A diabetes epidemic is poised to strike, according to a study recently released by the American Diabetes Association.
The prediction is based on an epidemiologic study conducted in San Antonio over the past 20 years, which found a 10% increase in diabetes among minorities, particularly Mexican-Americans, and a 7% increase among non-Hispanic whites.
Reporting a dramatic increase in the incidence of the most commonly found Type II diabetes over the last decade, Michael Stern, M.D., an author of the study, noted that there has been a concomitant increase in obesity, a predisposing factor for Type II diabetes.
This silent diabetes epidemic could have a serious impact on healthcare costs. The ADA reports that $98.2 billion was spent on diabetic care in 1997, 75% of which covered total medical expenses. On a per-capita basis, the cost of medical care for diabetics is four times that of nondiabetics.
Doctors familiar with treating the disease also are witnessing an alarming surge in diabetes among adolescents, reported Gerald Bernstein, M.D., president of the Chicago-based ADA.
Already nearly 16 million people in the U.S. have diabetes. More than 90% have Type II diabetes, according to the National Diabetes Information Clearinghouse. This year alone an additional 800,000 adults, generally those over age 40, will be diagnosed with diabetes, according to various scientific reports.
Because diabetes predisposes patients for other diseases, if the upward trend in diabetes cases continues, there will be a "significant impact on the rate of cardiovascular mortality," warned Stern, a professor of clinical epidemiology at the University of Texas, San Antonio.
Doctors say HMOs and primary-care providers will have to beef up their spending to nip the diabetes epidemic in the bud.
"In the short term, we will see a significant increase in the money being spent on care of diabetes," said Mitchell Silverman, M.D., an endocrinologist at Newark (N.J.) Beth Israel Medical Center. Additional costs could include more claims from patients with serious side effects, such as cardiovascular and kidney disease, and from practitioners for coverage of additional recommended diagnostic tests, he added.
The diabetes wave is prompting hospitals to step up disease management programs that can potentially reduce the cost of diabetes care.
The 392-bed Medical Center at Princeton, Princeton, N.J., is intensifying its preventive programs for diabetes, said Lori Sherman-Apel, program director at the hospital's diabetes treatment center. "We are offering education to our diabetic patients in survival skills, which enable us to provide help in a timely fashion, keeping down the length of their stay and improving the quality of healthcare."
Over the past year the hospital has seen more than a 37% increase in diabetic patients. In light of this surge, the facility is focusing on educating the community about early detection. Its diabetes center, one of the 60 such units run by Diabetes Treatment Centers of America, has added more intensive outreach programs for seniors and is promoting more aggressive treatment therapies, such as self-testing and insulin pumps.
Federal organizations also are collaborating to educate people about the risks of the disease. The Centers for Disease Control and Prevention and the National Institutes of Health, with support of the ADA, jointly launched a $3 million national campaign called the National Diabetes Education Program. Among other aspects, it promotes diabetes awareness and community intervention.