1. The Economic, Emotional and Physical Costs of Diabetes: Facts & Figures Felicia Hill-Briggs, PhD, ABPP
2018 President of Health Care and Education, American Diabetes Association
Professor of Medicine, Sr. Director Population Health Research and Development, Johns Hopkins Medical Institutions, Baltimore, MD
Healthy Churches November 15, Hilton Head, S.C.

2. November is American Diabetes Month.
November 14th is World Diabetes Day.

3. The Global Costs of Diabetes
451 million people globally have diabetes; 1 out of every 11 people around the world.
On track to reach 693 million people with diabetes by 2025 (in just 8 years).
Global economic cost of diabetes = $830 billion each year.
Diabetes is Increasing especially fast in the poorest countries, due to people adopting Western diets and lifestyles, leading to increased overweight/obesity and lack of physical activity.
Source: International Diabetes Federation, November 2017

4. The Human Costs of Diabetes
In the U.S.

5. Every 21 seconds someone in the U.S is diagnosed with diabetes.
Diabetes Figures, United States
9.3% of the population
Working-aged adults prevalence - number of adults, years, per 1,000 people (2012 data):
By Age: years = 4.1 per years = 16.2 per (Numbers can’t be summed because the denominators are different)
Working-aged adults incidence – number of adults, years, per 1,000 people (2014 data):
By Age: years = 3.2 per 1,000. Age 45 – 64 = 10.5 per 1,000. Total = 14 per 1,000.
Prediabetes:
In January of this year, the ADA, along with the CDC, AMA, and the Ad Council launched the National Prediabetes Campaign to make the public, employers, and healthcare providers aware that type 2 diabetes can be prevented or delayed. The National Diabetes Prevention Program (NDPP), through the CDC, is available to employers and health plans to implement. With the NDPP, whose community implementation has been underway over 10 years now, we are seeing a change in diabetes incidence rates in the U.S. Over the last 2 years, the upward trend in new cases has leveled off and shows signs of being reversible. ADA SOC recommend 3rd party insurers cover. Disparities in access, which can be addressed by employers and health plans.
Every 21 seconds someone in the U.S is diagnosed with diabetes.
Sources: American Diabetes Association; Centers for Disease Control and Prevention

6. Social Determinants of Health, World Health Organization (WHO)
The social determinants of health are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems. 

7. Source: Centers for Disease Control and Prevention (CDC)
Racial/Ethnic Minorities Have Higher Diabetes Burden Prevalence (%) of diagnosed diabetes, ages 20 years and older
Source: Centers for Disease Control and Prevention (CDC)

8. The Poor Carry Higher Diabetes Burden
Braveman PA, et al. Copyright © American Public Health Association All Rights Reserved. Used With Permission.

9. Complications of Diabetes
75% 80 – 97% of people with diabetes have diabetic eye disease (retinopathy); leading cause of noncongenital blindness in U.S., with 2,000 to 24,000 new cases each year
40% of people with diabetes will have end-stage kidney diease (nephropathy), needing dialysis or transplant
Death from heart disease is 2-4 times higher in people with diabetes
Stroke is 3 – 4 times more likely in people with diabetes

10. 60% of all non-traumatic below the knee amputations are
due to diabetes, accounting for 80,000/year
Cancer
People with diabetes have a 2-4 times higher rate of death from all cancers
Brain health
74% increased risk of all types of dementia
56% increased risk of Alzheimer’s dementia
127% increased risk of vascular dementia

11. African Americans and Diabetes Complications
African Americans with diabetes, compared with Whites with diabetes, have:
15% higher prevalence of nerve disease (neuropathy)
34% higher prevalence of stroke
50% higher prevalence of diabetic eye disease (retinopathy)
6-fold higher prevalence of kidney disease leading to end-stage renal disease
3-6 fold higher prevalence of amputation 11

12. The Economic Costs of Diabetes
To Health care

13. Diabetes Health Care Costs
The total cost of diabetes and prediabetes in the U.S. is $322 billion.
One 1 out of every five 5 health care dollars is spent caring for a person with diabetes
One 1 out of every three 3 Medicare dollars is spent on diabetes care
Source: American Diabetes Association

14. 57.6% spent on pharmaceuticals
Among 155 conditions, diabetes had the highest health care spending in 2013, with an estimated $101.4 billion in spending, including
57.6% spent on pharmaceuticals
23.5% spent on ambulatory (outpatient) care.
Dieleman et al. JAMA, 2016

15. The Costs of Diabetes
To people with diabetes

16. Medical Spending for People With Diabetes
Medical costs for people with diabetes are 2.3 times higher than for people without diabetes.
Personal health care spending for people with diabetes increased by $64.4 billion over the past 15 years.
The average price of insulin increased nearly 3 times between and 2013, and prices continue to rise.
Source: American Diabetes Association

17. The Emotional Cost of Diabetes
Up to 45% of people with diabetes report Diabetes Distress
1 in 4 people with diabetes has Depressive disorder
1 in 5 people with diabetes has Anxiety disorder
3 in 4 older adults with diabetes will experience Dementia

18. Diabetes Costs People Years of Life, Work, Wages, and Productivity
Global total economic burden of diabetes is 1.31 trillion USD (1.8% of the world GDP):
49% of the cost is due to drop-out from the workforce
46% is due to early death
4% is due to being absent from work (sick-days)
2% is due to reduced productivity while at work.
$245 BILLION USD
Total costs and lost work and wages for people with diagnosed diabetes in U.S.
Source: Bonner et al. Lancet Diabetes Endocrinology, June 2017

19. Diabetes’ Contribution to the U.S. Economy
Drug Discovery
– as of 2016, 171 new drug therapies were in development for treating type 1 and type 2 diabetes. (Zhang, Gregg. Lancet, 2017)
Medical device and
equipment discovery
Maintenance care
and therapeutics
High-cost procedures

20. New Solutions?
national Diabetes Prevention

21. Launch of the National Prediabetes Campaign
American Diabetes Association (ADA)
Centers for Disease Control and Prevention (CDC)
American Medical Association (AMA)
Ad Council

22. Launch of the National Prediabetes Campaign
What every person should do:
Take the Prediabetes Risk Test and find out your score.
See your doctor if your score is in the risk range, and get screened with a blood test.
Start a lifestyle-based Diabetes Prevention Program.
American Diabetes Association (ADA)
Centers for Disease Control and Prevention (CDC)
American Medical Association (AMA)
Ad Council

23. ADA and CDC Partnership
BROADER DISSEMINATION
ADA local offices
ADA Diabetes Self-Management Education (DSME) programs
CDC grant for ADA programs in Hispanic communities in key states

24. Felicia Hill-Briggs, PhD, ABPP
Thank You!
Felicia Hill-Briggs, PhD, ABPP