An estimated 17.5 million Americans have diabetes, costing an
estimated $174 billion in medical and other costs, such as missed
days from work, in 2007.
The American Diabetes Association released the estimates
yesterday, updating a 2003 report that put diabetes costs at $132
billion.
In Virginia, the rate of diabetes has almost doubled since 1995.
The report says the number of Americans with diabetes is growing
at 1 million new cases a year. Reasons include an aging population
and more overweight Americans.
"When they talk about costs, they are talking about direct costs
and indirect costs," explained Dr. John N. Clore, a diabetes expert
at VCU Medical Center.
"Loss of work, loss of productivity, time off, those are indirect
costs," said Clore, a professor in the division of endocrinology and
metabolism.
"The direct costs are those related to not only the diagnosis but
treating the condition. People with diabetes, with poorly controlled
diabetes, are at increased risk for cardiac events," Clore said.
"There are a lot of costs associated with screening for
cardiovascular events and treating cardiovascular events. Similarly,
for things like eye disease, kidney disease and nerve damage -
treating and screening for them."
The American Diabetes Association report was presented during a
briefing in Washington yesterday. The researchers calculated the
estimates from several data sources.
Virginia's increased numbers of diabetics are a result of a
combination of factors.
"The rate in 1995 was 3.9 percent of adults," said Ann Forburger,
project manager for the Diabetes Prevention and Control Project at
the Virginia Department of Health. "In 2006, that rate is 7.4
percent."
In addition to more older and more overweight people, Forburger
said more screening also is a factor. People are being identified
who in the past might have gone undiagnosed.
Some direct costs of diabetes care include medications, insulin
supplies, physician visits, glasses, special orthopedic shoes,
hospital care, nursing home care, and surgery.
"If you don't control it really good, it costs even more," said
Kim Pollock, an information technology worker in the Richmond area.
Pollock, 55, was diagnosed with Type 2 diabetes about 20 years
ago. He has had eye and kidney complications. He developed diabetes
when he switched from a physically active job as a steel worker to a
more sedentary job and gained about 50 pounds, he said.
"I am lucky to have insurance," Pollock said. "The people who
don't have insurance, how they cope with all this?"
Greta Trent of Powhatan County said she spends $500 to $600 out
of pocket a year for diabetes medications.
"That's after insurance," said Trent, 59. "That is just for the
medications. That does not include doctors visits or anything else."
Elvin Cordle, 74, has significantly reduced his diabetes care
costs by losing 30 pounds and changing how he eats. The Bon Air
resident walks 5 miles most days at a local mall and regularly
attends a Living With Diabetes discussion group.
"When I found out I had diabetes, I knew the only way I was going
to live like I wanted to live was to exercise," said Cordle, who was
diagnosed with Type 2 diabetes in September 2005.
To reduce diabetes, health care providers are identifying people
who have pre-diabetes.
Pre-diabetes occurs "when blood sugar is not high enough to be
diabetes, but higher than normal," Forburger explained. It is not
inevitable that those folks will develop diabetes, she said.
Proven prevention includes exercising 30 minutes a day at least
five times a week, reducing body weight 5 to 7percent, and eating a
healthier diet.
"Even if you delay it 10 years, that is 10 more years not living
with the disease and the potential complications down the road," she
said.
To screen for pre-diabetes, a person's blood sugar level is
measured after they have not eaten for at least eight hours.
"As fasting glucose levels go up, risk for diabetes goes up,"
said Clore, at VCU. "It's a moment when lifestyle modification can
make such a huge impact."
Diabetes in Virginia
Adults diagnosed: 431,867 people
Estimated adults undiagnosed: 215,934
Virginians ages 40-74 estimated to have pre-diabetes: 1,226,628
Some costs:
In 2005, there were 11,704 hospital discharges in Virginia in
which diabetes was the primary diagnosis. The average stay was five
days and the average cost per stay was $17,417.
Overall, hospitalization costs related to diabetes in Virginia in
2005: $203.8 million
Source: Virginia Department of Health www.vahealth.org/cdpc/
diabetes
Diabetes in the U.S.
Adults diagnosed: 17.5 million
Estimated adults undiagnosed: 6 million
Annual cost: $174 billion, of which $116 billion is direct
medical cost and $58 billion is indirect cost.
SOURCE: American Diabetes Association
For more information or to see estimated Virginia costs, go to
www.diabetes.org
Contact staff writer Tammie Smith at TLsmith@timesdispatch.com or
(804) 649-6572.
ILLUSTRATION: PHOTO
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