The future burden of Type 2 Diabetes and the role of glycaemic control and GLP1-RAs

In this work, we estimate the future burden of T2D in the UK and assess the impact of glycaemic target achievement, both with and without GLP1-RAs. We developed a system dynamics model to predict the prevalence and burden of T2D and associated complications. Two treatment scenarios were evaluated: Scenario A, representing population-wide attainment of glycaemic targets, and Scenario B, applying a population-wide GLP-1 RA effect in addition to glycaemic target attainment. The prevalence of T2D is expected to rise from 3.7M (5.3%) in 2024 to 6.3M (5.5-7.3M; 8.3% [7.9-8.8%]) in 2060, with total yearly costs increasing from £20.7bn to £33.4bn. Total cumulative savings (2024-2060) of £61.4bn and £140.7bn were estimated for scenario A and B, respectively.

The object of this work was to assess the impact of glycaemic target achievement, both with and without optimal treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RAs), on the predicted burden of type 2 diabetes (T2D) and associated complications from a UK healthcare system and society perspective

A system dynamics model was developed to predict the prevalence and burden of T2D and associated complications, stratified by age and haemoglobin A1c (HbA1c), in the UK from 2024 to 2060. Two treatment scenarios were evaluated: Scenario A, representing population-wide attainment of glycaemic targets, and Scenario B, applying a population-wide GLP-1 RA effect in addition to glycaemic target attainment. The GLP-1 RA effect was modelled via hazard ratios applied to age- and HbA1c-stratified rates of micro- and macrovascular complications

Following current trends, the prevalence of T2D is expected to rise from 3·7M (5·3%) in 2024 to 6·3M (5·5-7.3M; 8·3% [7·9-8·8%]) in 2060, with total yearly costs increasing from £20·7bn to £33·4bn. Scenario A resulted in total cumulative savings of £61·4bn by 2060, driven by reductions in the direct cost of complications. Scenario B prevented 4·5 times as many macrovascular complications and 6 times as many deaths as Scenario A, resulting in total cumulative savings of £140·7bn. Savings in Scenario B were driven by the monetary value of life-years saved.

We conclude that the cardiorenal protection afforded by GLP-1 RAs confers significant additional value compared with glycaemic control alone.

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Recommended citation: Davies, M., Padgett, T.E., McEwan, P. et al. The Future Burden of Type 2 Diabetes and the Role of Glycaemic Control and GLP1-RAs. Mayo Clinic Proceedings. (2026). 10.1016/j.mayocp.2026.10.021