title: Medical cost associated with prediabetes.
abstract: In this article, we estimate national health care resource use and medical costs in 2007 associated with prediabetes (PD), defined as either fasting plasma glucose between 100 and 125 or oral glucose tolerance test between 140 and 200. We use Poisson regression with medical claims for an adult population continuously insured between 2004 and 2006 to analyze patterns of health care resource use by PD status. Combining rate ratios that reflect health care use patterns with national PD prevalence rates from the National Health and Nutrition Examination Survey, we calculate etiological fractions to estimate the portion of national health resource use associated with PD. The findings suggest that PD is associated with statistically higher rates of ambulatory visits for hypertension; endocrine, metabolic, and renal complications; and general medical conditions. PD is associated with a slight increase in visit rates for neurological symptoms, peripheral vascular disease, and cardiovascular disease, but the increase is not statistically significant. There is no indication that PD is associated with an increase in emergency visits and inpatient days. Extrapolating these patterns to the 57 million adults with PD in 2007 suggests that national annual medical costs of PD exceed $25 billion, or an additional $443 for each adult with PD. PD is associated with excessive use of ambulatory services for comorbidities known to be related to diabetes. Our findings strengthen the business case for lifestyle interventions to prevent diabetes by adding additional economic benefits that potentially can be achieved by preventing or delaying PD.
authors.affiliation: The Lewin Group, Falls Church, Virginia, USA. yiduo.zhang@lewin.com
authors.forename: Yiduo
authors.initials: Y
authors.lastname: Zhang
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Dall
authors.forename: Yaozhu
authors.initials: Y
authors.lastname: Chen
authors.forename: Alan
authors.initials: A
authors.lastname: Baldwin
authors.forename: Wenya
authors.initials: W
authors.lastname: Yang
authors.forename: Sarah
authors.initials: S
authors.lastname: Mann
authors.forename: Victoria
authors.initials: V
authors.lastname: Moore
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Le Nestour
authors.forename: William W
authors.initials: WW
authors.lastname: Quick
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D005260:Female; D005102:Health Expenditures; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D011236:Prediabetic State / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose