To Change Health Care, Change Diabetes.

As we work to change health care in America, we must recognize the need to dramatically change diabetes.   Twenty-four million Americans have diabetes at a cost to our nation of an estimated $218 billion for diabetes and pre-diabetes, according to a series of studies recently published in Population Health Management.  Imagine the effects diabetes will have on our health and economy in the future if we don’t take action now. The prevalence and economic burden of undiagnosed and pre-diabetes make the case for the importance of policies that promote early diagnosis and prevention.  About 25 percent of Americans with diabetes aren’t even aware they have the disease.  And, those with undiagnosed diabetes result in $18 billion in health expenses, or $2,864 per person each year, according to one of the studies mentioned above.

The numbers associated with pre-diabetes, a precursor to type 2 diabetes, are equally as staggering.  Pre-diabetes affects an estimated 57 million Americans and costs our nation more than $25 billion a year in increased medical costs.  This translates to $443 for each adult suffering from pre-diabetes, according to another study in the series which looked at the costs of pre-diabetes.  The costs stem from the fact that people with the condition have higher rates of medical visits than those with normal blood-sugar levels.  They also seek medical attention more often for issues associated with diabetes, including high blood pressure and metabolic and renal complications. While the rates of undiagnosed diabetes and pre-diabetes are alarming, studies show that type 2 diabetes can be significantly prevented, or at least delayed, by losing weight through diet and regular exercise.  But, even with evidence supporting prevention, our nation isn’t allocating adequate resources.  In 2005, a study by the National Changing Diabetes® Program found that the federal government spent nearly $80 billion more on those with diabetes than those without the disease, and only $4 billion of that was spent on prevention and health promotion.   Early diagnosis and prevention are good places to start, but we must also take measures to improve diabetes care and management.  The first step to care improvement is to measure the quality of care being delivered in a consistent way.  A recent study (to be published) documents tremendous variability of how care quality is now being measured. Aggressive treatment is another key component of changing diabetes.  Studies show that intensive treatment to reduce blood sugar levels can delay or prevent debilitating and costly complications of diabetes, such as heart disease, stroke, blindness, kidney failure and amputation. Changing diabetes is not a simple task and requires coordination.  Strategies and activities among the 18 to 21 federal agencies that impact diabetes need to be aligned in order for us to succeed in the fight against this disease.  We must also look at our federal budget process and make adjustments to more accurately assess the long-term impact of prevention programs.  The current 10-year budget window doesn’t take into account that the value of prevention and improved treatment needs to be assessed over a longer period of time.           To truly reform health care in America, we must change diabetes.

Dana Haza is senior director of the National Changing Diabetes® Program, a diabetes leadership initiative established by Novo Nordisk to drive health systems change at the national and local levels.

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14 replies »

  1. Usually I don’t read post on blogs, but I wish to say that this write-up very pressured me to try and do it! Your writing style has been surprised me. Thank you, very nice post.

  2. I stick on the beginning of your writing.Awareness factor is one of the key to solve the problem.That’s why community work is valuable here,because the informed people knows that water taken,exercise,discipline in our diet,could help many to not get,therefore avoiding big spending for the Government.

  3. 25% of people with diabetes are not aware of it!?! Wow! Thank you for your informative and inspirational blog, It really opened my eyes to some facts I was not previously aware of.

  4. Health Care Change My grandfather had diabetes and passed away before I reached kindergarten. He didn’t take care of his disease, and it lead to many costly complications (before his death) including kidney failure and an amputation of one of his legs.

  5. What about Type 1 diabetes, my 13 year has type 1. Many people do not understand that type 1 is not preventable like type 2. He is slim and eats a very balanced diet as my whole family does, and also gets adequate exercise. Please do not put him in a box with the people that can prevent this. Many do not understand what it takes to care for a child with type 1 and the burden it puts on the child, as well as the financial strain it puts on our family. Some of your comments are ignorant when you label diabets as a whole and do not understand the various types! My son who has type 1 diabetes is now taking part in a commitee in his junior high to change the menu their to a more healthier menu. As of now, he brings his lunch every day because they do not offer a healthy enough lunch for a type 1 diabetic child.

  6. My grandfather had diabetes and passed away before I reached kindergarten. He didn’t take care of his disease, and it lead to many costly complications (before his death) including kidney failure and an amputation of one of his legs.
    I think you have a very interesting point about in order to change health care, we must change diabetes. People at-risk need to get tested sooner. Aggressive treatment must be done. Not only will it change health care and prevent costly procedures, but it will save more lives.

  7. Can’t stand it anymore:
    We may actually agree. My point is that the explosion in obesity and pre-diabetes is not a failure of the health care system (as the original post implies), but the inevitable result of the society we have designed.
    I can and do talk diet and exercise all day long to my patients, but it’s really spitting in the wind in a country that: provides massive subsidies to the sugar and corn industries; allows schools to eliminate phys ed and sell junk food to kids; designs cities so that walking is impossible and every activity depends on driving; and so on.
    Until the individual makes the decision that, in spite of all the societal forces pushing in the opposite direction, they are going to exercise and loose weight, there is nothing I can do as a physician to “treat” obesity and pre-diabetes (and prescribing more Novo Nordisk products certainly is not the answer).

  8. Diabetes is SO bad for you, and is something you CAN PREVENT. We have a major issue on our hand regarding the foods being sold in this country.

  9. Ok R Watkins. And just when would you like all the crazed 50 hour (at least) a week working people in this insane country which has allowed itself to become completely driven by markets and money to do all of this exercise and how would you like them to afford healthy food and the time to cook it? If they start working sane hours and get paid enough to buy healthy foods, that’s probably $218 billion right there.

  10. R Watkins, may I paraphrase?
    “Just say do it yourself”
    Uhhhmmmmm…….great plan, thanks

  11. Prevention of pre-diabetes and diabetes means diet and exercise. The cost, per individual, is zero dollars and zero cents. What’s the problem?

  12. The cost of diabetes really is staggering. Your assessment that not enough money is being allocated to prevention is right on the mark. Unfortunately, this is true of the overall health reform bill now making its way through Congress. Until we allocate more resources towards prevention of diabetes and other costly chronic conditions, we will never have meaningful reform.
    Sean Teare
    Aprexis Health Solutions

  13. I couldn’t agree more. Most people who I talk to about it don’t even believe me when they hear how much diabetes is costing our country.
    Many other countries face the same issues and some predict if something drastic isn’t done then the costs of diabetes will bankrupt their health care budget.
    The good news is awareness is increasing and progress is being made in many areas. It may be slow in some cases but it’s happening. And the more we (those with diabetes) better manage it and control our blood sugar levels the more we will not only improve our health but save on the medication and complication costs. On the aggregate, that will be a huge savings.
    While we are making progress, there is so much more to be done.

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