The Economic Burden of Elevated Blood Glucose Levels in 2017: Diagnosed and Undiagnosed Diabetes, Gestational Diabetes Mellitus, and Prediabetes

Timothy M Dall, Wenya Yang, Karin Gillespie, Michelle Mocarski, Erin Byrne, Inna Cintina, Kaleigh Beronja, April P Semilla, William Iacobucci, Paul F Hogan, Timothy M Dall, Wenya Yang, Karin Gillespie, Michelle Mocarski, Erin Byrne, Inna Cintina, Kaleigh Beronja, April P Semilla, William Iacobucci, Paul F Hogan

Abstract

Objective: This study was conducted to update national estimates of the economic burden of undiagnosed diabetes, prediabetes, and gestational diabetes mellitus (GDM) in the United States for year 2017 and provide state-level estimates. Combined with published estimates for diagnosed diabetes, these updated statistics provide a detailed picture of the economic costs associated with elevated blood glucose levels.

Research design and methods: This study estimated medical expenditures exceeding levels occurring in the absence of diabetes or prediabetes and the indirect economic burden associated with reduced labor force participation and productivity. Data sources analyzed included Optum medical claims for ∼5.8 million commercially insured patients continuously enrolled from 2013 to 2015, Medicare Standard Analytical Files containing medical claims for ∼2.8 million Medicare patients in 2014, and the 2014 Nationwide Inpatient Sample containing ∼7.1 million discharge records. Other data sources were the U.S. Census Bureau, Centers for Disease Control and Prevention, and Centers for Medicare & Medicaid Services.

Results: The economic burden associated with diagnosed diabetes (all ages), undiagnosed diabetes and prediabetes (adults), and GDM (mothers and newborns) reached nearly $404 billion in 2017, consisting of $327.2 billion for diagnosed diabetes, $31.7 billion for undiagnosed diabetes, $43.4 billion for prediabetes, and nearly $1.6 billion for GDM. Combined, this amounted to an economic burden of $1,240 for each American in 2017. Annual burden per case averaged $13,240 for diagnosed diabetes, $5,800 for GDM, $4,250 for undiagnosed diabetes, and $500 for prediabetes.

Conclusions: Updated statistics underscore the importance of reducing the burden of prediabetes and diabetes through better detection, prevention, and treatment.

© 2019 by the American Diabetes Association.

Figures

Figure 1
Figure 1
Prevalence of diabetes and prediabetes in the U.S., 2017.

