title: The economic burden of elevated blood glucose levels in 2012: diagnosed and undiagnosed diabetes, gestational diabetes mellitus, and prediabetes.
abstract: OBJECTIVE
  To update estimates of the economic burden of undiagnosed diabetes, prediabetes, and gestational diabetes mellitus in 2012 in the U.S. and to present state-level estimates. Combined with published estimates for diagnosed diabetes, these statistics provide a detailed picture of the economic costs associated with elevated glucose levels.
  
  
  METHODS
  This study estimated health care use and medical expenditures in excess of expected levels occurring in the absence of diabetes or prediabetes. Data sources that were analyzed include Optum medical claims for ∼4.9 million commercially insured patients who were continuously enrolled from 2010 to 2012, Medicare Standard Analytical Files containing medical claims for ∼2.6 million Medicare patients in 2011, and the 2010 Nationwide Inpatient Sample containing ∼7.8 million hospital discharge records. The indirect economic burden includes reduced labor force participation, missed workdays, and reduced productivity. State-level estimates reflect geographic variation in prevalence, risk factors, and prices.
  
  
  RESULTS
  The economic burden associated with diagnosed diabetes (all ages) and undiagnosed diabetes, gestational diabetes, and prediabetes (adults) exceeded $322 billion in 2012, consisting of $244 billion in excess medical costs and $78 billion in reduced productivity. Combined, this amounts to an economic burden exceeding $1,000 for each American in 2012. This national estimate is 48% higher than the $218 billion estimate for 2007. The burden per case averaged $10,970 for diagnosed diabetes, $5,800 for gestational diabetes, $4,030 for undiagnosed diabetes, and $510 for prediabetes.
  
  
  CONCLUSIONS
  These statistics underscore the importance of finding ways to reduce the burden of prediabetes and diabetes through prevention and treatment.
authors.affiliation: IHS Life Sciences, Washington, DC tim.dall@ihs.com.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Dall
authors.affiliation: The Lewin Group, Falls Church, VA.
authors.forename: Wenya
authors.initials: W
authors.lastname: Yang
authors.affiliation: The Lewin Group, Falls Church, VA.
authors.forename: Pragna
authors.initials: P
authors.lastname: Halder
authors.affiliation: The Lewin Group, Falls Church, VA.
authors.forename: Bo
authors.initials: B
authors.lastname: Pang
authors.affiliation: Novo Nordisk Inc., Plainsboro, NJ.
authors.forename: Marjan
authors.initials: M
authors.lastname: Massoudi
authors.affiliation: Novo Nordisk Inc., Plainsboro, NJ.
authors.forename: Neil
authors.initials: N
authors.lastname: Wintfeld
authors.affiliation: IHS Life Sciences, Washington, DC.
authors.forename: April P
authors.initials: AP
authors.lastname: Semilla
authors.affiliation: Novo Nordisk Inc., Plainsboro, NJ.
authors.forename: Jerry
authors.initials: J
authors.lastname: Franz
authors.affiliation: The Lewin Group, Falls Church, VA.
authors.forename: Paul F
authors.initials: PF
authors.lastname: Hogan
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D057210:Delayed Diagnosis / Q000191:economics / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000097:blood / Q000175:diagnosis* / Q000191:economics* / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000097:blood / Q000191:economics* / Q000453:epidemiology; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000097:blood / Q000191:economics* / Q000453:epidemiology; D011247:Pregnancy; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose