WASHINGTON – Jerome Goodman didn’t need the American Diabetes Association to tell him that it’s getting more expensive to be a diabetic — he sees it every month when he looks at his bills for medication and supplies.
The 72-year-old Pikesville resident said he spends more than $100 a month on diabetes and related conditions, far more than he spent 15 years ago when he was diagnosed with the disease.
“It (diabetes) increases my cost of medicine,” Goodman said.
State health officials feel his pain: A surge in the number of people diagnosed with diabetes and increases in the cost of treatment is driving costs up sharply.
The total direct medical cost for diabetes treatment in Maryland was $16 billion from 1997 to 2001, according to formulas used by the Centers for Disease Control and Prevention to calculate the cost of the disease to states.
The cost of diabetes care in Maryland in 2001 was about $3.5 billion, up from $2.8 billion in 1997, according to the formula. Direct medical cost is the amount spent on services like institutional care, outpatient care and home health and hospice care.
The 26 percent increase mirrored the increase in the number of people diagnosed with diabetes in the state, which went from 210,000 in 1997 to 264,000 in 2001. But that increase represented a sharp increase in the percentage of Marylanders with the disease, rising from 5.7 percent to 6.8 percent.
“What a dramatic increase means is that it is going to take so much more to care for people,” said Earl Shurman, chief of Maryland’s diabetes prevention and control division.
It will affect more than just people with diabetes, he said. When the state spends more money on health care it can spend less money on things like education.
“The pie is only so big . . . if a bigger portion of that pie is going toward taking care of people with diabetes you have less for other things,” Shurman said.
Over the last decade, Shurman said, the prevalence of diabetes grew nearly 40 percent, with the largest increases coming in the 30 to 49-year old range.
“It really is an epidemic worldwide,” he said. “This large increase in prevalence is going to contribute to an increase in medical costs for the country in the future.”
The American Diabetes Association said that spending on direct medical costs for diabetes doubled nationally from 1997 to 2002. It estimated that when costs such as lost productivity and wages are added in, the cost of the disease in 2002 reached about $132 billion.
The association projects that nearly 14.5 million people in the United States could have the disease by 2010.
The largest increase has been in Type-II diabetes, which is usually attributed to poor eating and exercise habits.
Like most experts, Shurman believes that the because diabetes often requires a change in lifestyle, rather than simply taking a pill, people find it harder to comply with the physician’s directions.
“You can’t just show up and your doctor’s going to make you better,” Shurman said. “You can’t just take a magic pill and be inactive and eat what you want and be fine.”
Goodman, who has served on the board of the Maryland Diabetes Association, understands the reluctance many people have to making the changes that diabetes requires. He remembers how when he was diagnosed, he told himself that if he just lost a little weight the diabetes would disappear.
Now he knows that what he needed was a real change in lifestyle.
“I go to the doctor every four months, I get my feet checked regularly and I make sure I go to the eye doctor once a year,” Goodman said of his health precautions now.
But he said the required lifestyle changes and the high costs of treating diabetes cause many people ignore the disease until they are forced into expensive hospital care.
“I had to learn that I have to exercise and keep my weight down,” Goodman said. “God forbid you have a leg amputated, you’re talking major bucks. Heart attack, major bucks.”
Shurman said that because of better medical treatments, diabetics are living longer with the disease and incurring more medical costs in the process.
One way to keep those costs down is to bring the reality of the disease home to people — an inadvertent bonus of the increasing prevalence of diabetes.
“One of the biggest challenges is making people feel a personal vulnerability to the risk,” Shurman said. “It’s not just a number.”