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Diabetes Complications Swelling U.S. Health Costs

Posted: Friday, April 20, 2007

Poorly managed type 2 diabetes costs the U.S. health system an extra $22.9 billion a year.

Those costs come from direct medical costs to treat heart, eye, kidney and other serious health problems associated with the disease, diabetes groups reported at a meeting of the American Association of Clinical Endocrinologists.

Annual health costs for a type 2 diabetic are three times that of the average American without diagnosed diabetes, according to a new report called State of Diabetes Complications in America.

"It is a pretty significant wake-up call for people, or should be. It really points out the importance of managing the disease," said Willard Manning, a health economist at the University of Chicago who worked on the report.

"We have tools today. The fact that people are still getting complications means we are not using our tools effectively enough," said Dr. Daniel Einhorn, who serves on the board of the American Association of Clinical Endocrinologists, which sponsored the report.

Diabetic complications cost almost $10,000 per patient each year, with $1,600 of that coming from patients' own pockets for costs not covered by insurance. That figure represents quite a bite for many diabetics, nearly 40% of whom had annual income of less than $35,000 in 2005.

Treating type 2 diabetes alone costs about $37 billion a year. When people fail to follow their diet, exercise and drug treatment plans, the disease leads to complications that boost the total health bill to $57.1 billion.

"That is a substantial sum in its own right," Manning said in a telephone interview. "When you take into account where some of that is going -- heart attacks, strokes, kidney failures -- things which lead to either reductions in employment or departures from the labor force... there is a substantial amount of additional cost."

The report estimates that one out of three people with the disease has one other serious health problem. One in 10 has two other serious health problems. One out of 15 has three other serious health problems, and one out of 13 has four or more.
"If you look at the list of the complications, most of them are there because of poorly managed diabetes," Manning said. "Either the patient doesn't recognize they have it and complications develop, or they are not good about adhering to their doctor's orders," he said, adding, "We've got to do a better job of managing the disease."

Additional Findings

7.9% of diabetics have congestive heart failure, compared with 1.1% of nondiabetics, costing an average of $7,932 per year per patient;
9.8% of diabetics experience heart attacks, compared with 1.8% of nondiabetics, costing patients $14,150 per year;
9.1% of diabetics have coronary heart disease, compared with 2.1% of people without diabetes, costing patients $6,062 per year;
6.8% of diabetics have strokes, compared with 1.8% of those without diabetes, costing patients $7,806 per year;
27.8% of diabetics develop chronic kidney disease, compared with 6.1% of people without diabetes, costing patients $9,002 per year;
22.8% of diabetics have foot problems -- such as amputations and numbness -- compared with 10% of nondiabetics, costing patients $4,687 per year; and
18.9% of diabetics have eye damage, costing patients $1,785 per year
The report, which was released at the American Association of Clinical Endocrinologists annual meeting in Seattle, combined data from two large national studies between 1999 and 2004. Cost estimates were adjusted into 2006 dollars.

Source: Diabetes In Control