According to data in a report published in the December 2009 issue of Diabetes Care(1), the cost of treating diabetes will triple by 2034 reaching a staggering $336 billion annually, up from the current $113 billion. A big reason for the projected increase is that by 2034 an estimated 44.1 million Americans will be living with diabetes (up from the current 23.7 million today).  These estimates are based on zero increase in the prevalence of obesity in 25 years, and for that reason, are considered to be conservative.

A similar report was published in Sept-Oct issue of the journal Health Affairs(2) but it didn’t get the media attention of this December publication.  The methods used to make the projections published in both publications were very complex and attempted to consider direct diabetes medical costs, trends in risk factors for diabetes (such as obesity), the natural progression of the disease and the effects of treatments including recent advancements in treatments.

There are a few issues that are worrisome about this report:

1. The financial burden of diabetes will add a significant strain to an overburdened health care system and certainly will be felt no matter what direction this country heads in terms of health-care reform.
2. Medicare will be strained to the breaking point because HALF of the $336 billion spent on diabetes care annually will come from Medicare. According to the study’s authors “the projected growth in diabetes care spending exceeds current projections of spending by Medicare”.
3. According to the authors, the detailed forecasting used in this report’s analysis is not currently used by government budget analysts (causing the issue mentioned above).

“Our study strongly suggests that diabetes will grow in the coming decades, both in population size and costs, and will have significant impacts on the lives of Americans and the financial viability of programs like Medicare.”

This report was done to improve the budgetary and health outcome data available to U.S. policymakers. How this will really play out over the next 25 years is up to all of us, citizens and policymakers alike. Americans needs to take a stand on diabetes and work toward improved diabetes management (through provider care, medication, diet and exercise) to reduce costly complications, and focus on diabetes prevention through healthy eating and physical activity. This study is America’s wake-up call to action – let’s hope we are paying attention.

“In light of the sheer magnitude of costs associated with diabetes, policymakers and the public need to understand how these costs will change over the next decades and how new policies may alter these trends in costs.”

1. Huang ES, Basu A., O’Grady M, Capretta J, Projecting the Future Diabetes Population Size and Related Costs for the U.S.  Diabetes Care. 2009; 32(12) 2225-2229.

2. Huang ES, Basu A, O’Grady M, Capretta J, Using Clinical Information to Project Federal Health Care Spending. Health Affairs. 2009 28(5) 978-990.