Diabetes complications swelling U.S. health costs

By Julie Steenhuysen

CHICAGO (Reuters) - 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.

"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.