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NEW AMERICAN DIABETES ASSOCIATION STUDY SHOWS TOTAL COST OF DIABETES SKYROCKETS TO $92 BILLION

 /ADVANCE/ ALEXANDRIA, Va., Sept. 29 /PRNewswire/ -- The health care costs of treating diabetes and those related to lost productivity attributable to diabetes and its complications have soared to nearly $92 billion in 1992 from $20.4 billion in 1987, according to a study recently completed by the American Diabetes Association (ADA). The report, titled "Direct and Indirect Costs of Diabetes in the United States in 1992," examined and compiled the costs related with health care expenditures for the treatment of diabetes, and estimated morbidity and mortality costs and the associated indirect costs due to diabetes.
 "The findings of this report are sobering, especially when you consider the majority of the diabetes price tag is for the complications of the disease," said American Diabetes Association President James R. Gavin III, M.D., Ph.D. "This is a wake up call for all people with diabetes to focus their treatment efforts on prevention of long-term complications, not just maintenance. It's time that diabetes patients embrace the Diabetes Control and Complications Trial (DCCT) message that good control of blood sugar levels can prevent the complications of diabetes."
 The Diabetes Control and Complications Trial is a landmark, decade- long study of the impact of blood sugar control on the development of diabetes complications sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases, a component of the National Institutes of Health. The DCCT convincingly validated what the American Diabetes Association has long told people with diabetes, based on theory and the results of smaller studies -- that good control of blood sugar levels can delay the onset and dramatically slow the progression of potentially life-threatening complications of the disease, such as kidney disease and blindness.
 Although the DCCT studied treatment of patients with insulin- dependent diabetes (type I), the association's position statement on the trial also urges consideration of tight blood sugar management for many people with non-insulin dependent diabetes (type II), a form of the disease that usually does not require insulin therapy and is treated primarily through diet and exercise.
 "The American Diabetes Association also strongly encourages the Clinton administration to carefully consider the results of our cost study and the DCCT in the health care reform process. In line with the overall prevention theme of the Clinton proposal, we call on the administration to ensure that the standards of treatment called for by the DCCT be equated with good, basic treatment for diabetes in any final insurance coverage," Gavin said.
 Additional key findings of the diabetes costs report include:
 -- Direct costs are estimated at $45.2 billion in 1992.
 -- Direct costs represent 5.8 percent of total personal health-care
 expenditures in the United States; however, diagnosed diabetes
 patients account for only 2.8 percent of the total U.S. civilian
 population.
 -- $39.1 billion (more than 86 percent) was spent on institutional
 care.
 -- $37.2 billion for hospital care and $1.8 billion for nursing home
 care.
 -- Patients with diabetes complications (heart and kidney disease,
 stroke, blindness, amputation) are hospitalized 2.8 days longer
 on average than non-diabetic patients with the same
 complications.
 -- Indirect costs (e.g., lost productivity) were estimated at
 $46.6 billion in 1992.
 Diabetes is a disease that affects the body's ability to produce or respond properly to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy. Currently there is no cure for diabetes.
 The American Diabetes Association is the nation's leading nonprofit health organization supporting diabetes research, advocacy, and information for health professionals, patients and the public. Founded in 1940, the association has an affiliate office in every state and conducts programs in more than 800 communities nationwide.
 THE DIRECT AND INDIRECT COSTS OF DIABETES IN THE UNITED STATES(A)
 -- The total annual economic cost of diabetes is estimated at $91.8
 billion in 1992 ($45.2 billion -- direct medical costs -- and
 $46.6 billion -- the value of productivity foregone due to
 disability and premature death).
 -- The total annual economic cost of diabetes in 1987 was estimated
 at $20.4 billion.
 Diabetes' Direct Costs:
 -- Estimated at $45.2 billion in 1992.
 -- Represents 5.8 percent of total personal health care expenditures
 in the United States; however, diagnosed diabetes patients
 account for only 2.8 percent of the total U.S. civilian
 population.
 -- Represented 2.2 percent of total personal health care
 expenditures in 1987.
 -- $39.1 billion (more than 86 percent) was spent on institutional
 care -- $37.2 billion for hospital care and $1.8 billion for
 nursing home care.
 Diabetes' Indirect Costs:
 -- Total indirect costs were estimated at $46.6 billion in 1992.
 -- Foregone productivity attributable specifically to diabetes is
 estimated at $26.9 billion in 1992.
 -- A total of 1 million work-loss days were attributable to diabetes
 in 1992. Three-quarters lost by diabetes patients 45 to 65 years
 old.
 -- A total of 47,800 workers were reported to be permanently
 disabled because of diabetes in 1992.
 -- Diabetes was the underlying cause of death for 48,259 people in
 1992.
 -- Cardiovascular disease was the underlying cause of death of
 nearly 60 percent of deaths among people with diabetes.
 -- Diabetes appeared as a contributory cause of death on an
 estimated 118,678 death certificates in 1992.
 DIABETES, THE DCCT, AND HEALTH CARE REFORM
 Increased Cost of Tight Management of Blood Sugar Levels:
 -- Annual cost of insulin-dependent (type I) diabetes treatment
 (professional care visits and supplies) is approximately $1,700
 per person per year.(B)
 -- The estimated annual cost of the tight management of blood sugar
 levels for type I diabetes recommended by the Diabetes Control
 and Complications Trial (DCCT) is $3,700 per person per year --
 an increase of 120 percent.(B)
 Current Medicare/Health Insurance Plans:
 -- Medicare covers physician visits, test strips, meters and lancets
 for insulin-treated patients only. Insulin and syringes are not
 covered. Patients visits with allied health professionals (RNs,
 RDs, Etc.) are not specifically covered.
 -- Individual and corporate insurance programs vary in levels of
 coverage, but most cover physician visits, insulin, syringes,
 test strips, meters and lancets to some degree. Allied health
 professional care varies in coverage from policy to policy.
 -- Limits and lack of coverage make tight management of diabetes,
 which increases the need for diabetes supplies, physician visits
 and visits with allied health professionals, difficult or
 impossible for many people with diabetes.
 Clinton Plan:
 -- Would extend Medicare coverage to prescription drugs and would
 include insulin.
 -- Would include coverage for allied health professionals and
 physician visits.
 -- Would eliminate exclusion for pre-existing conditions, including
 diabetes.
 -- Appears that the plan will provide enough coverage to make tight
 management of type I diabetes possible, but it is too early to be
 certain. The association's position is that tight management
 recommended by the DCCT should be considered good, basic diabetes
 treatment.
 (A) -- Diabetes-related hospitalizations totaled 371,969 in 1992.
 -- The mean length of stay was 6.2 days.
 -- Patients with diabetic complications (heart and kidney
 disease, stroke, blindness, amputation) are hospitalized 2.8
 days longer on average than non-diabetic patients with the
 same complications.
 -- Nearly two-thirds of all hospitalizations were for diabetic
 patients less than 65 years old.
 -- Diabetic patients are at a 1.5 times greater risk to be
 hospitalized than non-diabetic patients.
 -- Diabetic patients are 11.7 times more likely to be
 hospitalized because of amputations.
 (B) National Institutes of Health
 -0- 9/29/93/1800
 /CONTACT: Jerry Franz, ext. 291, or Chris McNamara, ext. 292, both of the American Diabetes Association, 703-549-1500/


CO: American Diabetes Association ST: Virginia IN: HEA SU:

IH-DC -- DC004 -- 6646 09/29/93 08:07 EDT
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Date:Sep 29, 1993
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