Nov. 27, 2009 -- If nothing is done, the number of Americans with diabetes will nearly double in the next 25 years and spending on the disease will nearly triple, a new study shows.
"A perfect storm is a good way to look at it," study researcher Elbert S. Huang, MD of the University of Chicago tells WebMD. "If things stay the way they are right now we will have massive increases in diabetes incidence in this country over the next two decades."
By 2034, as many as 44 million Americans will have diabetes, up from 23 million today, according to the new projections, published in the November issue of the American Diabetes Association journal Diabetes Care.
The cost of caring for diabetes patients is projected to rise from $113 billion to $336 annually, and that is before adjusting for inflation.
These costs will outpace the increase in cases because more diabetes patients will be older and sicker and will require more expensive medical care, experts say.
Trouble for Medicare
Age is one of the biggest risk factors for type 2 diabetes, and the transition of baby boomers from middle to old age will drive much of the increase, the study shows.
As a result, by 2034, half of all direct spending in diabetes care is projected to occur in the Medicare population.
About 8 million Americans covered by Medicare now have diabetes and it cost $45 billion to treat them in 2009.
The number of diabetes patients whose treatment is paid for by Medicare is projected to nearly double to 14.6 million in the next 25 years, and the cost of caring for them is expected to quadruple.
By 2034, annual Medicare spending on diabetes care is projected to rise to $171 billion.
Although little can be done about the aging of the population, much can be done about the other major risk factor for type 2 diabetes -- obesity.
About 65% of Americans are overweight, and about one-third are obese, the CDC says.
The obesity rate among adults in the U.S. doubled between 1980 and 2004, but it appears to have leveled off since then.
The new diabetes model developed by the Huang and colleagues predicts a slight decline in obesity rates in the U.S. over the next two decades.
Target Obesity, Change the Future
All agree that a bigger decline in obesity, achieved though successful public health initiatives, could make a huge difference.
The future projected in the newly published study does not have to become reality, experts say.
"The cost of doing nothing is clearly going to be quite high," study co-researcher Michael O'Grady, PhD, said in a news conference. "To do nothing right now is going to cost billions and billions of dollars."
American Diabetes Association chief scientific and medical officer David M. Kendall, MD says it is now clear that even modest lifestyle changes, such as losing a few pounds or taking a walk most days a week, can drastically reduce a person's risk for developing diabetes.
The Diabetes Prevention Program was one of the largest studies ever to examine the impact of diet, exercise, and drug treatments on diabetes rates in patients at high risk for developing the disease.
The study found that these people cut their diabetes risk dramatically by losing just 7% of their body weight and engaging in moderate exercise for at least 30 minutes, a minimum of five times a week.
Early treatment with the diabetes drug metformin also helped delay or prevent diabetes, but to a lesser extent.
"Even modest weight loss and as little as 30 minutes of exercise five or more days a week and inexpensive treatments can keep people healthy," he tells WebMD. "That is really the big message."