The descriptive epidemiology of type 2 diabetes in the United Kingdom from 2004 to 2021

Purpose To provide contemporary estimates of the incidence and prevalence of type 2 diabetes in the UK. Methods Data from UK primary care (CPRD) were analyzed using an automated, analytical platform that produces validated, rapid analytics called Livingstone. Results We selected 1,125,028 people with type 2 diabetes (44.7% female). The crude incidence was stable. In 2004 the incidence rate was 4.18 cases per 1,000 people, reducing to 4.13/1,000 in 2021. There was a shift in age-specific incidence to earlier age-groups. The crude prevalence showed a marked increase, rising from 2.95% to 5.41%, levelling off slightly in later years. Increases in prevalence were observed in all groups. Northern Ireland consistently had the lowest prevalence, and Wales had a notably higher prevalence, increasing from 3.71% in 2004 to 6.37%. The mean age at diagnosis decreased in females by 5.5 years to 58.5 years, and by 2.5 years in men, to 58.8 years. Conclusions The incidence of type 2 diabetes was largely stable over 20 years but there were changes over time in age specific groups resulting from a shift to earlier onset or earlier diagnosis. The shift to earlier diagnosis was far more pronounced in women than in men. Prevalence increased markedly, but the rate of increase appeared to be levelling-off a little. There were notable differences in the epidemiology of type 2 diabetes between the four constituent countries of the UK. The number of younger people diagnosed with type 2 diabetes remains a concern. ### Competing Interest Statement Livingstone is a proprietary analytical platform that analyses routine healthcare data ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes CPRD data are available from the UK MHRA