A growing number of patients and a switch to newer medicines has brought about a doubling of England's spending on diabetes medicines.

The drugs bill from GP prescribing for diabetes hit £561 million in 2006, up seven per cent on the previous year and almost double the cost in 2002.

Across all the categories of diabetes drugs, there has been a relatively rapid switch away from older treatments towards new.

In short-acting insulins, soluble insulin (neutral insulin) has been almost entirely replaced by insulin analogues, most notably the market leader, Novo Nordisk's NovoRapid.

Meanwhile, Sanofi-Aventis' long-acting insulin analogue Lantus (insulin glargine) continued to gain a greater market share. Spending on the drug rose to around £15 million in 2006 as it replaced  isophane insulin as the standard long-acting insulin product.

Sales of newer oral medications for diabetes have also grown very rapidly, most notably GSKs Avandia. Sales in England hit £14 million in 2006, while prescriptions for Avandamet (Avandia combined with metformin) overtook Takeda's rival glitazone product Actos for the first time.

Testing strips used by patients to monitor their blood glucose is another major prescribing expense and hit a high of £35 million in 2005. The Department of Health enforced a price-cut on manufacturers in October 2006, bringing down the total cost by12%.

The figures are published in a comprehensive new report by The Information Centre, part of the NHS Prescribing Support Centre.

There are an estimated 1.7 million people in the UK with type II diabetes  representing a rise of around 200,000 since 2002. The total is expected to reach 2.1 million by 2025  a figure which has been revised downwards recently, but one which will still mean a hugely increased burden of disease on patients and the NHS.

Despite the rapid increase in spending, a new survey shows that patients with type II diabetes in the UK have the worst blood sugar control in Europe.

Research carried out for The International Diabetes Federation (and sponsored by Lilly) showed many UK patients with type II diabetes were unaware they had poor control and regarded their disease as the 'mild' form of the disease.

"There is no such thing as mild diabetes," said Simon ONeill, Director of Care, Information & Advocacy Services at Diabetes UK.

"Diabetes is a serious condition, yet this European survey highlights that this message is failing to get through.

"People with diabetes need to better understand the risks they face and work in partnership with their healthcare professionals to better control their condition."

pharmafocus@wiley.co.uk