The Cost of Diabetes

One of this morning's guests on C-SPAN's Washington Journal program (see video below) was Dr. Ann Albright, Director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC). Dr. Albright was on the program to discuss the CDC's recent research paper titled Geographic Distribution of Diagnosed Diabetes in the U.S. in which CDC researchers described what they have dubbed 'the diabetes belt.' The belt is a string of counties stretching over 15 southeastern states where incidence of diabetes happens to be particulalry strong. From the abstract:

'In 2010, data from the 2007 and 2008 Behavioral Risk Factor Surveillance System were combined with county-level diagnosed diabetes prevalence estimates. Counties in close proximity with an estimated prevalence of diagnosed diabetes ≥11.0% were considered to define the diabetes belt. Prevalence of risk factors in the diabetes belt was compared to that in the rest of the U.S. The fraction of the excess risk associated with living in the diabetes belt associated with selected risk factors, both modifiable (sedentary lifestyle, obesity) and nonmodifiable (age, gender, race/ethnicity, education), was calculated.

Nearly one third of the difference in diabetes prevalence between the diabetes belt and the rest of the U.S. is associated with sedentary lifestyle and obesity. Culturally appropriate interventions aimed at decreasing obesity and sedentary lifestyle in counties within the diabetes belt should be considered.' (emph. added).

This final sentence from the abstract, aside from the data itself, may indeed be the most important part of the study, which was published in the American Journal of Preventative Medicine. According to the American Diabetes Association's (ADA) website, the cost of diabetes as of 2007 was $174 billion, broken down to $116 billion for direct medical costs and $58 billion for disability, time away from work and premature death. The estimated costs reach even higher when costs for pre- and undiagnosed diabetes are factored in based on research also cited by the ADA (more information on localized costs is available here.)

In addition to the fact that those with diabetes (about 8% of the population according to the ADA) are suffering, their illness puts a strain on the healthcare system specifically, and more broadly the US economy. And, although incidence of diabetes is to some degree influenced by genetic factors, lifestyle choices play a greater part in whether someone will ultimately be impacted by the disease (notably this is true of Type II diabetes which has by far the greater footprint; type 1 diabetes, which impacts only about 5% of sufferers, is almost completely genetic).

This gets us back to the final statement of the CDC study's abstract, 'Culturally appropriate interventions aimed at decreasing obesity and sedentary lifestyle in counties within the diabetes belt should be considered.' If most of the cases of diabetes are preventable, or at least able to be delayed, education could be a tremendous tool in informing those most at risk of contributing factors to the disease. For if education is indeed able to reduce what is already a tremendous strain on the healthcare system and the economy, it could ultimately provide one of the truest examples of the old cliche 'an ounce of prevention is worth a pound of cure.'

Dr. Albright discusses the CDC study on 'the diabetes belt.'