PRINCETON, NJ – The diabetic population in the United States will almost double and annual medical spending on the disease is projected to hit $336 billion, triple the current rate, in the next 25 years, according to a study published in the December issue of Diabetes Care.

The analysis, by a team from the University of Chicago, forecasts that the number of Americans living with diabetes will rise from 23.7 million in 2009 to 44.1 million in 2034, those living with diabetes and covered by Medicare will rise from 6.5 million to 14.1 million, and Medicare spending on diabetes will jump from $45 billion this year to $171 billion in 2034.

Based on this projection, "Medicare spending alone will represent just over 50 percent of direct spending on diabetes in 2034," the authors said.

The research considers the natural progression of the disease, effects of treatment and obesity rates in the United States, which are "factors that are currently not used by government budget analysts.”

"The size of the current diabetes population exceeds many prior forecasts and we expect that the future growth of population and its associated costs will be explosive,” said Elbert Huang, lead author of the paper and an assistant professor of medicine in the Department of Medicine at the University of Chicago. “Finding ways to reduce the number of people who develop diabetes is both a national public health priority and a fiscal imperative.”

The best way to stem the rise in diabetes is to implement proven preventive care programs on a national level, he said. This will require that policymakers understand that diabetes prevention is a long-term investment that will  reap benefits over decades, he said, rather than years.

The Congressional Budget Office, which assesses the cost of proposed legislation, does not typically consider cost savings beyond 10 years. Because diabetes develops over a long period of time, with the highest costs coming later in life, savings are far more apparent at 25 years than at 10 years. For this reason, policymakers need a long-term analysis of costs in order to make accurate decisions that reflect the true impact of prevention programs.

"Managing diabetes means preventing the pain and expense of diabetes complications, including heart disease, amputation, kidney disease and blindness," said Michael Mawby, chief government affairs officer and director of the National Changing Diabetes Program (NCDP), a diabetes leadership initiative established by Novo Nordisk to drive health system change at the national and local level, which funded the research.

Legislation introduced earlier this year is designed to lead to a more accurate assessment of the costs and benefits of preventive health, including preventing complications and delaying progression of chronic diseases such as diabetes. The bipartisan Preventive Health Savings Act of 2009 (HR 3148) calls on the CBO to weigh clinical or observational studies when modeling projected costs and savings related to preventive health.