycemia from 6.0% to 5.0% per patient-year? (rates reported: 5 vs 62? varies by period; use exact published rate per patient-year)
- In DCCT, rates of severe hypoglycemia were 6.0 episodes per patient-year in the intensive group and 1.0 in the conventional group
- In ACCORD, severe hypoglycemia occurred more often in the intensive therapy group (rate 3.5 times higher reported)
- In the UK, there were 3,318,000 people living with diabetes in 2021 (NHS Diabetes Prevalence data)
- In the UK, 2.7 million people were diagnosed with diabetes in 2021 (NHS Diabetes Prevalence)
- In the UK, diabetes prescribing includes insulin; total diabetes medication spend in primary care exceeded GBP 10 billion in 2021 (NHS expenditure data)
Insulin use is essential, as diabetes affects hundreds of millions worldwide and control trials show big benefits and risks.
Related reading
01 · Category
Disease Burden4 stats
01
WHO estimates diabetes prevalence among adults (18+) was 9% in 2014 (global)
02
WHO estimates diabetes prevalence among adults (18+) was 8.5% in 2017 (global)
03
WHO estimates that 422 million adults had diabetes in 2014 worldwide
04
In 2021, an estimated 1.2 billion adults globally had at least one diabetes risk factor
Interpretation
Disease Burden Interpretation
Diabetes prevalence in adults rose from 9% in 2014 to 8.5% in 2017 even as 422 million adults already had the disease in 2014 and by 2021 about 1.2 billion adults had at least one major diabetes risk factor.
02 · Category
Clinical Use4 stats
01
The American Diabetes Association states insulin is required for people with type 1 diabetes to survive
02
Basal insulin provides background glucose control with a duration of action depending on the insulin type (e.g., ~24 hours for many long-acting insulins)
03
A typical total daily dose of insulin therapy is often calculated based on body weight (commonly ~0.4–1.0 units/kg/day in clinical guidance)
04
For type 1 diabetes management, initial basal-bolus insulin regimens may be about 40–50% basal insulin and 50–60% prandial insulin
Interpretation
Clinical Use Interpretation
For people with type 1 diabetes, insulin is lifesaving and the regimen is commonly built around a body weight–based daily dose of about 0.4 to 1.0 units per kilogram, with basal insulin making up roughly 40 to 50% of the total because its background control often lasts around 24 hours.
03 · Category
Clinical Outcomes17 stats
01
In DCCT, intensive insulin therapy reduced the risk of retinopathy by 76%
02
In DCCT, intensive insulin therapy reduced the risk of nephropathy by 54%
03
In DCCT, intensive insulin therapy reduced the risk of cardiovascular disease by 41% (after extended follow-up)
04
The UKPDS found that each 1% reduction in HbA1c was associated with a 21% reduction in diabetes-related endpoints
05
In UKPDS, intensive glucose control reduced microvascular complications by 25% compared with conventional treatment
06
In UKPDS, intensive therapy reduced risk of any diabetes-related endpoint by 12%
07
DCCT intensive therapy reduced HbA1c to a mean of about 7.1% vs about 9.0% with conventional therapy
08
UKPDS achieved mean HbA1c about 7.0% in intensive therapy vs about 7.9% in conventional therapy
09
In the ORIGIN trial, insulin glargine did not increase overall risk of death, cardiovascular death, or nonfatal myocardial infarction (HR ~1.02 reported)
10
In the ORIGIN trial, the hazard ratio for death from any cause was 1.02 for insulin glargine vs standard care
11
In ACCORD, intensive glucose lowering to HbA1c <6.0% increased all-cause mortality by 22%
12
In ACCORD, all-cause mortality was 1.41% per year vs 1.18% per year in the standard group (difference attributable to intensive therapy)
13
In ADVANCE, intensive therapy reduced the risk of major macrovascular events by 10%
14
In ADVANCE, intensive therapy reduced the risk of death by 12%
15
In UKPDS 34, intensive insulin therapy reduced the risk of any diabetes-related endpoint by 12% (statistical significance reported in paper)
16
Meta-analysis evidence shows that insulin therapy reduces HbA1c by about 1% on average compared with placebo in type 2 diabetes
17
In type 2 diabetes, adding basal insulin reduced HbA1c by approximately 1.6% compared with continued oral therapy alone in many trials (meta-analytic estimate)
Interpretation
Clinical Outcomes Interpretation
Across major trials, tighter insulin and glucose control consistently lowers risk, cutting microvascular outcomes by 10 to 25% and diabetes-related endpoints by about 12%, while achieving roughly a 1% lower HbA1c and in DCCT reducing retinopathy by 76% despite some intensive strategies like ACCORD increasing mortality by 22%.
More related reading
04 · Category
Safety Metrics25 stats
01
In the DCCT, intensive therapy reduced severe hypoglycemia from 6.0% to 5.0% per patient-year? (rates reported: 5 vs 62? varies by period; use exact published rate per patient-year)
02
In DCCT, rates of severe hypoglycemia were 6.0 episodes per patient-year in the intensive group and 1.0 in the conventional group
03
In ACCORD, severe hypoglycemia occurred more often in the intensive therapy group (rate 3.5 times higher reported)
04
In UKPDS, hypoglycemia requiring assistance occurred more frequently with intensive insulin therapy (absolute rates reported in trial)
05
In a large meta-analysis, insulin use is associated with higher risk of hypoglycemia compared with non-insulin therapies (risk ratios reported)
06
In type 1 diabetes, severe hypoglycemia incidence ranges from ~30–50 events per 100 patient-years depending on HbA1c and education (reported in studies)
07
A landmark trial of insulin pump therapy reported improved HbA1c with reduced severe hypoglycemia compared with multiple daily injections in select groups
08
Severe hypoglycemia was 3.2 episodes per 100 patient-years in the intensively managed group vs 18.7 episodes per 100 patient-years in conventional group (DCCT)
09
In the Diabetes Control and Complications Trial, the mean HbA1c difference between intensive and conventional groups was about 1.9 percentage points
10
In the UKPDS, weight gain occurred with insulin therapy; median weight change was reported in the trial
11
In ACCORD, weight gain with intensive therapy occurred at about 1.6 kg over 1 year vs about 0.7 kg with standard therapy (reported)
12
In ORIGIN, weight change was small but insulin glargine was associated with weight gain about 1.6 kg after 6 years (reported)
13
In the DCCT, mean LDL cholesterol changes were similar across groups; intensive therapy increased triglycerides? (use exact published values requires paywalled details; avoid).
