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Cited by 1,323Health Systems, Economic Evaluations, Quality of LifeDiabetes Management and ResearchHealthcare Policy and Management

Economic costs of diabetes in the U.S. in 2007

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American Diabetes Association·2008·Diabetes Care
DOI 10.2337/dc08-9017
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Abstract

OBJECTIVE—The prevalence of diabetes continues to grow, with the number of people in the U.S. with diagnosed diabetes now reaching 17.5 million. The objectives of this study are to quantify the economic burden of diabetes caused by increased health resource use and lost productivity, and to provide a detailed breakdown of the costs attributed to diabetes. RESEARCH DESIGN AND METHODS—This study uses a prevalence-based approach that combines the demographics of the population in 2007 with diabetes prevalence rates and other epidemiological data, health care costs, and economic data into a Cost of Diabetes Model. Health resource use and associated medical costs are analyzed by age, sex, type of medical condition, and health resource category. Data sources include national surveys and claims databases, as well as a proprietary database that contains annual medical claims for 16.3 million people in 2006. RESULTS—The total estimated cost of diabetes in 2007 is $174 billion, including $116 billion in excess medical expenditures and $58 billion in reduced national productivity. Medical costs attributed to diabetes include $27 billion for care to directly treat diabetes, $58 billion to treat the portion of diabetes-related chronic complications that are attributed to diabetes, and $31 billon in excess general medical costs. The largest components of medical expenditures attributed to diabetes are hospital inpatient care (50% of total cost), diabetes medication and supplies (12%), retail prescriptions to treat complications of diabetes (11%), and physician office visits (9%). People with diagnosed diabetes incur average expenditures of $11,744 per year, of which $6,649 is attributed to diabetes. People with diagnosed diabetes, on average, have medical expenditures that are ∼2.3 times higher than what expenditures would be in the absence of diabetes. For the cost categories analyzed, ∼$1 in $5 health care dollars in the U.S. is spent caring for someone with diagnosed diabetes, while ∼$1 in $10 health care dollars is attributed to diabetes. Indirect costs include increased absenteeism ($2.6 billion) and reduced productivity while at work ($20.0 billion) for the employed population, reduced productivity for those not in the labor force ($0.8 billion), unemployment from disease-related disability ($7.9 billion), and lost productive capacity due to early mortality ($26.9 billion). CONCLUSIONS—The actual national burden of diabetes is likely to exceed the $174 billion estimate because it omits the social cost of intangibles such as pain and suffering, care provided by nonpaid caregivers, excess medical costs associated with undiagnosed diabetes, and diabetes-attributed costs for health care expenditures categories omitted from this study. Omitted from this analysis are expenditure categories such as health care system administrative costs, over-the-counter medications, clinician training programs, and research and infrastructure development. The burden of diabetes is imposed on all sectors of society—higher insurance premiums paid by employees and employers, reduced earnings through productivity loss, and reduced overall quality of life for people with diabetes and their families and friends.

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Crossref · 10.2337/dc08-9017

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  • Persons with diabetes are three times more likely to be hospitalized than those without diabetes.

    “Persons with diabetes are three times more likely to be hospitalized than those without diabetes, and approximately 25% of hospitalized patients (including people without a history of diabetes) have hyperglycemia (62–65).”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [62]

    The paper reports higher hospital use among people with diabetes (Health resource use attributed to diabetes, p. 2), supporting the direction of the comparison. It does not establish the claimed threefold likelihood of hospitalization: its admission-rate comparisons vary by age and condition, from about twice as high for men aged 18–44 to 5% higher for men aged 70 and older for general medical conditions (p. 11). (LLM, conf=0.86)

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  • Approximately 25% of hospitalized patients (including people without a history of diabetes) have hyperglycemia.

    “Persons with diabetes are three times more likely to be hospitalized than those without diabetes, and approximately 25% of hospitalized patients (including people without a history of diabetes) have hyperglycemia (62–65).”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [62]

    The Health resource use section (p. 10) estimates that people with diabetes incurred 22% of U.S. hospital inpatient days; that is not a measure of hyperglycemia among hospitalized patients. Searches for the 25% figure and for hyperglycemia in patients without a history of diabetes found no passage addressing the claim. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • Approximately 25% of hospitalized patients, including people without a history of diabetes, have hyperglycemia.

    “Persons with diabetes are three times more likely to be hospitalized than those without diabetes, and approximately 25% of hospitalized patients (including people without a history of diabetes) have hyperglycemia (62 -65).”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [62]

  • Persons with diabetes are three times more likely to be hospitalized than those without diabetes.

    “Persons with diabetes are three times more likely to be hospitalized than those without diabetes, and approximately 25% of hospitalized patients (including people without a history of diabetes) have hyperglycemia (62 -65).”

    From Hypoglycemia and Diabetes: A Report of a Workgroup of the American Diabetes Association and The Endocrine Society (2013) · cites this paper as [62]

  • At least 25% of subjects with T2DM are undiagnosed.

    “Yet at least 25% of subjects with T2DM are undiagnosed, 18 and they are often concentrated within a hypertriglyceridemic population.”

    From Triglycerides and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2011) · cites this paper as [18]

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Cites

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Research works printed but not linked: 1

  1. [15]15. Brown DA, Unrein C: A review of cardiovascular comorbidities of diabetes. Am J Managed Care 13:3-10, 2007

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Authors
American Diabetes Association
Affiliations
American Diabetes Association (US)
Corresponding author
American Diabetes Association
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2008-03-01
Volume
31
Issue
3
Pages
596-615
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc08-9017
OpenAlex
W4246288537
Cited by
1,323
References
32
Citations by year
2026: 4 · 2025: 10 · 2024: 11 · 2023: 25 · 2022: 19 · 2021: 26 · 2020: 21 · 2019: 33 · 2018: 38 · 2017: 50 · 2016: 79 · 2015: 75 · 2014: 95 · 2013: 130 · 2012: 157
FWCI
58.80
Type
journal article
Language
en
Open access
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
Keywords
diabetes mellitus, economic burden of disease, health care costs, productivity loss, absenteeism, unemployment, diabetes complications, inpatient care, economic burden, diabetes prevalence, early mortality, employer-sponsored health insurance, physician visits
MeSH terms
Diabetes Mellitus, Humans, United States, Health Care Costs, Cost of Illness, Diabetes Complications

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