Annual NHS spending on diabetes is set to increase from £9.8 billion to £16.9 billion over the next 25 years and account for 17% of the Service's entire budget by 2035, a new report warns.

Moreover, the cost of treating diabetes complications - including kidney failure, nerve damage, stroke, blindness and amputation - is expected to almost double, from £7.7 billion currently to £13.5 billion by 2035/6, says the Impact Diabetes study, which has been published in the journal Diabetic Medicine.

The total cost associated with diabetes in the UK currently stands at £23.7 billion and is predicted to rise to £39.8 billion by 2035/6, says the report, which is authored by the York Health Economic Consortium (YHEC) and has been developed in partnership between Sanofi Diabetes and the charities Diabetes UK and the Juvenile Diabetes Research Foundation (JDRF).

79% of NHS diabetes spending goes on complications, many of which are preventable, say the authors, who suggest that investing in the checks and services that help people manage the condition and, therefore, reduce the risk of complications, could actually be less expensive than the current approach.

Key findings from the report include that:

- there are currently around 3.8 million people living with diabetes in the UK and by 2035/6 this is expected to increase to 6.25 million;

- the current annual cost of direct patient care (including treatment, intervention and complications) for those living with the condition is £9.8 billion, or £1 billion for type 1 diabetes and £8.8 billion for type 2;

- current annual indirect costs associated with diabetes, such as those related to increased death and illness, work loss and the need for informal care, are estimated at £13.9 billion, or £900,000 for type 1 diabetes and £8.8 billion for type 2; and

- deaths from diabetes in 2010/11 resulted in over 325,000 lost working years.

In addition, an estimated 850,000 people in the UK have undiagnosed diabetes, and the authors estimate this cost at an additional £1.5 billion.

By 2035/6, they forecast that: - the cost of direct care for patients will have risen to £16.9 billion, or £1.8 billion for type 1 disease and £15.1 billion for type 2: and - indirect costs will have increased to approximately £22.9 billion, or £2.4 billion for type 1 diabetes and £20.5 billion for type 2.

The findings of the Impact Diabetes report highlight the urgent need to invest in delivering already-agreed national care standards for people with both type 1 and type 2 diabetes, and for more investment in the scientific research that can help improve understanding of the condition, say the organisations commissioning the report.

It also shows clearly, for the first time, the cost of the unavoidable autoimmune condition type 1diabetes separately, noted Karen Addington, chief executive of JDRF. 

"This is important because the causes of type 1 and the challenges it presents are very different to type 2, and only medical research can lift this burden on families, the NHS and the economy," she said.

Barbara Young, chief executive of Diabetes UK, added that it also shows that, without urgent action, "the already huge sums of money being spent on treating diabetes will rise to unsustainable levels that threaten to bankrupt the NHS." 

But "the most shocking part of this report is the finding that almost four-fifths of NHS diabetes spending goes on treating complications that, in many cases, could have been prevented. The failure to do more to prevent these complications is both a tragedy for the people involved and a damning indictment of the failure to implement the clear and recommended solutions," she said.

"Unless the government and the NHS start to show real leadership on this issue, this unfolding public health disaster will only get worse," Ms Young warned.

Dr Andrew Hockey, medical director at Sanofi Diabetes, pointed out that there are many guidelines to help manage diabetes effectively, but to what extent they are followed is up for debate.

"We plan to carry out further research to examine the cost impact if National Institute for Health and Clinical Excellence [NICE] guidelines were fully adopted across the UK, including the extent of cost savings that could potentially amass from reduced or delayed complications. This should help to highlight how investment in effective management could potentially reduce the overall cost burden of diabetes," said Dr Hockey.