Breaking down diabetes

In the last 20 years, the number of adults diagnosed with diabetes has more than doubled.

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What is diabetes?

Diabetes mellitus refers to several conditions where the body does not produce appropriate levels of insulin (measured as A1C scores over a three-month period), a hormone that unlocks cells to allow glucose, or blood sugar, to enter. Diabetics either don’t create enough insulin, or their cells don’t respond properly to insulin.

By the numbers:

  • The federal National Diabetes Statistics Report 2020 estimates that in 2018 34.2 million people – 10.5% of the population – had diagnosed diabetes, while 2.8% had diabetes that had not been diagnosed.
  • An estimated 84-88 million adults had prediabetes (a serious health condition in which a person’s blood sugar levels are higher than normal but not high enough yet to be diagnosed as type 2 diabetes).
  • The percentage of adults with diabetes increases with age, and an estimated one-third of U.S. adults over the age of 60 have diabetes, diagnosed or undiagnosed. Another one-third have prediabetes.
  • In the last 20 years, the number of adults diagnosed with diabetes has more than doubled as the US population has aged and become more overweight.
  • Approximately 1.5 million new cases of diabetes in adults were diagnosed in 2018.

Types of diabetes


A person is considered prediabetic if he or she has higher blood glucose (blood sugar) levels that are higher than normal, but not high enough to justify a diagnosis of diabetes

Type 1

Also known as insulin-dependent diabetes, it is an auto-immune condition that attacks the pancreas affecting the ability to create insulin. Formerly called juvenile onset diabetes.

Type 2

The most common form of diabetes. In which a diabetic’s body either doesn’t produce enough insulin or becomes resistant to insulin. It is a largely preventable progressive disease influenced by risk factors such as smoking, obesity, physical inactivity, high blood pressure and poor diet.

Gestational diabetes

Diabetes that is diagnosed for the first time during pregnancy (gestation) and is believed to be triggered by hormonal changes. It is a temporary condition, although it does raise the risk of eventually developing Type 2 diabetes. The Center for Disease Control estimates that it occurs in 2 to10% of pregnancies.

Metabolic process

  1. Food is eaten
  2. Digestive system converts carbohydrates into glucose, or blood sugar
  3. Glucose enters bloodstream
  4. Pancreas releases insulin
  5. Insulin allows glucose from the blood to enter cells which use it for energy

Cost burden of diabetes

The total estimated cost of diagnosed diabetes in 2017 in the U.S. was $327 billion, according to the National Diabetes Statistics Report 2020. This total reflects $237 billion in direct medical costs and an additional $90 billion in reduced productivity (absenteeism and reduced productivity at work for those in the labor force, inability to work, and premature deaths attributed to diabetes).

The American Diabetes Association (ADA) estimates that economic costs of diabetes, adjusted for inflation, increased by 26% from 2012 to 2017. This is due to both an increased prevalence of diabetes and the increased cost per person. The growth in diabetes prevalence and medical costs is primarily among the population aged 65 years and older, raising economic cost of the Medicare program.

Growth of direct and indirect costs of diabetes in the U.S.

  Direct Indirect Total
2012 $188 billion $73 billion $260 billion
2017 $237 billion $90 billion $327 billion


People with diagnosed diabetes incur average medical expenditures of approximately $16,750 per year, of which roughly $9,600 is directly attributed to diabetes. People with diagnosed diabetes have, on average, medical expenditures of 2.3 times higher than people who do not have diabetes.

Diabetes is an ideal target for prevention strategies as it is a major risk factor for other serious chronic conditions and can be managed through a combination of lifestyle changes and health care interventions such as prescription medications including insulin. The high prevalence of diabetes means that prescriptions for diabetes medications are very common.

As an experienced Pharmacy Benefits Manager (PBM), IPM is well-equipped to help clients and members deal with the rising cost of diabetes and diabetes medications.

Health and Economic Costs of Chronic Diseases

National Diabetes Statistics Report 2020

Division of Diabetes Translation at a Glance