The Economic Imperative to Conquer Diabetes
- Judith Fradkin, MD and
- Griffin P. Rodgers, MD, MACP
- From the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
- Address correspondence and reprint requests to Judith Fradkin, MD, Division of Diabetes, Endocrinology and Metabolic Diseases, NIDDK, NIH, 3100 Center Dr., 31/9A27, Bethesda, MD 20892. E-mail: jf58s{at}nih.gov
The new data presented in this issue (1) estimating the 2007 economic cost of diabetes in the U.S. at $174 billion are sobering. One in five health care dollars is spent caring for someone with diabetes, and one in ten dollars spent on health care is attributable to diabetes and its complications. In addition to the $116 billion in excess medical expenditures, the loss to the nation in economic productivity is $58 billion. Yet, even these staggering totals are incomplete because the American Diabetes Association (ADA)-commissioned study excludes unknown costs such as those associated with undiagnosed diabetes (about one in four people with diabetes) and the unpaid care and associated loss of productivity of family members.
This study also does not consider the costs of pre-diabetes, which affects 54 million Americans (2) and modestly increases cardiovascular disease risk (3), because there is inadequate information to assess its impact on medical costs or productivity. Nonetheless, the looming risk of diabetes (up to 70% of individuals with pre-diabetes will progress to diabetes) (3) and longitudinal data demonstrating an association between glucose level in middle age and future Medicare charges (4) portend even higher future economic costs. In today's U.S. population, about one in five individuals over age 60 years has diabetes, but one in three Americans born in 2000 is projected to develop diabetes over their lifespan (5).
Increased prevalence of overweight and obesity and sedentary lifestyle are well-recognized drivers of the epidemic of type 2 diabetes in the U.S. and worldwide, together with an aging and more diverse American population. While attention has focused on increasing rates of obesity and, consequently, type 2 diabetes in children and young adults, the incidence of type 1 diabetes is also rising and the age of onset falling in the U.S. and Europe (6 …
