The Cost of Diabetes Care—An Elephant in the Room

Everyone dealing with health care today knows there is an elephant in the room, impossible to miss but frequently ignored—the cost of diabetes care. Although clinicians and scientists may wish to neglect the financial side of diabetes care and focus on less contentious and more familiar matters, this option is no longer viable. For people with diabetes and their families, the elephant stands in the way every day, and for those who plan health services and payment, it is a major concern. Fortunately, the scientific methods used in epidemiologic, clinical, and health services research can be applied to the economics of diabetes care. Collecting observations, identifying patterns, forming hypotheses, and prospectively testing the hypotheses can be just as relevant when one of the variables examined is the cost of care. It is the mission of Diabetes Care to present the best scientific studies related to diabetes. This issue of Diabetes Care has a special section focused on the economic impact of diabetes, including studies designed to understand it and to assess potential solutions. The American Diabetes Association (ADA) has previously reported the costs of diabetes in the U. S. for the years 2002 (1), 2007 (2), and 2012 (3). This issue of Diabetes Care includes a 2017 update (4). Because the methods used in these analyses are similar, comparisons are possible. The most noteworthy findings from the current report are the continuing increase and the remarkable magnitude of the total direct costs of diabetes in the U. S.: 116 billion in 2007, 176 billion in 2012, and 237 billion in 2017. The cost of care for people with diabetes now accounts for ∼1 in 4 health care dollars spent in the U. S. Care for a person with diabetes now costs an average of 16, 752 per year. As in prior reports, the 2017 …