References

    1. American Diabetes Association 3. Comprehensive medical evaluation and assessment of comorbidities: Standards of Medical Care in Diabetes–2018. Diabetes Care 2018;41(Suppl. 1):S28–S37
    1. American Diabetes Association Economic costs of diabetes in the U.S. in 2017. Diabetes Care 2018;41:917–928
    1. Dall TM, Yang W, Halder P, et al. . The economic burden of elevated blood glucose levels in 2012: diagnosed and undiagnosed diabetes, gestational diabetes mellitus, and prediabetes. Diabetes Care 2014;37:3172–3179
    1. Zhang Y, Dall TM, Chen Y, et al. . Medical cost associated with prediabetes. Popul Health Manag 2009;12:157–163
    1. Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion. National Diabetes Statistics Report, 2017 [Internet], 2017. Available from . Accessed 12 November 2018
    1. Centers for Disease Control and Prevention; National Center for Chronic Disease Prevention and Health Promotion. National Diabetes Statistics Report, 2014 [Internet], 2014. Available from . Accessed 12 November 2018
    1. Matthews TJ, Hamilton BE. Mean Age of Mothers is on the Rise: United States, 2000–2014 [Internet]. NCHS Data Brief, No 232. Hyattsville, MD, National Center for Health Statistics, 2016. Available from . Accessed 12 November 2018
    1. Dall TM, Zhang Y, Chen YJ, Quick WW, Yang WG, Fogli J. The economic burden of diabetes. Health Aff (Millwood) 2010;29:297–303
    1. Zhang Y, Dall TM, Mann SE, et al. . The economic costs of undiagnosed diabetes. Popul Health Manag 2009;12:95–101
    1. Chen Y, Quick WW, Yang W, et al. . Cost of gestational diabetes mellitus in the United States in 2007. Popul Health Manag 2009;12:165–174
    1. Biesheuvel CJ, Vergouwe Y, Steyerberg EW, Grobbee DE, Moons KGM. Polytomous logistic regression analysis could be applied more often in diagnostic research. J Clin Epidemiol 2008;61:125–134
    1. Dall TM, Narayan KMV, Gillespie KB, et al. . Detecting type 2 diabetes and prediabetes among asymptomatic adults in the United States: modeling American Diabetes Association versus US Preventive Services Task Force diabetes screening guidelines. Popul Health Metr 2014;12:12.
    1. Turi KN, Buchner DM, Grigsby-Toussaint DS. Predicting risk of type 2 diabetes by using data on easy-to-measure risk factors. Prev Chronic Dis 2017;14:E23
    1. Flegal KM, Panagiotou OA, Graubard BI. Estimating population attributable fractions to quantify the health burden of obesity. Ann Epidemiol 2015;25:201–207
    1. Breton M-C, Guénette L, Amiche MA, Kayibanda J-F, Grégoire J-P, Moisan J. Burden of diabetes on the ability to work: a systematic review. Diabetes Care 2013;36:740–749
    1. Asay GRB, Roy K, Lang JE, Payne RL, Howard DH. Absenteeism and employer costs associated with chronic diseases and health risk factors in the US workforce. Prev Chronic Dis 2016;13:E141.
    1. DiBonaventura M, Link C, Pollack MF, Wagner JS, Williams SA. The relationship between patient-reported tolerability issues with oral antidiabetic agents and work productivity among patients having type 2 diabetes. J Occup Environ Med 2011;53:204–210
    1. Loeppke R, Taitel M, Haufle V, Parry T, Kessler RC, Jinnett K. Health and productivity as a business strategy: a multiemployer study. J Occup Environ Med 2009;51:411–428
    1. Rodbard HW, Fox KM, Grandy S; Shield Study Group . Impact of obesity on work productivity and role disability in individuals with and at risk for diabetes mellitus. Am J Health Promot 2009;23:353–360
    1. U.S. Census Bureau. Average Number of People Per Household, By Race And Hispanic Origin, Marital Status, Age, and Education of Householder: 2017 [Internet], 2017. Available from . Accessed 12 November 2018
    1. US Census Bureau. Income and Poverty in the United States [Internet], 2017. Available from . Accessed 12 November 2018
    1. Mitchell RJ, Bates P. Measuring health-related productivity loss. Popul Health Manag 2011;14:93–98
    1. Kaiser Family Foundation. The Role of Medicaid for People with Diabetes [Internet], 2012. Available from . Accessed 2 January 2019
    1. Li Q, Blume SW, Huang JC, Hammer M, Graf TR. The economic burden of obesity by glycemic stage in the United States. Pharmacoeconomics 2015;33:735–748
    1. Leung MYM, Carlsson NP, Colditz GA, Chang S-H. The burden of obesity on diabetes in the United States: medical expenditure panel survey, 2008 to 2012. Value Health 2017;20:77–84
    1. Weaver CG, Ravani P, Oliver MJ, Austin PC, Quinn RR. Analyzing hospitalization data: potential limitations of Poisson regression. Nephrol Dial Transplant 2015;30:1244–1249
    1. Payne EH, Hardin JW, Egede LE, Ramakrishnan V, Selassie A, Gebregziabher M. Approaches for dealing with various sources of overdispersion in modeling count data: scale adjustment versus modeling. Stat Methods Med Res 2017;26:1802–1823

Source: PubMed

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