Diabetes to become most expensive disease

A doctor (L) checks the blood sugar level of a passerby at a free blood sugar level check-up camp.


Tess Vigeland: A new study's out today from the insurance company UnitedHealth about the economic cost of diabetes in this country. And where do I begin?

Diabetes is projected to cost $500 billion by 2020. That's a tenth of all health care spending -- $3.4 trillion in total costs over the next 10 years. I read those numbers and asked Gregory Warner to parse them from our Marketplace health desk at WHYY. Hi Gregory.


Vigeland: Tell me a little bit about this study first of all: how does diabetes cost so much?

WARNER: Well basically if you break down the numbers pretty roughly, about a sixth of that money goes actually to treat diabetes and another third goes to diabetes-related diseases and complications like heart disease. But then a lot of the burden of disease is actually not medical; it's just things like lost productivity and extra time and money spent by families for care. And when you consider the number of people with diabetes, and the age getting younger and younger, that's when the costs start adding up.

Vigeland: Boy, apparently they really do. But still -- a tenth of the country's health care spending is going to diabetes? That's the prediction here. That would make diabetes the most expensive disease there is, wouldn't it?

WARNER: Yeah, when you factor in all the costs, it might be. But curiously, as I researched this, Alzheimer's is also up there. Again, because of all the complicating factors: the extra care, the nursing homes, and unpaid time to spouses and children. I talked to Joel Hay, he's an economist at the University of Southern California:

Joel Hay: Alzheimer's and diabetes, if nothing changes, will bankrupt our society. And whether we go through diabetes or Alzheimer's, I think it's kind of moot.

Vigeland: Gregory, he sounds almost cheerful there.

WARNER: Well there's a gallows humor shared by most health economists.

Vigeland: But he does bring up a good question. I read these numbers, I don't want bankruptcy, but what am I supposed to do?

WARNER: Well right, because you're not going to read $500 billion and then not buy a sugar doughnut.

Vigeland: Well maybe I would.

WARNER: You would, Tess. The rest of us, I'm not sure. Ultimately, though, who do these numbers matter to? They matter to Congress; these are the numbers that end up in the first paragraph of those congressional reports. And even more importantly, they're the numbers considered by the NIH -- the National Institutes for Health -- when they decide how to allocate research dollars. I mean, in fact, the best example of this might be the early estimates of the costs of HIV/AIDS in the late '80s. Those numbers turned out to be totally overblown, but they resulted in a huge amount of dollars -- way more than was spent on cancer and any other disease -- pouring in and now, look, we have a disease that was once a death sentence. It's now something you can live with if you have access to the meds.

Vigeland: So you talk about the cost, and you build up the funding.

WARNER: Exactly. And as you mentioned, people do get numb to all these numbers, hearing about the billions, the trillions. So there's also this image problem that the disease has. A number of advocacy organizations, because next month is National Diabetes Month, they're prepping campaigns that are going to emphasize that you can die from diabetes -- you know, heart disease, heart failure, organ failure. So they want to change that image of diabetes as something you sort of shuffle around with to something that you die from. Look, telling people that you're going to die does sometimes change their behavior, but it definitely raises funding.

Vigeland: All right. Marketplace's Gregory Warner joining us from Philadelphia. Thanks.

WARNER: Thanks Tess.

About the author

Gregory Warner is a senior reporter covering the economics and business of healthcare for the entire Marketplace portfolio.
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so, how would cutting the Federal subsidies to archer daniels midland et al for high fructose corn syrup, help to save money while cutting down on diabetes and cut costs there as well?

Thank you for this story.

The fact that diabetes is largely a preventable disease is a huge wake-up call to this country. We cannot afford poor eating habits no longer -- on the personal or national level. We also can no longer afford to leave the health of our citizens up to specialists who lack cross-disciplinary knowledge.

Case in point: One factor in diabetes that is largely not understood by physicians is untreated ADHD. ADHD is associated with higher rates of obesity, research shows, and while many people with ADHD do exercise many others don't. Maintaining an exercise routine requires a high level of motivation and remembrance of consequences, which many adults with ADHD simply do not have.

Many people with unrecognized/untreated ADHD symptoms "self-medicate" with food or in other ways lack the internal signaling that says "stop eating, you've had enough."

Telling people with ADHD to stop doing this without providing adequate medical treatment, is not going to work. ADHD is all about impulsive and inattentive behavior -- not learning from consequences. Consequences can seem too far off in the future to have any relevant influence on immediate behavior.

Education campaigns will go only so far. GPs need to become more aware of the red flags for ADHD. instead, research shows that GPs are uncomfortable in their ability to recognize and treat ADHD.

It's time to change that -- for many cases of diabetes (as well as substance use disorders, lack of fitness caused by low motivation to exercise, cigarette-smoking, and even hypertension) are related to untreated ADHD.

Thank you,
Gina Pera, author/advocate
Is It You, Me, or Adult A.D.D.?

Sigh ...
Why is it so very hard for you smart, articulate journalists to slip the simple phrase "Type 2" into your reporting on "diabetes"?
As we were listening to your report of the cost, presumed avoidable, of "diabetes" my 12 year old daughter was carb counting her dinner, as we have for ever single bit of food to pass her lips since she was diagnosed with Type 1 diabetes at the age of 4.
Please. Please! It's so hard to be a kid with this relentless and exhausting disease, does she really need to hear you imply that her unavoidable autoimmune disease is going to bankrupt the system? Really?
It's a small thing I ask of you. Much less than I have asked of her over the past 8 years as she has endured uncountable injections and blood sugar checks.
You can do better.

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