Diabetes complications are common—but are they affordable?

Diabetes treatment itself comes at a considerable price, but related complications like eye disease, kidney damage and amputations can elevate medical bills into the tens of thousands, German researchers reported this month in Diabetes Care.

Diagnosed diabetes mellitus alone cost the U.S. an estimated $245 billion in 2012, according to a 2013 study, with $176 billion attributed to direct medical costs and $69 billion due to reduced productivity. Those numbers translated to individual patient expenditures of $7,900 per year—$13,700 when including diabetes-related costs and complications.

While more than 29 million Americans have diabetes, according to the Centers for Disease Control and Prevention, just 7 million Germans suffer from the same diagnosis. Lead author Katharina Kähm, MPH, and colleagues at the Munich-based research center Helmholtz Zentrum München examined data from 316,220 type 2 diabetics in an effort to quantify how much national spending can be linked back to complications of the common disease.

“We wanted to know the extent of the associated costs that are borne by the statutory health insurance and thus by society as a whole,” Kähm said in a release.

The researchers evaluated data from the three years between 2012 and 2015, accounting for costs for inpatient and outpatient care, pharmaceuticals, rehabilitation and nonmedical aids and appliances. Since type 2 diabetes is most common in older men, Kähm and her team modeled their results on those of a 60 to 69-year-old man.

All costs were expressed in 2015-value Euros in Kähm et al.’s study; these figures were converted to present-day U.S. dollars for this article. These were the results:

Diabetic foot: $1,606, or €1,293

Amputation: $17,738, or €14,284

Retinopathy: $833, or €671

Blindness: $3,642, or €2,933

Kidney disease: $4,162, or €3,353

End-stage renal disease: $28,178, or €22,691

Nonfatal stroke: $12,131, or €9,769

Fatal stroke: $13,878, or €11,176

Nonfatal myocardial infarction/cardiac arrest: $9,978, or €8,035

Fatal MI/CA: $10,804, or €8,700

Nonfatal ischemic heart disease: $8,131, or €6,548

Fatal IHD: $26,006, or €20,942

Chronic heart failure: $4,858, or €3,912

Angina pectoris: $3,346, or €2,695

“The results show clinical and health policy decision makers the considerable financial consequences of diabetes-related complications,” co-author Rolf Holle said in the release. “The study can thus be helpful in the planning and prioritization of new prevention and treatment programs in the management of type 2 diabetes.”