OBJECTIVES: Cost-utility analysis in diabetes requires utility estimates for diabetic complications. Models frequently rely on UKPDS data. UK requirements for preference elicitation have changed since UKPDS publication. We conducted a systematic review of the literature to identify utility values for diabetes complications suitable for use in Health Technology Assessment (HTA). METHODS: A systematic search of online databases was conducted using key words relating to diabetes, major complications, utility assessment and quality of life. Reference lists of identified citations were reviewed. Studies reporting utility single-index measures in patients with any of 33 pre-specified diabetes related states were included: states considered were diabetic complications and adverse events associated with anti-diabetic therapies (AEs).  Papers were qualitatively assessed: criteria included relevance of studied population to Type 1 or Type 2 diabetes, sample size, methodological quality and consistency with current UK HTA guidelines. Comorbidity is common in diabetes: methodology papers addressing combination of utility values were identified in a structured search and reviewed. RESULTS: The search returned 3024 hits, 169 articles were reviewed and 32 publications were identified as suitable for review. Utility or disutility values suitable for UK HTA were obtained for 23 diabetes states. For 10 complications, including late stage renal disease and some AEs, no utility value were identified that met UK HTA criteria. There is no consensus in the literature on how utility measures should be combined in patients with more than one complication. CONCLUSIONS: We identified a set of utility values suitable for economic analysis for HTA in diabetes. To further inform UK HTA, additional research should create robust utility values for diabetic renal disease, and evaluate the empirical accuracy of alternative methods of combining utility values in patients with multiple complications.