By 2034, nearly twice as many Americans will have diabetes and spending on the disease will triple, further straining the U.S. health system and testing the viability of Medicare and other government health insurance programs, U.S. researchers said on Friday.
"We forecast that in the next 25 years, the population size of people with diabetes — both diagnosed and undiagnosed — will rise from approximately 24 million people to 44 million people by the year 2034," said Dr. Elbert Huang of the University of Chicago, whose study appears in the journal Diabetes Care.
"We anticipate that the cost of taking care of those people — and these are direct medical costs — will triple over the same period of time, going from $113 billion today to $336 billion (per year)," Huang said in a telephone interview.
Huang said the burden of treating so many people with diabetes will strain the viability of Medicare, the U.S. health insurance program for the elderly and disabled.
Huang projects that the number of people covered by Medicare will rise from 8.2 million to 14.6 million, and annual Medicare spending on diabetes will jump from $45 billion to $171 billion.
In the United States, about 11 percent of adults have diabetes. Most have type 2 diabetes, the kind closely linked to obesity.
The rising diabetes burden could further complicate efforts to rein in U.S. healthcare spending in the coming decades.
Congress is grappling with legislation to extend health coverage to millions of uninsured people, control healthcare spending and bar insurance industry practices such as denying coverage to people with pre-existing medical conditions.
'MAJOR PUBLIC HEALTH PROBLEM'
"Diabetes is a major public health problem right now, but it's important for the country and for policymakers to have an idea of what will happen in the next couple of decades," Huang said.
"We already have a financial crisis at hand in healthcare and we need to plan for how we can deal with those costs in the future," Huang said.
For the study, the researchers built a forecasting model of diabetes population costs that tracks how many people will develop diabetes over the next decades and how much it will cost. The model accounts for the size of different generations that will be entering the diabetes population.
"That is important to account for because we know that age itself is a major predictor of diabetes, and we know that the baby boomer generation is entering an age where there's a high risk of developing diabetes," he said.
It also assumes that no progress is made in terms of rates of obesity, diabetes prevention and diabetes care. If obesity levels rise, Huang said, the model may actually underestimate the problem.
He said the study emphasizes the importance of public health efforts already under way to try to reverse the number of people who have diabetes.
"We know from a recent trial — the Diabetes Prevention Program — we know we can prevent diabetes through diet and exercise," Huang said.
In that 10-year study, overweight people with elevated blood sugar levels who lost a modest amount of weight lowered their risk of developing diabetes by at least a third.
People over age 60 got even more dramatic results, cutting their risk of diabetes during the study period by about half.
"I do feel preventing diabetes is the first step," Huang said.