The United States of Diabetes: New Report Shows Half the Country Could Have Diabetes or Prediabetes at a Cost of $3.35 Trillion by 2020

November 23, 2010

More than 50 percent of Americans could have diabetes or prediabetes by 2020 at a cost of $3.35 trillion over the next decade if current trends continue, according to new analysis by UnitedHealth Group’s (NYSE: UNH) Center for Health Reform & Modernization, but there are also practical solutions for slowing the trend.

New estimates show diabetes and prediabetes will account for an estimated 10 percent of total health care spending by the end of the decade at an annual cost of almost $500 billion – up from an estimated $194 billion this year.

The report, “The United States of Diabetes: Challenges and Opportunities in the Decade Ahead,” produced for November’s National Diabetes Awareness month, offers practical solutions that could improve health and life expectancy, while also saving up to $250 billion over the next 10 years, if programs to prevent and control diabetes are adopted broadly and scaled nationally. This figure includes $144 billion in potential savings to the federal government in Medicare, Medicaid and other public programs.

Key solution steps include lifestyle interventions to combat obesity and prevent prediabetes from becoming diabetes and medication control programs and lifestyle intervention strategies to help improve diabetes control.

“Our new research shows there is a diabetes time bomb ticking in America, but fortunately there are practical steps that can be taken now to defuse it,” said Simon Stevens, executive vice president, UnitedHealth Group, and chairman of the UnitedHealth Center for Health Reform & Modernization. “What is now needed is concerted, national, multi-stakeholder action. Making a major impact on the prediabetes and diabetes epidemic will require health plans to engage consumers in new ways, while working to scale nationally some of the most promising preventive care models. Done right, the human and economic benefits for the nation could be substantial.”

The annual health care costs in 2009 for a person with diagnosed diabetes averaged approximately $11,700 compared to an average of $4,400 for the remainder of the population, according to new data drawn from 10 million UnitedHealthcare members. The average cost climbs to $20,700 for a person with complications related to diabetes. The report also provides estimates on the prevalence and costs of diabetes, based on health insurance status and payer, and evaluates the impact on worker productivity and costs to employers.

Diabetes currently affects about 27 million Americans and is one of the fastest-growing diseases in the nation. Another 67 million Americans are estimated to have prediabetes. There are often no symptoms, and many people do not even know they have the disease. In fact, more than 60 million Americans do not know that they have prediabetes. Experts predict that one out of three children born in the year 2000 will develop diabetes in their lifetimes, putting them at grave risk for heart and kidney disease, nerve damage, blindness and limb amputation.

Estimates in the report were calculated using the same model as the widely-cited 2007 study on the national cost burden of diabetes commissioned by the American Diabetes Association (ADA).

Diabetes and Obesity

The report also focuses on obesity and its relationship to diabetes. Being overweight or obese is one of the primary risk factors for diabetes, and with more than two-thirds of American adults and 17 percent of children overweight or obese, the risk is clearly rising. In fact, over half of adults in the U.S. who are overweight or obese have either prediabetes or diabetes, and studies have shown that gaining just 11-16 pounds doubles the risk of type 2 diabetes and gaining 17-24 pounds nearly triples the risk.

“Because diabetes follows a progressive course, often starting with obesity and then moving to prediabetes, there are multiple opportunities to intervene early and prevent this devastating disease before it’s too late,” said Deneen Vojta, M.D., senior vice president of the UnitedHealth Center for Health Reform & Modernization, who helped develop UnitedHealth Group’s Diabetes Prevention and Control Alliance.


The United States of Diabetes: Challenges and Opportunities in the Decade Ahead focuses on four categories of potential cost savings over the next 10 years:

  • Lifestyle Intervention to Combat Obesity: There is an opportunity to reduce the number of people who would develop prediabetes or diabetes by nearly 10 million Americans, through public health initiatives and the wider use of wellness programs to combat obesity.
  • Early Intervention to Prevent Prediabetes from Becoming Diabetes: Evidence from randomized controlled trials and UnitedHealth Group’s own experience demonstrates that the use of community-based intervention programs – such as the UnitedHealth Group Diabetes Prevention Program (DPP) in partnership with the Y – could reduce the number of people with prediabetes who convert to diabetes by an additional 3 million. The DPP is based on the original U.S. Diabetes Prevention Program, funded by the National Institutes of Health (NIH) and the CDC, which demonstrated that with lifestyle changes and modest weight reduction, individuals with prediabetes can prevent or delay the onset of the disease by 58 percent.
  • Diabetes Control through Medication and Care Compliance Programs: Better management of diabetes through improved medication and care compliance programs can help control the disease and reduce complications, such as UnitedHealth Group’s Diabetes Control Program (in partnership with community pharmacists).
  • Lifestyle Intervention Strategies for Diabetes Control: The wider use of public-private partnerships to develop the infrastructure to scale nationally the promising learnings of the Look AHEAD Trial.

The report's analysis draws on evidence-based, practical solutions derived from research, pilot programs and UnitedHealth Group’s own experience serving more than 75 million individuals worldwide.

About the UnitedHealth Center for Health Reform & Modernization
The Center serves as the focal point for UnitedHealth Group’s work on health care modernization and national health reform. The Center assesses and develops innovative policies and practical solutions for the health care challenges facing the nation. For more information about the Center and to view the full report, go to:

About UnitedHealth Group
UnitedHealth Group is a diversified health and well-being company dedicated to helping people live healthier lives and making health care work better. With headquarters in Minnetonka, Minn., UnitedHealth Group offers a broad spectrum of products and services through six operating businesses: UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement, UnitedHealthcare Community & State, OptumHealth, Ingenix and Prescription Solutions. Through its family of businesses, UnitedHealth Group serves more than 75 million people worldwide. Visit for more information. 

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