Diabetes linked to large decrease in life years, increase in health care costs

Diabetes is associated with significant reductions in life expectancy and increases in health care expenditures over a lifetime, according to recent findings.

“Our results provide evidence that the health and economic burden of diabetes is substantial over the life span,” the researchers wrote. “We find that certain population groups are most susceptible to the health and economic consequences of diabetes over the life course.”

In the study, Su-Hsin Chang, PhD, of Washington University School of Medicine, and colleagues evaluated the age-, race-, sex- and BMI-specific risks of diabetes, death and annual health care costs for individuals with or without diabetes. They conducted the analysis using data from the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey from 1997 and 2007 and the NHIS Linked Mortality Public-use Files with mortality follow-up to 2006. The researchers used a three-state Markov model (diabetes, no diabetes and death) to compute life year and total lifetime health care costs by age, race, sex and BMI categories.

The researchers found in terms of BMI-specific risk, the life years lost in patients with diabetes reflected an inverted U-shape for most BMI categories, with the overweight group demonstrating the largest number of life years lost.

The lifetime health care expenditures were higher for white patients vs. black patients and higher for women vs. men. With individuals aged 50 years as an example, the researchers found that white women with diabetes and BMI more than 40 kg/m2 had 17.9 life years remaining and accumulated lifetime health costs of $185,609, while white women with diabetes and normal weight had 22.2 life years remaining and accrued lifetime health costs of $183,704.

Additionally, the researchers observed a decrease with age in life years lost to diabetes, with those aged 70 or older having the lowest average of life years lost. The number of life years lost was comparable between insured and uninsured individuals. However, those with insurance had roughly double the health care cost disparities vs. the uninsured.

According to the researchers, these findings may be useful in identifying at-risk populations and implementing prevention and treatment strategies.

“Policy makers can implement diabetes prevention and intervention policies that target these populations to decrease life years lost and reduce the economic burden of diabetes more effectively,” the researchers wrote. – by Jennifer Byrne

Disclosure: The researchers report no relevant financial disclosures.

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