New analysis finds cost of diabetes and pre-diabetes reached $218 billion in 2007

A new analysis found that the cost of diabetes and pre-diabetes reached $218 billion in 2007, with the exploding number of cases of type 2 diabetes responsible for the majority of the costs. The National Changing Diabetes® Program (NCDP), a program of Novo Nordisk, commissioned the analysis, published online as a Web First article today in Health Affairs and performed by researchers at The Lewin Group.

According to the study, diagnosed type 2 diabetes accounted for $174.4 billion of 2007 spending on diabetes and undiagnosed type 2 diabetes was responsible for $18 billion in costs. Spending on type 1 diabetes totaled $14.9 billion in 2007. Pre-diabetes, a state of elevated blood glucose that affects one in every four adults in the U.S. and is a precursor to diabetes, cost $25 billion. Gestational diabetes, which develops during pregnancy, was associated with $636 million in costs.

"Families dealing directly with the disease know how out-of-pocket medical expenses and reduced earnings can be fiscally disastrous, but diabetes hurts every American," said Tim Dall, managing director of The Lewin Group, who led the research. "The burden of diabetes and pre-diabetes -- $700 for every man, woman and child in the country in 2007 -- represents a hidden 'tax' that we all pay through higher insurance premiums."

The analysis examined both direct medical costs, which accounted for $153 billion in spending, and $65 billion in indirect costs associated with absenteeism and disease-related productivity losses.

Spending on each case of type 1 diabetes totaled about $15,000 in 2007. Type 2 diabetes cost nearly $10,000 per patient per year. In contrast, those with pre-diabetes required an average of only $443 in additional medical costs.

But a growing body of research has shown that low-cost pre-diabetes patients can cut their risk of developing diabetes with lifestyle modifications. The landmark Diabetes Prevention Program (DPP) trial found that lifestyle modifications including increases in physical activity and moderate weight loss in patients at risk for diabetes could cut their rate of developing diabetes by as much as 58 percent compared with a control group. Additionally, a 10-year follow-up of DPP patients published last year found that the benefits originally seen persisted for at least a decade, with individuals in the lifestyle modification intervention experiencing a 34 percent lower risk of diabetes than those who received no intervention.

"Diabetes, in the late stages, is an expensive disease to treat. Our best chance of keeping the cost of diabetes manageable is to take the lessons of the DPP and work to prevent diabetes in those at highest risk," said Michael Mawby, the chief government affairs officer at Novo Nordisk. "The only way to make this effort work on a large scale is through thoughtful, nationally funded programs."

Without intervention, costs are expected to skyrocket. Research published last year in the American Diabetes Association journal Diabetes Care projected that the country's diabetes population will double over the next 25 years and direct annual medical spending on the disease is projected to hit $336 billion by 2034.