One in four American adults suffer from pre-diabetes, at a cost of more than $25 billion a year in increased medical services, according to new data from The Lewin Group.
More than 180,000 pregnant women are also diagnosed with gestational diabetes, and healthcare costs attributed to the condition are estimated at $623 million a year, a companion study showed.
The American Diabetes Association (ADA) published a cost study in 2008 that estimated the total direct and indirect costs of diagnosed diabetes in the United States at $174 billion. The National Changing Diabetes Program (NCDP) recently engaged The Lewin Group to provide a more comprehensive assessment of the annual cost of diabetes by expanding the current economic research model to include undiagnosed diabetes, gestational diabetes and pre-diabetes.
According to the expanded study, these additional costs brought the nation's total diabetes-related medical expenses and lost productivity in 2007 to $218 billion.
"We are only beginning to grasp the full economic impact of diabetes," said George Huntley, chairman of the board for the ADA. "For the first time we can demonstrate that healthcare costs begin to rise long before diabetes has developed. Both of these early conditions are associated with significant increases in the use of healthcare services and expenses. Yet with aggressive intervention, both can be averted or at the very least delayed."
The studies were conducted by The Lewin Group and appear in the current edition of Population Health Management. Both studies tracked medical claims filed between 2004 and 2006 to identify patients with pre-diabetes and gestational diabetes and compared their healthcare use with a reference population.
"These cost estimates are likely to understate the real economic burden of pre-diabetes and do not take into account the reduced quality of life associated with pre-diabetes," said Yiduo Zhang of The Lewin Group, the lead author of the pre-diabetes study. "Even before type 2 diabetes develops, we found that the everyday life of people with pre-diabetes is being affected."
According to the study, as many as 83 percent of people with impaired glucose tolerance may develop diabetes unless they take significant steps to lose weight, eat right and exercise more. The total annual cost of pre-diabetes to the nation's healthcare system is more than $25 billion, or $443 for each adult suffering from the condition, according to the study.
"It is absolutely critical that we understand the economic impact of diabetes on the nation so that we can develop healthcare policies that can effectively support the necessary behavior change and aggressive medical management needed to stem the diabetes epidemic," said Dana Haza, senior director of NCDP, an initiative created by Novo Nordisk to drive systems change at the national and local level.
Gestational diabetes mellitus (GDM) affects 4.5 percent of pregnancies that result in deliveries and is associated with significantly higher rates of medical complications for both mother and newborn. The condition costs an estimated $636 million in 2007, or $3,305 per pregnancy plus $209 in the newborn's first year of life. More than a third (36 percent, or $230 million) of these costs are carried by government programs such as Medicaid.
"The effects of gestational diabetes can be seen for decades and take a tremendous toll on the health and well being of both mother and child," Haza said.