OBJECTIVES: Applying geographic Information System (GIS) techniques in health researches become an important new tool for data analysis. We aimed to use GIS to examine the relationship between utilization trends of incretin-based and peptides therapies (IBPTs) and prevalence of diabetes at state-level among the U.S. Medicaid population. METHODS: A descriptive, retrospective study design focusing on IBPTs prescriptions in Medicaid program was performed for four longitudinal years of 2007, 2010, 2013, and 2015. Annual number of prescriptions of IBPTs were extracted from the national Medicaid pharmacy database provided by the Centers for Medicare & Medicaid Services (CMS). Annual age-adjusted prevalence of diagnosed diabetes at state-level were obtained from Center for Disease Control and Preventions (CDC). US maps were presented using US Cartographic boundary shapefile which downloaded from Census Bureau’s MAF/TIGER geographic database. Special analysis using ArcMap 10.5.1 were performed to create choropleth maps for diabetes prevalence, and point maps for IBPTs number of prescriptions. RESULTS: There were gradual increases in the prevalence and utilization of IBPTs in all around the US especially in the eastern and southern regional states. Not all states with high prevalence of type 2 diabetes have high utilization of IBPTs, such as Mississippi, Kentucky and West Virginia which prevalence of diabetes ranged between 12% to 14%. In 2015, while the top three states that have the highest number of IBPTs prescriptions were NY (502,086), CA (343,961), and OH (130863), the top three states with the highest prevalence of diabetes were PR (14.7%), MS (13.6%), WV (12.5%). CONCLUSIONS: States located in the east coast have high utilization of IBPTs more than the southern states where the prevalence of the diabetes is the most. Studying the spatial distribution and trends of each IBPTs individually and compare it to the standard diabetes medications would provide a better understanding of current practice.