Diagnosed diabetes cost the United States an estimated $245 billion in 2012, according to new research released by the American Diabetes Association (ADA) this week. The new figure represents a 41% rise in five years. In 2007, when the cost were last estimated, it came to $174 billion.

A report on the research, commissioned by the ADA, was published online before print in Diabetes Care on 6 March.

The study examines the increased financial cost, use of health resources and productivity that is lost due to diabetes in 2012, and breaks down the figures by gender, race/ethnicity, for the whole country and state by state.

The $245 billion includes $176 in direct medical costs (such as hospital and emergency care, visits to the doctor, and medications), and an estimated $69 billion resulting from indirect costs like absenteeism, reduced productivity, diabetes-related job loss, and productivity loss due to premature deaths.

The rate of diabetes has reached epidemic proportions in the US, where nearly 26 million adults and children have the serious, life-threatening disease, and another 79 million are estimated to have prediabetes, a cluster of risk factors that puts them at greater risk for developing type 2 diabetes.

Robert Ratner, ADA's Chief Scientific & Medical Officer, says in a statement:

"As the number of people with diabetes grows, so does the economic burden it places on this country."

The study finds that medical expenditure for people with diabetes is about 2.3 times higher than for people who don't have the disease and that the main driver of the increased overall financial burden on the country is the rise in proportion of the population that has the disease.

"The cost of diabetes is rising at a rate higher than overall medical costs with more than one in 10 health care dollars in the country being spent directly on diabetes and its complications, and more than one in five health care dollars in the US going to the care of people with diagnosed diabetes," says Ratner.

He also explains that one of the key factors behind the increase is that there are now many more people being treated for diabetes in the US than ever before.

But, he also points out that while treating the disease is expensive, the main driver of cost is the increase in prevalence and the fact it is rising "dramatically".

The report also shows that:
  • 64% of diabetes care in the US is met by government insurance (Medicare, Medicaid and the military).

  • The remaining cost is met by private health insurance (34.4%) or uninsured people (3.2%).

  • Cost per head in 2007 was $6,649, compared with $7,900 in 2012; an increase of 19% over five years.

  • Cost per head is higher for women than for men ($8,331 and $7,458 respectively).

  • Cost per head is higher among non-Hispanic blacks ($9,540) than among non-Hispanic whites ($8,101), and lower among Hispanics ($5,930).

  • California is the state with largest number of people with diabetes and carries the highest cost burden of $27.6 billion.

  • But, even though Florida has a smaller population than California, Texas and New York, at $18.9 billion it has the second highest cost burden for diabetes.
The study concludes that these figures show the "substantial burden that diabetes imposes on society".

However, it points out the disease also imposes other, less obvious burdens on society, such as pain and suffering, the care provided by unpaid caregivers, and the costs associated with undiagnosed diabetes.

Looking to the future, it doesn't look like the figures are going to level off anytime soon.

"Recent estimates project that as many as one in three American adults will have diabetes in 2050," says Ratner.

"These numbers are alarming and further highlight the need for our nation to address this epidemic," he urges.

A study from the NIH and the CDC published in February, finds that the number of Americans meeting their diabetes goals - blood sugar, blood pressure and cholesterol - has increased considerably over a 12-year period.

Written by Catharine Paddock PhD