Key takeaways
Insulin is a hormone produced by the pancreas that helps the body regulate blood sugar levels.
All people with Type 1 diabetes and 15% of people with Type 2 diabetes need pharmaceutical insulin.
More than 150 million people worldwide, including about 8.4 million Americans, rely on insulin treatment, which can be a significant financial burden.
Insulin is a naturally occurring hormone that regulates blood glucose levels. People with diabetes mellitus may need pharmaceutical (prescription) insulin because they are either unable to produce or appropriately respond to insulin. In the 100 years since researchers isolated insulin for medical use, insulin therapies have improved diabetes management for millions of people. Today, at least 150 million people worldwide depend on insulin therapy to live and thrive, according to a report in the journal BMJ Open Diabetes Research and Care.
Prevalence of diabetes
Diabetes is a very common health problem. According to the Centers for Disease Control and Prevention’s 2026 National Diabetes Statistics Report (NDSR), 40.1 million Americans have diabetes.
Diabetes statistics worldwide
- Researchers estimate that 589 million to 830 million people are living with diabetes worldwide. (International Diabetes Federation (IDF), 2025; World Health Organization (WHO), 2024)
- Global diabetes prevalence quadrupled from 1990 to 2022. (WHO, 2024)
- In 2022, nearly 60% of people with diabetes were not taking medication for their condition. (WHO, 2024)
- In 2024, 3.4 million people died from diabetes worldwide. (IDF, 2025)
Diabetes statistics in the U.S.
- In 2023, an estimated 12% of the total U.S. population was living with diabetes.
- Diabetes prevalence increases with age. Nearly 29% of Americans ages 65 years or older are living with diabetes.
- More American men (14.9%) than women (12.4%) have diabetes.
- About 16% of American Indian or Alaska Native Americans have been diagnosed with diabetes.
- About 12% of Black, non-Hispanic Americans have been diagnosed with diabetes.
- About 12% of Hispanic Americans have been diagnosed with diabetes.
- About 10% of Asian Americans have been diagnosed with diabetes.
- About 7% of non-Hispanic White Americans have been diagnosed with diabetes.
Source: NDSR, 2026
Diabetes statistics by type of diabetes
It’s important to understand that there is more than one type of diabetes. Healthcare professionals generally divide diabetes diagnoses into four types:
- Type 1 diabetes is characterized by insufficient insulin production.
- Type 2 diabetes occurs when the body cannot produce or respond to insulin correctly.
- Gestational diabetes mellitus (GDM) is a type of diabetes that happens during pregnancy.
- Prediabetes is high blood sugar that advances to Type 2 Diabetes if left untreated.
Type 1 diabetes
- About 2.1 million Americans have Type 1 diabetes. (NDSR, 2026)
- About 314,000 U.S. children and adolescents have Type 1 diabetes. (NDSR, 2026)
- In 2022, an estimated 21,732 American adolescents were diagnosed with Type 1 diabetes. (American Diabetes Association (ADA))
Type 2 diabetes
- Type 2 diabetes accounts for more than 90% of diabetes cases in adults in the U.S. (IDF, 2025)
- About one-third to one-half of people with Type 2 diabetes are undiagnosed. (IDF, 2025)
- Type 2 diabetes risk increases with age. (Mayo Clinic, 2025)
- In 2022, an estimated 14,490 American youth were diagnosed with Type 2 diabetes. (ADA)
Gestational diabetes
- Gestational diabetes occurs in about 7% of pregnancies in the United States. (StatPearls, 2025)
- Gestational diabetes typically develops around the 24th week of pregnancy. (Gestational, Centers for Disease Control and Prevention (CDC), 2024)
- The risk of developing gestational diabetes increases with age. (Journal of Diabetes Investigation, 2025)
Prediabetes
- About 115.2 million adults in the U.S. had prediabetes as of 2023, which is approximately 44% of the adult population. (NDSR, 2026)
- One in three adolescents in the United States had prediabetes in 2023, which is about 8.4 million people. (NDSR, 2026)
- More than half of all people aged 65 and older are believed to have prediabetes. (NDSR, 2026)
- Nearly 80% of people with prediabetes are unaware that they have it. (NDSR, 2026)
- The prevalence of prediabetes in adults hasn’t changed much since 2005, but people with the condition are now more likely to know they have it, despite most still being unaware. (NDSR, 2026)
- The most substantial risk factors for prediabetes in adults are overweight and obesity. (CDC, 2024)
- People older than 45 are more likely to develop prediabetes. (Cleveland Clinic, 2026)
Insulin use in the U.S.
