Insulin Resistance — The Medication Burden
For every condition in this table, insulin resistance is either the primary driver, a major contributing cause, or a well-established accelerant. The figures below represent the estimated number of people on medication for each condition in the USA and UK — and the proportion of that prescription burden that traces back, causally, to insulin resistance as its root.
~75%
of all long-term
US prescriptions linked
to insulin resistance
US prescriptions linked
to insulin resistance
~70%
of all long-term
UK prescriptions linked
to insulin resistance
UK prescriptions linked
to insulin resistance
1.1bn
prescription items
dispensed annually
by the NHS
dispensed annually
by the NHS
4.5bn
prescriptions filled
annually in the
United States
annually in the
United States
| Condition | IR Role | USA on medication (millions) |
UK on medication (millions) |
USA adults affected % |
UK adults affected % |
Population % |
|---|---|---|---|---|---|---|
| Metabolic & Cardiovascular | ||||||
Type 2 Diabetes Metformin, SGLT2i, GLP-1, insulin |
Primary cause | 29.0 | 4.4 | 11.3% | 8.3% | |
Hypertension ACE inhibitors, beta blockers, diuretics, CCBs |
Primary cause | 68.0 | 9.0 | 47.0% | 30.0% | |
High Cholesterol / Dyslipidaemia Statins, fibrates, ezetimibe |
Primary cause | 37.0 | 7.5 | 28.0% | 25.0% | |
Cardiovascular Disease Antiplatelet, anticoagulants, nitrates, statins |
Primary cause | 21.0 | 3.5 | 11.5% | 7.6% | |
Non-Alcoholic Fatty Liver Disease Typically managed via T2DM / metabolic drugs |
Primary cause | 8.0 | 1.5 | 24.0% | 20.0% | |
| Neurological & Mental Health | ||||||
Alzheimer's / Dementia Donepezil, memantine, rivastigmine |
Primary cause | 4.0 | 0.7 | 2.1% | 1.8% | |
Depression & Anxiety SSRIs, SNRIs, anxiolytics |
Major contributor | 45.0 | 8.3 | 17.0% | 17.0% | |
ADHD Methylphenidate, amphetamine salts, atomoxetine |
Major contributor | 9.5 | 0.5 | 4.4% | 1.5% | |
| Inflammatory & Autoimmune | ||||||
Arthritis (OA & RA) NSAIDs, DMARDs, biologics, corticosteroids |
Major contributor | 32.0 | 5.5 | 21.0% | 18.0% | |
Asthma Inhaled corticosteroids, bronchodilators, biologics |
Major contributor | 15.5 | 4.2 | 8.0% | 8.0% | |
IBD (Crohn's & Colitis) Biologics, immunosuppressants, mesalazine |
Major contributor | 2.4 | 0.5 | 1.3% | 1.0% | |
Multiple Sclerosis Disease-modifying therapies, corticosteroids |
Major contributor | 1.0 | 0.15 | 0.4% | 0.3% | |
| Other Insulin Resistance–Linked Conditions | ||||||
GERD / Acid Reflux PPIs, H2 blockers (omeprazole, ranitidine) |
Contributing factor | 28.0 | 5.0 | 20.0% | 15.0% | |
Chronic Kidney Disease ACE inhibitors, SGLT2i, erythropoietin |
Major contributor | 7.0 | 1.1 | 3.8% | 2.5% | |
PCOS Metformin, oral contraceptives, anti-androgens |
Primary cause | 5.0 | 1.0 | 10.0% | 10.0% | |
Stroke (survivors on medication) Antiplatelets, anticoagulants, antihypertensives |
Primary cause | 7.0 | 1.2 | 2.9% | 1.2% | |
Gout Allopurinol, colchicine, febuxostat |
Major contributor | 4.5 | 0.7 | 3.9% | 2.5% | |
Sleep Apnoea CPAP (device), weight management drugs |
Major contributor | 6.0 | 0.9 | 6.0% | 4.0% | |
USA — People on Medication per Condition
Millions of adults | IR-linked conditions only
UK — People on Medication per Condition
Millions of adults | IR-linked conditions only
Important: overlap between conditions. Many individuals in this table are counted more than once — a person with Type 2 diabetes, hypertension, and high cholesterol will appear in three rows and is typically on three or more separate drug classes simultaneously. This is precisely the point: insulin resistance is a single upstream cause that generates multiple downstream diagnoses, each treated with a separate prescription. The cumulative medication burden for one person with unresolved insulin resistance is often 3–6 drugs taken for life. Addressing the root cause before diagnosis would, in most cases, have prevented all of them.
On the IR role classifications: "Primary cause" means insulin resistance is the dominant, well-established upstream driver with strong mechanistic and epidemiological evidence. "Major contributor" means insulin resistance is a significant driver alongside other causes — it worsens severity, accelerates onset, and increases prevalence but may not be solely responsible. "Contributing factor" means insulin resistance plays a measurable role but other mechanisms are more dominant. In every case listed, reversing insulin resistance reduces disease burden or risk.
Note on medication figures: USA figures draw on CDC National Health Interview Survey, NCHS, and IMS Health / IQVIA prescription data. UK figures draw on NHS Digital prescription data, NHS Health Survey for England, and published disease registry statistics. "On medication" means currently prescribed long-term drug therapy for that condition. These are conservative estimates — actual figures for several conditions are likely higher due to undiagnosed cases and off-label prescribing. Figures are approximate and represent the 2022–2024 period.
Key data sources
US prescription & prevalence data: CDC National Health Interview Survey 2022. NCHS Health, United States 2023. IQVIA Institute for Human Data Science — Medicine Use and Spending in the US 2023. CDC National Diabetes Statistics Report 2024. AHA Heart Disease and Stroke Statistics 2024. CDC Arthritis Data & Statistics. Alzheimer's Association Facts & Figures 2024.
https://www.cdc.gov/nchs/nhis/index.htm
https://www.cdc.gov/diabetes/php/data-research/index.html
https://www.cdc.gov/nchs/nhis/index.htm
https://www.cdc.gov/diabetes/php/data-research/index.html
UK prescription & prevalence data: NHS Digital — Prescription Cost Analysis England 2022/23. NHS Health Survey for England 2022. NICE Clinical Guidelines. Diabetes UK Statistics 2024. British Heart Foundation Heart Statistics 2024. Alzheimer's Society UK 2024.
https://digital.nhs.uk/data-and-information/publications/statistical/prescription-cost-analysis
https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england
https://digital.nhs.uk/data-and-information/publications/statistical/prescription-cost-analysis
https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england
Insulin resistance as causal driver — systematic reviews: Reaven GM (1988); DeFronzo & Ferrannini (1991); Grundy SM et al. — metabolic syndrome and cardiovascular risk (Circulation 2012); de la Monte & Wands — Type 3 Diabetes (PMC2769828); Frontiers in Endocrinology — IR and stroke (2022); multiple systematic reviews cited in individual condition charts.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11601873/
https://pmc.ncbi.nlm.nih.gov/articles/PMC11601873/