Diabetes complications hiking U.S. health costs

Diabetes complications hiking U.S. health costs
Type 2 diabetics spend three times as much on care

Updated: 2:39 p.m. ET April 10, 2007

CHICAGO - Poorly managed type 2 diabetes costs the U.S. health system an
extra $22.9 billion a year in direct medical costs to treat heart, eye,
kidney and other serious health problems associated with the disease,
diabetes groups reported on Tuesday.

Annual health costs for a type 2 diabetic are three times that of the
average American without diagnosed diabetes, according to a new report
called State of Diabetes Complications in America.

"It is a pretty significant wake-up call for people, or should be. It

really points out the importance of managing the disease," said Willard
Manning, a health economist at the University of Chicago who worked on
the report.
About 20.8 million Americans have diabetes, which causes about 5 percent
of all deaths globally each year.

Most have type 2, or adult-onset diabetes, in which the body loses its
ability to use insulin.

Obesity and lack of exercise are linked with type 2 diabetes, which can
cause blindness, heart disease, stroke, chronic kidney disease and foot
problems that can require amputations.

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"We have tools today. The fact that people are still getting
complications means we are not using our tools effectively enough," said
Dr. Daniel Einhorn, who serves on the board of the American Association
of Clinical Endocrinologists, which sponsored the report.

Einhorn said diabetes continues to be the leading cause of blindness.
Two thirds of people with diabetes get heart disease or stroke, and
death rates are two to four times higher in adults with diabetes than
without.

Costly complications
Diabetic complications cost almost $10,000 each year, with $1,600 of
that coming from patients’ own pockets for costs not covered by insurance.

That figure represents quite a bite for many diabetics, nearly 40
percent of whom had annual income of less than $35,000 in 2005.

Treating type 2 diabetes alone costs about $37 billion a year. When
people fail to follow their diet, exercise and drug treatment plans, the
disease leads to complications that boost the total health bill to $57.1
billion.

"That is a substantial sum in its own right," Manning said in a
telephone interview.

"When you take into account where some of that is going — heart attacks,
strokes, kidney failures — things which lead to either reductions in
employment or departures from the labor force … there is a substantial
amount of additional cost."

The report, which was released at the American Association of Clinical
Endocrinologists’ annual meeting in Seattle, combined data from two
large national studies between 1999 and 2004. Cost estimates were
adjusted into 2006 dollars.

The report estimates that one out of three people with the disease has
one other serious health problem. One in 10 has two other serious health
problems. One out of 15 has three other serious health problems, and one
out of 13 has four or more.

"If you look at the list of the complications, most of them are there
because of poorly managed diabetes," Manning said.

"Either the patient doesn’t recognize they have it and complications
develop, or they are not good about adhering to their doctor’s orders,"
he said, adding, "We’ve got to do a better job of managing the disease."

Almost 21 million Americans have diabetes, a disease that affects the
body’s ability to manage glucose, or blood sugar.

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