“The rise of GLP-1s like Ozempic, Wegovy, and Mounjaro has contributed to a shift in the entire industry of diabetes treatment, but that didn’t eliminate the need for insulin,” says Inna Melamed, Pharm.D., a functional medicine practitioner and author of Digestive Reset. “Many patients, especially those with long-standing diabetes, beta-cell failure, or Type 1 diabetes, still rely on insulin.”
- An estimated 8.4 million Americans rely on insulin to survive. (ADA, 2022)
- About 6.1% of U.S. adults with diagnosed diabetes report both having Type 1 diabetes and using insulin. (NDSR, 2026)
- About 13.3% of U.S. adults with diagnosed diabetes started using insulin within a year of their diagnosis. (NDSR, 2026)
Insulin use worldwide
- As of 2021, at least 40 companies worldwide made or marketed insulin products. (WHO, 2021)
- All people with Type 1 diabetes and about 15% of people with Type 2 diabetes need insulin. (WHO, 2021)
- An estimated 150 million people worldwide depend on insulin therapy for their diabetes. (BMJ Open Diabetes Research & Care, 2021)
- Only 50% of people who need insulin have access to it. (Doctors Without Borders, 2024)
- Only 1 in 7 Africans living with Type 1 diabetes has access to lifesaving insulin therapy. (Doctors Without Borders, 2024)
Types of insulin
There are several different types of insulin. The best kind of insulin for each person depends on the person’s diet, age, type of diabetes, and more.
Insulin can be divided into three types (JAMA, 2024):
- Human
- Analog
- Biosimilar
Human insulin is lab-made insulin that is identical to what the body naturally produces. It’s been around the longest and works well, but its timing (onset and duration) is less flexible.
Analog insulin is slightly modified human insulin, designed to act faster or last longer, making it easier to match how the body normally releases insulin around meals and throughout the day.
Biosimilar insulin is a highly similar version of an existing insulin product (usually an analog), with no meaningful clinical differences, but often offered at a lower cost.
From 2016 to 2020, insulin analogs and insulin biosimilars were the most commonly used insulin types in the U.S., according to JAMA. The same report stated that insulin pens and newer insulin types were gaining popularity during that period.
Diabetes Coupons & Discount Diabetes Supplies
How many people use insulin pumps?
Most insulin pump users have Type 1 diabetes, according to a 2019 report in Diabetes Spectrum. At the time of the report, more than 350,000 people in the United States used insulin pumps. That’s a dramatic increase from fewer than 7,000 users in 1990.
A 2024 market report estimates 1.5 million people use insulin pumps worldwide.
Insulin prices over time
Unfortunately, the economic costs of diabetes are high. “Insulin pricing has been an issue for years,” Dr. Melamed says. “There are recent price cuts due to public and legal pressure, but the prices are still remaining high.”
- More than $306 billion is spent annually on direct medical costs for diabetes. Insulin costs represent 7% of that total, or about $21.5 billion. (Diabetes Care, 2024)
- Between 2014 and 2019, the average monthly insulin price rose from $318 to $493. (Diabetes Care, 2020)
- Between 2014 and 2019, the monthly out-of-pocket cost for insulin users with insurance coverage rose from $49 to $58. (Diabetes Care, 2020)
- Between 2017 and 2018, about 14% of insulin users spent more than 40% of their income (minus food costs) on insulin. (Health Affairs, 2022)
- The average cost of insulin for Medicare Part D beneficiaries fell from about $51 to $22 for a 30-day supply between 2019 and 2023. (Johns Hopkins University, 2026)
- Currently, monthly insulin prices are capped at $35 for Medicare Part D beneficiaries with participating plans. (Centers for Medicare and Medicaid Services, 2025)
- In 2024, 37% of insulin users reported rationing their insulin to save money. (Yale University, 2025)
Ultimately, the out-of-pocket medical cost of insulin varies widely depending on a person’s insurance coverage, insulin type, insulin delivery system, the number of vials needed per month, and the brand of insulin. For example, Fiasp Flextouch costs more than Insulin Lispro.
RELATED: Insulin prices: How much does insulin cost?
How many Americans use insurance for insulin?
Many Americans rely on health insurance to help cover insulin costs and other diabetes-related medical care. Almost all insurance plans, including Medicare and Medicaid plans, cover insulin because it is considered an essential drug.
- About 52% of insulin users are Medicare beneficiaries.
- About 33% of insulin users have private insurance.
- About 12% of insulin users are enrolled in Medicaid.
