Diabetes: One of the costliest conditions

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By the numbers: How Diabetes expenses add up

2.3

times higher the average medical expenses were for people with diabetes as opposed to people without the disease in the United States in 2007.

$58 billion

estimated indirect costs (disability, work loss, premature mortality) caused by diabetes in the United States in 2007.

$116 billion

estimated direct medical costs associated with diabetes in the United States in 2007.

Source: Centers for Disease Control and Prevention

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Nearly 500,000 adults in Illinois and 600,000 adults in Indiana have some form of diabetes, according to their state health departments.

Increasing numbers of children and adolescents also have been diagnosed with type 2 diabetes — typically known as adult onset diabetes. And residents of urban areas have unique challenges in managing the disease.

Gregory Larkin, Indiana state health commissioner, wrote in a 2010 report on diabetes that the disease has emerged as one of the most prevalent and costly diseases affecting the state.

“While the impact of diabetes may appear daunting, there is room for optimism,” he wrote. “Diabetes is not inevitable and in many instances can be prevented.”

Behind the numbers

In Chicago and northwest Indiana, an average to above-average portion of the population has diabetes. The percentage of adults (20 years or older) with diagnosed diabetes ranged from 7 percent in McHenry County to 10.3 percent in Lake County, Indiana, in 2008 — the most recent county-level data available. The same year, the nationwide percentage was 7.8.

Residents of certain Chicago neighborhoods carry a larger share of diabetes, based on estimates and individual surveys conducted by city universities. Dr. Lou Philipson, a diabetologist at the University of Chicago, said that in heavily Hispanic and Puerto Rican wards, such as Humboldt Park, upwards of 20 percent of the residents have diabetes — more than double the national average.

One reason is access to care. In urban areas, there tend to be concentrations of diabetes specialists, but patients need transportation to get to those specialists and the means to pay for treatment.

“Many people with diabetes have no resources, and that is really a disaster because diabetes is a really expensive disease,” Philipson said. “We encourage people to check their blood sugar, eat a good diet and get regular care. And without access to care, we’re going to see sicker people who really will be very costly to the health care system.”

Latest research

Recent research has shown that some long-term damage to the body, especially the heart and circulatory system, may already be occurring during prediabetes. This is a new name for the condition also known as impaired glucose tolerance or impaired fasting glucose.

According to the American Diabetes Association, before people develop type 2 diabetes, they almost always have prediabetes — blood glucose levels that are higher than normal but not yet high enough to be diagnosed as diabetes. There are 79 million people in the United States who have prediabetes.

People can prevent or delay the onset of type 2 diabetes through a healthy lifestyle: improve your diet, increase your level of physical activity and maintain a healthy weight.

These steps are known to help reduce the risk of the most common types of diabetes. But Philipson and his colleagues at the Kovler Diabetes Center at U of C hope to understand unusual forms of the disease.

He received a monetary award from the American Diabetes Association to create a new national registry to track all unusual inherited forms of diabetes: people who develop diabetes in the first year of life, families with strong histories of diabetes, and thin people who have type 2 diabetes (which is associated with being overweight 85 percent of the time, Philipson said).

He also is working to identify genes causing diabetes and how those genes are involved in regulating blood sugar. The cities of New York, San Antonio and Toronto are creating diabetes registries for public health purposes, he said.

“The idea is diabetes is so important economically, it’s become almost the disease of our time as far as chronic diseases,” Philipson said. “They would be able to track what the numbers are and track where resources should be in helping the population.”