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November 28, 2009 in Nation/World
Diabetes cases, costs to surge
Spending could triple by 2034, study finds
CHICAGO – Even if the percentage of Americans who are obese stays the same, diabetes cases will nearly double in the U.S. in the next 25 years and the cost of treating the disease will almost triple, according to a new study by researchers based at the University of Chicago.
The study, published Friday in the journal Diabetes Care, found the number of people with diagnosed and undiagnosed diabetes will climb from almost 24 million this year to about 44 million in 2034. Over the same period, annual diabetes-related treatment costs are expected to increase from $113 billion to $336 billion in 2007 dollars.
Alarmingly, Medicare spending on diabetes is expected to jump from $45 billion to $171 billion and could exceed current projections for all Medicare costs, the researchers said. Much of the increase in cases and costs will be driven by aging baby boomers, the 77 million Americans born between 1946 and 1964.
“It’s a combination of the increasing numbers of people who have diabetes along with the cost of treating diabetes that gives us these frightening numbers,” said study co-author Dr. Elbert Huang, professor of medicine at the University of Chicago. “The study reinforces the importance of public health efforts to prevent diabetes – by transforming the way we eat and increasing the amount of exercise we do – and emphasizes the importance of finding new ways of treating diabetes efficiently.”
Huang also said the study’s findings could be considered conservative because the researchers’ estimates are based on stable obesity rates.
The number of people becoming obese has risen steadily for many years, though the authors predict that obesity levels among people who don’t have diabetes will top out in the next decade, then decline slightly, from 30 percent today to about 27 percent by 2033.
Costs related to diabetes are rising in part because the disease is striking people at younger ages, which can mean more time to develop expensive complications. Diabetes is the leading cause of blindness, amputations and end-stage kidney disease.
“The study was entirely consistent … with previous reports that the growth in diabetes is substantial and ever-increasing, and the costs of diabetes also are substantial and ever-increasing,” said Dr. David Kendall, chief scientific and medical officer for the American Diabetes Association.
Earlier this month, a separate team of researchers at Loyola University Health System reported that more diabetics are becoming morbidly obese. It found that one in five people with Type 2 diabetes are morbidly obese, or 100 pounds or more overweight.
About 90 percent of diabetics have Type 2, which occurs when the body becomes resistant to the effects of insulin or doesn’t make enough insulin. Type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone needed to allow glucose in the food we eat to enter cells to produce energy.
Dr. Holly Kramer, lead study author and professor of preventive medicine at Loyola University Medical Center, said the two studies go hand-in-hand because obesity is the main environmental risk factor for diabetes.
The greatest growth in obesity has been among obese diabetics who are getting heavier, Kramer said. Focusing solely on overall obesity rates minimizes the magnitude of a massive public health problem, she and her colleagues wrote in their report, published online in the Journal of Diabetes and its Complications.
“When you are 100 pounds or more overweight, losing a substantial amount of weight and keeping it off is incredibly difficult,” Kramer said. “The cost of care is going to rise substantially because these people are going to have co-morbid conditions in addition to their diabetes – likely more than one – such as heart disease, end-stage kidney disease, arthritis, sleep apnea and fatty liver disease.”
Kramer and colleagues reported that about 62 percent of adults in the U.S. with Type 2 diabetes are obese and about 21 percent are morbidly obese.
Obesity is defined in terms of body mass index, a measure of body fat based on height and weight.
Obama honors Medal of Freedom recipients as heroes 
Ninch on November 28 at 8:30 a.m.
Too bad this article was not released before the Thanksgiving pig out. I understand diabetes and its complications… and that some people are more genetically inclined to get diabetes (e.g. Native Americans)….but I do not understand how overall Americans can afford (both health and financial costs) to become morbidly obese. It takes a lot of time, money, and effort to eat that much food to become that obese. I bet a lot of it is eating out every meal (and it includes all eating out…not just at fast food joints). I love food, but I have ended up leaving restaurants before ordering because I was repulsed from observing obese people literally “pigging out.” May I suggest behavior change treatment to include learning good table manners in addition to eating smaller portions?
Here are some other suggestions:
1. An educational campaign that focuses on eating 6 small meals a day, which results in fewer calories consumed and more level blood sugar. One never really feels hungry.
2. A return to the original food pyramid (or similar) which is understandable and reasonably easy to remember so that when people choose what to eat they have a mental concept in mind. If one has already eaten their portions of meat or breads/cereals then one needs to focus on what is remaining. The “new” food pyramid is ridiculous and not even constructed as a pyramid!
3. Replace the dreaded word “exercise” with “physical activity.” There are so many healthy ways to get the latter without having to use a gym, and most of which can be incorporated into one’s day without setting aside a time slot.
Bottom line: Changes in behavior that are easily doable reap results right away. Focus on small incremental steps and before one knows one is leading a healthy lifestyle…losing fat, building muscle, and getting needed nutrition. Replace the lectures and health threat scares (which seldom work and depress most people) with illustration of the benefits of feeling better (physically and emotionally).
SugarShane on November 28 at 11:54 a.m.
Ninch, good luck with that. The information has been out there for some time, but like ciggarettes or alcohol, to most people, the risks dont outweigh the benefits. I can sympathize with leaving after being made ill by watching really fat people eat. I want to yell out WHAT are you doing every time I see someone really fat at McD’s. If one day being fat becomes as obnoxious as smoking, maybe people will finally criticize fat people publically like smokers. Oh and btw, the food pyramd is wrong, no one needs a “meat” catagory. You need meat maybe once a month, not with every meal as the meat sellers would have you believe, and thats excluding red meat.