OBJECTIVES: Health Technology Assessment (HTA) is mostly known for its health economic properties even though it is a multidisciplinary form of policy research examining short- and long-term consequences of the application of a health technology. There is an increased focus on ethical analyses in HTA. A descriptive analysis was conducted on diabetes HTA reports describing ethical analyses. METHODS: The NHS Centre for Reviews and Dissemination HTA database (http://www.crd.york.ac.uk/crdweb/) was searched (1991-2009) using the keyword ‘diabet*’. HTA reports in English language assessing diabetes treatments were included and screened for any type of ethical analyses. RESULTS: Of 263 HTA reports identified in the initial search, 60 met the inclusion criteria. 4 reports included a type of ethical analysis (2 from CADTH, Canada; 1 from AHTA, Australia and 1 from NZHTA, New Zealand). CADHT conducted ethical analyses on short- and long-acting insulin analogues respectively, concluding that both types of insulin analogues did not exacerbate – might even better - the psychosocial issues of diabetes, however more quality-of-life evidence were needed. In AHTA’s assessment of a continuous glucose monitoring device they described equity and access issues related to costs, and that the device could not replace standard of care, but should be used as an adjunct. NZHTA’s assessment of continuous glucose monitoring devices was also related to equity concerns, concluding a need for more affordable devices. CONCLUSIONS: Ethical analyses are sparse in diabetes, despite stated objectives of best practice and HTA definitions. In the identified cases, ethical analyses were targeted to meet patients’ needs as well as a tool to restrict access for the purpose of fair distribution in government funded healthcare systems. Further research on the methods of ethical analyses is warranted as well as the formulation of guidelines to fully estimate the value and ensure an optimal role for ethical analyses in HTA.