Costs Are High From Undiagnosed Diabetes

Billions of Dollars in Health Care Bills Attributed to Americans Who Don't Know They Have Diabetes

By Bill Hendrick
WebMD Health News

Reviewed By Louise Chang, MD

May 8, 2009 -- Millions of Americans who have diabetes don't even know they have the disease, but they run up an estimated $18 billion bill in health care costs annually, a new study shows.

Scientists used data from more than 3 million people included in the National Health and Nutrition Examination Survey to estimate costs and numbers of people in the U.S. with undiagnosed diabetes, tabulating bills for treatment of various symptoms of the disease.

Reporting in the journal Population Health Management, the researchers say their calculations suggest that about 6.3 million adults -- about a fourth of the people in the U.S. with diabetes -- have the disease but haven't been diagnosed.

This undiagnosed population accounts for about $18 billion in health care costs annually, the study shows.

Researchers examined the health care use patterns of a group of people for the two-year period leading up to their diagnosis of diabetes.

Diabetes costs the American economy about $174 billion in medical care expenses and lost productivity, based on calculations for 2007, the study shows. But that figure is a significant understatement, according to the researchers, who say costs related to undiagnosed people with diabetes could raise the total to more than $192 billion.

Annual health care needs for people with undiagnosed diabetes tend to be higher than for people who do not have the disease, the study of the federal statistics indicated.

"Diabetes is one of the most devastating chronic diseases and costs the nation billions of dollars," says David B. Nash, MD, a professor of health policy in the Jefferson School of Population Health in Philadelphia.

"Building an evidence base as to what works and what doesn't is going to be critical," he says in a news release.

The study also shows that:

  • The economic cost of undiagnosed diabetes is $2,864 per person.
  • Incremental costs of undiagnosed diabetes begin at least eight years before diagnosis.
  • About 4%-6% of men 35 to 64 have undiagnosed diabetes.
  • About 14% of men 65 to 69 have undiagnosed diabetes.

The researchers used the data to estimate total national ambulatory visits, emergency room visits, and hospital inpatient days, among other things. Medical costs associated with undiagnosed diabetes include $2.3 billion for cardiovascular disease, $720 million for hypertension, $443 million for kidney problems, and $293 million for neurological symptoms.

"To the best of our knowledge, no study has investigated the health care use patterns and economic costs for patients with [undiagnosed diabetes], although present research does show an increase in medical costs in the years leading up to diagnosis," the authors write.

The study's lead author was Yiduo Zhang, PhD, from the Lewin Group in Falls Church, Va. Fellow researchers were from Ingenix Pharmainformatics in Cary, N.C., and Ingenix Research in Basking Ridge, N.J.

Some of the scientists on Zhang's team acknowledged receiving grants from i3 Research and pharmaceutical and biotechnology firms.

SOURCES: News release, Mary Ann Liebert Inc. Zhang, Y. Population Health Management, 2009; vol 12.

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