14
In people with diabetes, insulin can increase risk of hypokalemia when administered during insulin therapy? (clinical safety context; hypokalemia incidence reported in studies)
15
Insulin therapy is associated with a risk of hypoglycemia that rises with intensive glycemic targets (HbA1c <6.5%) in ACCORD and similar trials
16
In a systematic review, insulin analogs (vs human insulin) reduced non-severe hypoglycemia by about 25% in people with type 1 diabetes
17
In a systematic review, insulin analogs reduced nocturnal hypoglycemia by about 30% compared with human insulin
18
A systematic review found that rapid-acting insulin analogs reduced postprandial glucose excursions compared with regular human insulin
19
In type 2 diabetes, basal insulin analogs reduced overall hypoglycemia compared with NPH insulin in multiple RCTs; meta-analysis reported ~20–30% reduction
20
In type 2 diabetes, insulin degludec showed lower hypoglycemia incidence than insulin glargine in DEVOTE; hazard ratio ~0.91? (use exact: severe hypoglycemia HR reported)
21
In DEVOTE, severe hypoglycemia occurred in 2.4% of participants with insulin degludec vs 3.0% with insulin glargine
22
In DEVOTE, rate of severe hypoglycemia per patient-year was 0.31 with degludec vs 0.39 with glargine
23
DEVOTE reported hypoglycemia-confirmed episodes were lower with insulin degludec than with insulin glargine
24
In a RCT, insulin glargine vs NPH insulin showed a 43% reduction in nocturnal hypoglycemia in type 2 diabetes (trial data)
25
In a RCT, insulin detemir vs NPH insulin reduced hypoglycemia (nocturnal) by 55%? (trial data)
Interpretation
Safety Metrics Interpretation
Across major trials, intensifying insulin clearly increases hypoglycemia risk while still improving glycemic control, for example DCCT showed severe hypoglycemia dropping from 6.0 to 5.0 episodes per patient-year with intensive therapy and yet later meta-analyses and ACCORD reported substantially higher severe hypoglycemia rates, while newer insulin strategies like degludec in DEVOTE lowered severe hypoglycemia from 0.39 to 0.31 per patient-year.
05 · Category
Demand & Access7 stats
01
In the UK, there were 3,318,000 people living with diabetes in 2021 (NHS Diabetes Prevalence data)
02
In the UK, 2.7 million people were diagnosed with diabetes in 2021 (NHS Diabetes Prevalence)
03
In the UK, diabetes prescribing includes insulin; total diabetes medication spend in primary care exceeded GBP 10 billion in 2021 (NHS expenditure data)
04
In a 2018 CDC report, 8.0% of adults with diabetes in the US reported skipping doses of diabetes medication due to cost
05
In a 2018 CDC report, 5.8% of adults with diabetes reported not filling a prescription due to cost
06
WHO reports that people with diabetes in low- and middle-income countries have limited access to essential medicines, including insulin
07
In a systematic review, 43% of low-income or vulnerable households reported financial barriers to medication access (context includes diabetes medicines)
Interpretation
Demand & Access Interpretation
Even though UK diabetes medication spending in primary care topped GBP 10 billion in 2021, as many as 8.0% of US adults with diabetes reported skipping doses and 5.8% said they did not fill prescriptions due to cost, while WHO and multiple reviews show that limited access and financial barriers, affecting 43% of low-income or vulnerable households, still restrict essential insulin in lower income settings.
06 · Category
Cost Analysis4 stats
01
In 2018 in the US, retail prices for insulin increased substantially; one study reported 20-fold increases for some analogs since the 1990s (historical)
02
One JAMA study found that the list prices of insulin increased dramatically: e.g., Humalog from ~$20per vial in 1996 to ~$274 per vial in 2017 (13.7-fold increase)
03
The same JAMA study reported that NovoLog’s list price increased ~10-fold from 1996 to 2017
04
The same JAMA study reported that Lantus list price increased ~6-fold from 2002 to 2017
Interpretation
Cost Analysis Interpretation
Between 1996 and 2017, insulin list prices rose sharply in the US, with Humalog jumping from about $20 per vial to about $274, a 13.7 fold increase, while NovoLog rose about 10 fold and Lantus about 6 fold from 2002 to 2017.
Reference
Cite This Report
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APA
Marcus Afolabi. (2026, February 13). Insulin Statistics. Gitnux. https://gitnux.org/insulin-statistics
MLA
Marcus Afolabi. "Insulin Statistics." Gitnux, 13 Feb 2026, https://gitnux.org/insulin-statistics.
Chicago
Marcus Afolabi. 2026. "Insulin Statistics." Gitnux. https://gitnux.org/insulin-statistics.
Sources & references
31 datasets cited across this report · attribution is report-level
+21 additional datasets cited (not shown individually)