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74 percent increase over five years in the economic burden of prediabetes

Diabetes prevalence, cost data broken down by state and by type of elevated blood glucose (diagnosed, undiagnosed, prediabetes and )

The economic burden of diabetes in America continues to climb, exceeding more than $322 billion in excess medical costs and lost productivity in 2012, or more than $1,000 for every American, according to a study being published in the December issue of that also includes a state-by-state breakdown of the prevalence and costs associated with diabetes. Additionally, increased costs associated with prediabetes and highlight the growing importance of prevention and early intervention.

The study, which follows up on a similar report published in 2010 and expands upon data released last year, shows a 48 percent overall jump in direct and indirect costs associated with diabetes over just five years. The estimates include the financial impact from those diagnosed with diabetes (21 million people) as well as the undiagnosed (8.1 million people), those with gestational diabetes (approximately 222,000 people) and adults with prediabetes (86 million people), a condition in which blood glucose levels are elevated but not yet high enough for a diagnosis of diabetes. It breaks down into $244 billion in excess medical costs (including physician’s office and hospital visits, prescription drugs and costly health conditions, such as hypertension and renal complications) and $78 billion in reduced productivity.

The researchers estimate that 27 percentage points of the 41 percent increase in medical costs stems from the growing number of people being diagnosed with diabetes in America, and that 14 percentage points of that rise comes from growth in the average cost per case of diabetes. However, an editorial in the same issue called the study “alarming” in that it shows a dramatic rise in costs for those with prediabetes and undiagnosed diabetes. Building on their work from 2007, the researchers found that over five years, the cost of prediabetes increased 74 percent (to $44 billion) while the cost of undiagnosed diabetes rose a staggering 82 percent (to $33 billion).

“These statistics underscore the importance of finding ways to reduce the burden of prediabetes and diabetes through better prevention and treatment,” said lead investigator Timothy M. Dall, MS, Managing Director with IHS Life Sciences. “The costs, in both financial and quality of life terms, are exceptionally high and in many cases could be preventable.”

“The concern remains that these are conditions for which, as a medical community, we may not have a heightened awareness or have sufficient plans to address,” the editorial writers noted.

The editorial writers – including Diabetes Care Editor William T. Cefalu, Managing Director of Medical Information Matthew P. Petersen, and the Association’s Chief Scientific and Medical Officer Dr. Robert E. Ratner, MD — conclude this study bolsters the need for intervention during the prediabetes stage, noting that there are both clinical and financial reasons to identify people with prediabetes. Previous studies, notably the landmark Diabetes Prevention Program, have shown that making lifestyle changes that include losing weight, increasing physical activity and changing one’s diet can greatly reduce the risk for type 2 diabetes.

“We believe that identifying prediabetes is worthwhile from both a clinical and a public health standpoint,” they wrote. “The need to identify those with undiagnosed diabetes is even more pressing,” they noted, because untreated diabetes can lead to numerous costly health complications, such as heart and kidney disease, nerve damage and vision problems.

“The crisis is worsening,” the editorial concludes. “The time to act is now. These data clearly should signal a call for action.”


The study also includes state-by-state data on diabetes prevalence and economic burden. Across the nation, the study found prevalence for diagnosed and gestational diabetes was highest in many of the southern states (Alabama, Florida, Kentucky and Mississippi) and West Virginia, and lowest in the mountain and western states (Alaska, Colorado, Montana, Utah) as well as Minnesota and Vermont. Geographic variations in economic burden reflect variations in prevalence, earnings and cost for medical care.

American Diabetes Association