- About 2% of insulin users do not have insurance.
Source: U.S. Department of Health and Human Services, 2022
How many Americans pay for insulin out of pocket?
From 2017 to 2018, an estimated 2.2% of insulin users (approximately 154,000 Americans) did not have insurance coverage, according to Yale University. However, it is possible that these uninsured individuals received some other form of financial assistance for insulin therapy expenditures.
- In 2019, people without health insurance paid nearly double the national average for insulin. (JAMA Network Open, 2024)
- In 2021, 29% of those with no health insurance reported rationing their insulin. (JAMA Network Open, 2024)
Insulin side effects
In clinical trials comparing two long-acting insulins, insulin glargine (Lantus) versus insulin isophane (NPH), participants reported the following adverse reactions:
- Upper respiratory tract infection (22.4% of Lantus users and 23.1% of NPH users)
- Unspecified infection (9.4% of Lantus users and 10.3% of NPH users)
- Accidental injury (5.7% of Lantus users and 6.4% of NPH users)
- Headaches (5.5% of Lantus users and 4.7% of NPH users)
Other common insulin side effects include gastrointestinal side effects, loss of appetite, dark urine, injection site reactions (redness, swelling, or itching), and muscle pain.
Some insulin side effects are dangerous and call for urgent medical attention. These include hypoglycemia (low blood sugar), hypokalemia (low potassium), and allergic reactions.
Frequently asked questions about insulin
Does insulin cure diabetes?
No. Insulin care manages high blood sugar from diabetes, but it does not cure diabetes.
What’s the difference between insulin and Ozempic?
Insulin and Ozempic are both injectable drugs that treat diabetes, but they work very differently. Insulin is a naturally occurring hormone that is necessary for people with Type 1 diabetes because their bodies cannot make it. Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist that increases insulin production, decreases glucagon secretion, and slows stomach emptying in people with Type 2 diabetes.
Does insulin cause weight gain?
Weight gain is a common side effect of insulin, according to the Obesity Medicine Association.
- 100 years on: the impact of the discovery of insulin on clinical outcomes, BMJ Open Diabetes Research and Care (2021)
- National diabetes statistics report, Centers for Disease Control and Prevention (2026)
- IDF diabetes atlas 2025, International Diabetes Federation (2025)
- Diabetes, World Health Organization (2024)
- Statistics about diabetes, American Diabetes Association (2023)
- Type 2 diabetes, Mayo Clinic (2025)
- Gestational diabetes, StatPearls (2025)
- Gestational diabetes, Centers for Disease Control and Prevention (2024)
- Advanced maternal age is a risk factor for both early and late gestational diabetes mellitus: The Japan environment and children’s study, Journal of Diabetes Investigation (2025)
- Diabetes risk factors, Centers for Disease Control and Prevention (2024)
- Prediabetes, Cleveland Clinic (2026)
- American Diabetes Association announces support for INSULIN Act at Senate press conference, ADA Newsroom (2022)
- Access to medicines and health products: Keeping the 100-year-old
- promise: making insulin access universal, WHO (2021)
- Diabetes: Only half of people who need insulin in the world have access to it, Doctors Without Borders (2024)
- Trends in insulin types and devices used by adults with Type 2 Diabetes in the United States, 2016 to 2020, JAMA Network (2021)
- A clinical overview of insulin pump therapy for the management of diabetes: past, present, and future of intensive therapy, DiabetesSpectrum (2019)
- Insulin pump market to reach $25.4 billion by 2033 driven by rising diabetes burden and shift toward precision insulin delivery, Yahoo Finance (2026)
- Economic costs of diabetes in the U.S. in 2022, Diabetes Care (2023)
- Impact of higher insulin prices on out-of-pocket costs in Medicare Part D, Diabetes Care (2020)
- Catastrophic spending on insulin in the United States, 2017–18, Health Affairs (2022)
- Medicare patients’ out-of-pocket costs for insulin decrease under mandated caps, Johns Hopkins University (2026)
- Medicare prescription drug affordability, Centers for Medicare & Medicaid Services (2025)
- Insulin rationing persists despite policy changes, study shows, Yale University (2025)
- Report on affordability of insulin, U.S. Department of Health & Human Services (2022)
- Insulin is an extreme financial burden for over 14% of Americans who use it, Yale University (2022)
- State-level insulin copayment caps — who benefits, and what is next? JAMA Network Open (2024)
- LANTUS- insulin glargine injection, solution, DailyMed (2024)
- Insulin and weight gain: Understanding the connection, Obesity Medicine Association (2024)
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