Prevention Guidelines

The High Cost of Diabetes

The direct medical costs of diabetes have more than doubled in the last 5 years

The annual cost of diabetes in medical expenditures and lost productivity increased from $98 billion in 1997 to $132 billion in 2002, a 35% increase! The direct medical costs more than doubled during this same time from $44 billion to $92 billion (109% increase).

This study, published by the ADA in the March issue of Diabetes Care, says the nation spends $13,243 on each person with diabetes compared to $2,560 per person without diabetes. After adjusting for differences in age, sex, and race, the study showed that people with diabetes incur medical expenses 2.4 times higher than those without diabetes.

Diabetes imposes a substantial cost burden to society in terms of money, poor health, and disability. Francine Kaufman, MD, president of ADA, said that the best way to reduce costs of diabetes and improve quality of life is through:

• Better use of preventive care
• Better diagnosis (6 million people in the U.S. don't even know they already have diabetes)
• More intensive disease management.

The cost estimates in lost productivity (lost work days, disability, and restricted activity) is $39.8 billion per year. Cardiovascular disease is the most costly complication of diabetes. Other major complications include eye disease and blindness, kidney disease, increased infections, foot problems, and amputations.

What can you do to prevent type 2 diabetes?

The Harvard study of 80,000 nurses for over 10 years showed that those nurses who had no risk factors for diabetes had only 1/10th the risk of developing diabetes compared to nurses with any risk factors. This finding was true even if the nurse had a family history of diabetes. This is good news! It means you can largely prevent diabetes by adopting a healthy lifestyle -- regular physical activity, maintaining a healthy weight, and good eating habits.

Here is a more detailed list of preventive actions for preventing type 2 diabetes:

• Maintain a healthy weight (BMI less than 25).
• Get 30 or more minutes of moderate to vigorous activity on most, preferably all, days of the week.
• Don't smoke.
• Limit animal fats and trans fats found in hydrogenated fats, hard stick margarine and shortening, most baked goods made from solid fats (cakes, cookies, chips), most fast foods, and most packaged or convenience foods.

In addition, the Harvard Nurses' study linked the following two dietary principles to a lower risk of diabetes and its complications such as heart disease.

• Unhydrogenated vegetable oils were protective against diabetes.
• Lower glycemic load foods reduced the risk for heart disease. They are absorbed more slowly, preventing the rapid rise of blood sugar and insulin levels that refined carbohydrates cause. Lower glycemic load foods are unrefined and higher in dietary fiber. Examples include whole grains, whole wheat bread, fresh fruits, vegetables, legumes, and nuts. High glycemic load foods include soda pop, white bread, white rice, and other more refined carbohydrate foods.

Summary
To decrease the economic impact of diabetes in your home or organization, remember these three primary strategies:

1. Encourage healthy lifestyles that prevent diabetes, especially maintaining a healthy weight and regular physical activity!

2. Encourage getting recommended health tests for early diagnosis of diabetes or prediabetes so it can be treated.

3. Encourage those with diabetes to follow careful management of their disease:

• Keeping blood sugar in a desirable range (as the doctor prescribes)
• Keep blood pressure low (130/80 or below)
• Keep blood cholesterol levels low (160 or less)
• Get recommended diabetic exams regularly as recommended: foot exams, eye exams, cholesterol checks, hemoglobin A1c test regularly as recommended by your doctor.

These tests ensure better medical care and help prevent costly complications from occurring.

References

Top

1. Tommy Thompson, HHS Secretary, press release Feb. 27, 2003 www.hhs.gov/news
2. Francine Kaufman, MD, American Diabetes Association press release, Feb. 27, 2003 www.diabetes.org
3. National Diabetes Education Program, http://www.ndep.nih.gov , 2003
4. ADA, Economic costs of diabetes in the U.S. in 2002, Diabetes Care, Mar 2003
5. ADA, The prevention or delay of type 2 diabetes, Diabetes Care, Mar 2003

Making Healthy Choices articles are written by Don Hall, DrPH, CHES president of LifeLong Health with contributions from associated health professionals. Content is general health information from evidence based research. It's purpose is not to treat disease or take the place of advice by your doctor but to promote healthy lifestyles. Persons with health problems should contact their physician for specific guidance.

Copyrighted 2003 by PrevMedix LLC. All rights reserved. Do not make unauthorized copies.

Updated: 2-27-03 DRH