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Counting the cost of Type 2 diabetes

Times Staff Writer

Three out of every 5 patients with Type 2 diabetes suffer from at least one significant complication of the disease, such as heart disease, stroke, eye damage, chronic kidney disease or foot problems leading to amputation, researchers said Tuesday.

One out of every 10 has two complications, 1 out of 15 has three and 1 out of 13 has four or more.

“These numbers are just incredible in terms of their implications for quality of life and healthcare costs,” said health economist Willard Manning of the University of Chicago, who presented the data at a Seattle meeting of the American Assn. of Clinical Endocrinologists.

These complications cost each patient an average of about $10,000 per year -- $1,600 of it out of their own pockets -- he said. Those are crucial numbers, he said, because an estimated 40% of diabetics have family incomes below $35,000 per year.

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“We are using the tools [to control diabetes] too late, and spending too much money on complications,” said Dr. Daniel Einhorn of the Sharp Diabetes Treatment and Research Center in San Diego in a teleconference releasing the findings.

“We knew that these complications were out there, but the sheer magnitude was a surprise,” he said.

About 18 million Americans suffer from Type 2 diabetes, in which increasing amounts of insulin are required to keep blood-sugar levels under control. The primary risk factors for the disease are obesity and lack of exercise.

The data for the first such survey were taken from the National Health and Nutrition Examination Survey, conducted by the National Center for Health Statistics between 1999 and 2004. The economic data came from the government’s Medical Expenditure Panel Survey conducted during the same period.

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The report was compiled by a coalition of the endocrinology association, the Amputee Coalition of America, Mended Hearts, the National Federation of the Blind and the National Kidney Foundation.

Their goal is to increase the number of diabetics who keep their blood sugar under control. “The better it is controlled, the lower the risk of complications,” Einhorn said. “We’ve known that for a long time, but remarkably, we are still getting a high burden of complications.”

Former Dallas Cowboys running back Ron Springs also spoke at the teleconference. Springs, 50, has had his left foot and two toes on his right foot amputated, and had a kidney transplant March 1. Fellow Cowboy Everson Walls was the donor.

Springs was diagnosed with diabetes shortly after he retired at the age of 34.

“I was so naive about it that I neglected it for 10 years,” he said. “I didn’t believe that it could happen to an NFL player who had been in shape all his life. For my neglect, I ended up suffering some of the complications.”

Among other findings in the report:

* Congestive heart failure occurs in 7.9% of diabetics, compared with 1.1% of people without the disease. It costs an average of $7,932 per year per patient.

* Heart attacks occur in 9.8% of diabetics, compared with 1.8% of others. They cost patients $14,150 per year.

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* Coronary heart disease occurs in 9.1% of diabetics, compared with 2.1% of others. It costs patients $6,062 per year.

* Strokes occur in 6.8% of diabetics, compared with 1.8% of others. They cost patients $7,806 per year.

* Chronic kidney disease occurs in 27.8% of diabetics, compared with 6.1% of others. It costs patients $9,002 per year.

* Foot problems, such as amputations and numbness, occur in 22.8% of diabetics, compared with 10% of others. They cost patients $4,687 per year.

* Eye damage occurs in 18.9% of diabetics. Comparable figures are not available for nondiabetics. It costs patients $1,785 per year.

thomas.maugh@latimes.com


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