A new study estimated that the number of Americans living with diabetes will double over the next 25 years, tripling the cost of associated healthcare to 336 billion dollars; this is even if the proportion of people in the population with diabetes does not change, said the researchers.

The study is the work of Dr Elbert S Huang from the Department of Medicine at the University of Chicago, Chicago, Illinois, and colleagues, and a paper on it appears in the December issue of Diabetes Care.

For the study Huang and colleagues developed a “Markov model” of diabetes costs that took into account some trends that had been left out of previous models, including trends in risk factors, the natural history of the condition and the effects of treatments.

For instance, they considered changes in the diabetes population over time, including the baby boomer effect and recent surges in obesity rates in the US, and the development of complications that affect the eyes, kidneys, circulation and nervous system.

Markov modelling is an approach that is increasingly being incorporated into tools that try to forecast how complex systems might behave in the future. Applications range from the study of diseases to reliability engineering, and there are lots of different types of Markov model.

The intention was to improve existing government forecasts in order for Congress to be better equipped for considering different policy options when they debate changes to the health care system, particularly Medicare, the US government’s insurance scheme for the over 65s and people with disabilities.

The researchers said that:

“”We built this model to improve the budgetary and health outcome information available to federal policymakers.”

“The model provides a rigorous assessment of the future burden of diabetes that accounts for the natural history of the disease and recent advances in treatment,” they added.

The researchers used data on 24 to 85 year olds who took part in the US Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey and National Health Interview Survey.

The results showed that:

  • Between 2009 and 2034, the number of Americans with diagnosed and undiagnosed diabletes will rise from 23.7 to 44.1 million.
  • The distribution of obesity in the population will not change: with about 65 per cent of people being overweight or obese.
  • Over the same 25 years, annual spending on healthcare related to diabetes is expected to rise from 113 billion to 336 billion dollars (in 2007 dollars).
  • For those eligible for Medicare, the diabetes population is expected to increase from 8.2 to 14.6 million over the 25 years.
  • The diabetes-related Medicare spending is also expected rise over this period from 45 to 171 billion.

Huang and colleagues concluded that:

“The diabetes population and the related costs are expected to at least double in the next 25 years.”

“Without significant changes in public or private strategies, this population and cost growth are expected to add a significant strain to an overburdened health care system,” they added.

“Projecting the Future Diabetes Population Size and Related Costs for the US.”
Elbert S. Huang, Anirban Basu, Michael O’Grady, and James C. Capretta.
Diabetes Care December 2009, vol. 32 no. 12, pp 2225-2229 .

Additional source: American Diabetes Association.

Written by: Catharine Paddock, PhD