The Burden of Obesity on Diabetes in the United States: Medical Expenditure Panel Survey, 2008 to 2012

Abstract

Objective Diabetes is one of the most prevalent and costly chronic diseases in the United States. This study analyzed the risk of developing diabetes and the annual cost of diabetes for a U.S. general population. Methods Data from the Medical Expenditure Panel Survey (MEPS), 2008–2012, was used to analyze (i) probabilities of developing diabetes and (ii) annual total healthcare expenditures for diabetics. The age-gender-race-body mass index (BMI) category specific risks of developing diabetes were estimated by fitting an exponential survival function to age at first diabetes diagnosis. Annual healthcare expenditures were estimated using a generalized linear model with log-link and gamma variance function. Complex sampling designs in the MEPS were adjusted for. All dollar values are presented in 2012 U.S. dollars. Results We observed a >6-fold increase in diabetes risks for class III obese (BMI≥40) individuals, compared to normal weight individuals. Using age 50 as an example, we found a >3-fold increase in annual healthcare expenditures for diabetics ($13,581), compared to non-diabetics ($3,954). Compared to normal weight (18.5≤BMI<25) individuals, class II obese (35≤BMI<40) and class III obese individuals incurred an annual marginal cost of $628 and $756, respectively. The annual healthcare expenditure differentials between diabetics and non-diabetics age 50 were the highest for individuals with class II ($12,907) and class III obesity ($9,703). Conclusions This paper highlights the importance of obesity on diabetes burden. Our results suggested that obesity, in particular, BMI ≥35, is associated with a substantial increase in the risk of developing diabetes and imposes a large economic burden.

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