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Insulin Resistance — The Medication Burden | USA & UK

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
~70%
of all long-term
UK prescriptions linked
to insulin resistance
1.1bn
prescription items
dispensed annually
by the NHS
4.5bn
prescriptions filled
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%
US
UK
Hypertension
ACE inhibitors, beta blockers, diuretics, CCBs
Primary cause 68.0 9.0 47.0% 30.0%
US
UK
High Cholesterol / Dyslipidaemia
Statins, fibrates, ezetimibe
Primary cause 37.0 7.5 28.0% 25.0%
US
UK
Cardiovascular Disease
Antiplatelet, anticoagulants, nitrates, statins
Primary cause 21.0 3.5 11.5% 7.6%
US
UK
Non-Alcoholic Fatty Liver Disease
Typically managed via T2DM / metabolic drugs
Primary cause 8.0 1.5 24.0% 20.0%
US
UK
Neurological & Mental Health
Alzheimer's / Dementia
Donepezil, memantine, rivastigmine
Primary cause 4.0 0.7 2.1% 1.8%
US
UK
Depression & Anxiety
SSRIs, SNRIs, anxiolytics
Major contributor 45.0 8.3 17.0% 17.0%
US
UK
ADHD
Methylphenidate, amphetamine salts, atomoxetine
Major contributor 9.5 0.5 4.4% 1.5%
US
UK
Inflammatory & Autoimmune
Arthritis (OA & RA)
NSAIDs, DMARDs, biologics, corticosteroids
Major contributor 32.0 5.5 21.0% 18.0%
US
UK
Asthma
Inhaled corticosteroids, bronchodilators, biologics
Major contributor 15.5 4.2 8.0% 8.0%
US
UK
IBD (Crohn's & Colitis)
Biologics, immunosuppressants, mesalazine
Major contributor 2.4 0.5 1.3% 1.0%
US
UK
Multiple Sclerosis
Disease-modifying therapies, corticosteroids
Major contributor 1.0 0.15 0.4% 0.3%
US
UK
Other Insulin Resistance–Linked Conditions
GERD / Acid Reflux
PPIs, H2 blockers (omeprazole, ranitidine)
Contributing factor 28.0 5.0 20.0% 15.0%
US
UK
Chronic Kidney Disease
ACE inhibitors, SGLT2i, erythropoietin
Major contributor 7.0 1.1 3.8% 2.5%
US
UK
PCOS
Metformin, oral contraceptives, anti-androgens
Primary cause 5.0 1.0 10.0% 10.0%
US
UK
Stroke (survivors on medication)
Antiplatelets, anticoagulants, antihypertensives
Primary cause 7.0 1.2 2.9% 1.2%
US
UK
Gout
Allopurinol, colchicine, febuxostat
Major contributor 4.5 0.7 3.9% 2.5%
US
UK
Sleep Apnoea
CPAP (device), weight management drugs
Major contributor 6.0 0.9 6.0% 4.0%
US
UK

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
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
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/

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

~70%

OF ALL LONG-TERM

UK PRESCRIPTIONS LINKED

TO INSULIN RESISTANCE

1.1bn

PRESCRIPTION ITEMS

DISPENSED ANNUALLY

BY THE NHS

4.5bn

PRESCRIPTIONS FILLED

ANNUALLY IN THE

UNITED STATES

CONDITION

IR ROLE

USA ON MEDICATION

(MILLIONS)

UK ON MEDICATION

(MILLIONS)

USA ADULTS

AFFECTED %

UK ADULTS

AFFECTED %

 

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

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

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/

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