Imagine a society where over half its people, i.e. the majority of them, are diabetic or prediabetic. There is a good chance this will happen in the USA by 2020. The estimated $3.35 trillion cost over the coming ten years is massive. A study by The Center for Health Reform & Modernization of UnitedHealth Group, an insurance company, reveals that if the current pattern continues, those figures will be a reality within the next ten years. The report offers some suggestions which may slow things down, and perhaps even turn them round.

By 2020, diabetes and prediabetes will use up approximately 10% of health care spending, the authors estimate. The current annual health care bill of $194 billion will shoot up to nearly $500 billion.

UnitedHealth says it produced the report for November’s National Diabetes Awareness month. Suggestions within it could save as much as $250 billion over the coming decade. Included are potential savings to the government in Medicare, Medicaid, and other programs of $144 billion.

It is vital that lifestyle interventions that address obesity and prevent prediabetes from developing into full blown diabetes are put into action. Medication programs to ensure proper diabetes control are also important.

Simon Stevens, executive vice president, UnitedHealth Group, and chairman of the UnitedHealth Center for Health Reform & Modernization, said:

“Our new research shows there is a diabetes time bomb ticking in America, but fortunately there are practical steps that can be taken now to defuse it. What is now needed is concerted, national, multi-stakeholder action. Making a major impact on the prediabetes and diabetes epidemic will require health plans to engage consumers in new ways, while working to scale nationally some of the most promising preventive care models. Done right, the human and economic benefits for the nation could be substantial.”

Average healthcare costs in the USA for people without diabetes stand at approximately $4,400, compared to $11,700 for those with the disease. For diabetes patients with complications, the average annual cost rises to $20,700. Add to this the impact on work productivity and employer costs and the numbers increase considerably.

Diabetes rates in the USA are growing at such a rate that it is now “one of the fastest-growing diseases in the nation.” 27 million Americans are known to have diabetes, and a further 67 million are thought to be prediabetic.

Diabetes Type 2 can sometimes have no symptoms at all. The same is the case with prediabetes. The percentage of babies born after the year 2000 who will probably have diabetes some time during their lives is extremely worrying. Diabetes significantly increases the risk of blindness, nerve damage, limb amputation, kidney disease, cancer, and heart disease.

The authors of the report explain the link between obesity and diabetes type 2 risk. Over two-thirds of US adults and 17% of children are overweight/obese. The report stresses that overweight/obesity rates are still rising, and consequently so are/will diabetes and prediabetes risk. The majority of American overweight/obese adults either have diabetes type 2 or prediabetes. The authors quote studies which have shown a doubling of type 2 diabetes risk when a person puts on 11-16 pounds of body weight. Those who gain 17 to 24 pounds triple their risk.

Deneen Vojta, M.D., senior vice president of the UnitedHealth Center for Health Reform & Modernization, who helped develop UnitedHealth Group’s Diabetes Prevention and Control Alliance, said:

“Because diabetes follows a progressive course, often starting with obesity and then moving to prediabetes, there are multiple opportunities to intervene early and prevent this devastating disease before it’s too late.”

The report offers four solutions:

Lifestyle intervention – public health initiatives and more extensive use of wellness programs could reduce diabetes/prediabetes human totals by up to ten million.

Preventing prediabetes from becoming full blown diabetes – community-based intervention programs have been shown to reduce prediabetes rates, consequently lowering eventual diabetes rates.

Medication and care compliance programs – to achieve better diabetes control. Well controlled diabetes significantly lowers the risk of complications. Another word for compliance is adherence (sticking to the treatment plan).

Public-private partnerships for lifestyle intervention strategies – the authors explain that more extensive use of public-private partnerships to develop infrastructure would have a beneficial effect on prediabetes and diabetes rates.

“The United States of Diabetes: Challenges and Opportunities in the Decade Ahead” (PDF)

Source: UnitedHealth Center for Health Reform & Modernization (UnitedHealth Group)

Written by Christian Nordqvist