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The reduced productivity and expenses associated with diabetes costs the U.S. economy more than $174 billion a year, according to a series of articles in the recent issue of Population Health Management.
The articles come during a time where debates on how to control medical costs are dominating the news as President Barack Obama and the Congress attempt to reform the delivery of healthcare in the U.S.
One of the reports shows that in 2007, the cost for caring for patients with diagnosed diabetes was $174 billion, while those with pre-diabetes was $25 billion. If you add in gestational diabetes, the total monetary impact of diabetes is $218 billion.
"We are only beginning to grasp the full economic impact of diabetes," said George Huntley, chair of the board for the American Diabetes Association. "For the first time we can demonstrate that health care costs begin to rise long before diabetes has developed. Both of these early conditions -including pre-diabetes and gestational diabetes - are associated with significant increases in the use of health care services and expenses. Yet with aggressive intervention, both can be averted or at the very least delayed."
Pre-diabetes is a precursor to type 2 diabetes characterized by elevated glucose levels, either fasting blood glucose levels of 100 to 125 mg/dl or oral glucose levels of 140 to 200 mg/dl. It affects one in four adults, or an estimated 57 million Americans and can be detected easily by blood glucose tests. According to the study, as many as 83 percent of people with impaired glucose tolerance will eventually develop diabetes without significant lifestyle intervention.
People with pre-diabetes have higher rates of medical visits compared to people with normal blood-sugar levels, according to the study. They also seek medical attention for high blood pressure as well as metabolic and renal complications at a higher rate than people without pre-diabetes.
Specifically, the study showed that people with pre-diabetes had 34 percent more ambulatory visits associated with their condition than the reference population, including 92 percent more visits for hypertension and 9 percent more visits for cardiovascular disease. This additional health care usage translated to an additional physician visit and two additional prescriptions per year for each person with diabetes.
Gestational diabetes affects 4.5 percent of pregnancies that result in deliveries and is associated with risks of medical complications for both mother and newborn. The study found the condition cost an estimated $636 million in 2007, or $3,305 per pregnancy. Nearly 9 percent of pregnant women over the age of 35 are likely to suffer from gestational diabetes, and the incidence of the condition is growing as a result of increasing obesity rates among women of child-bearing age. Adult offspring of mothers with gestational diabetes have a significantly increased risk of developing type 2 diabetes as well as cardiovascular disease.
"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," said study author Dana Haza.
The huge costs associated with diabetes and its related conditions lend support to previous studies showing that diabetes screening of adults could result in significant cost savings for the healthcare system, approximately $20,000 per adult.
In addition, the estimated 6.3 million people with undiagnosed diabetes were estimated to cost the medical system an additional $18 billion a year since their medical costs begin to rise in the eight years before they are diagnosed. Diabetes testing to detect these patients could lower costs by allowing more effective treatment.
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