On economic impact of diabetes

---

Muhammad Abdul Mazid
DIABETES is a chronic condition that occurs when the body cannot produce enough or effectively use insulin. Insulin is a hormone produced by the pancreas that allows glucose from food to enter the body's cells where it is converted into energy needed by muscles and tissues to function. As a result, a person with diabetes does not absorb glucose properly, and glucose stays circulating in the blood (hyperglycaemia) damaging tissues over time. This damage leads to life-threatening health complications.
According to Fifth Edition of Diabetes Altlas ( 2011) published by the International Diabetic Federation (IDF), the estimated number of adults living with diabetes has soared to 366 million, representing 8.3% of the global adult population. This number is projected to increase to 552 million people by 2030, or 9.9% of adults, which equates to approximately three more people with diabetes every 10 seconds.
There is none to deny the crude fact that Diabetes imposes a large economic burden on any national healthcare system. Estimated figures show healthcare expenditures on diabetes accounted for 11.6% of the total healthcare expenditure in the world in 2010. About 95% of the countries spend 5.0% or more of their total healthcare dollars on diabetes. IDF estimates also project that global health expenditures to prevent and treat diabetes and its complications surpassed US dollar 376 billion in 2010 and by 2030, this number will exceed some USD490 billion. An average of USD703 per person was depleted on diabetes in 2010 globally. More than three-quarters of the global expenditure in 2010 were used for persons who are between 50 and 80 years of age. Also, more money is expected to be spent on diabetes care for women than for men.
Research results show that there remain a large disparity in healthcare spending on diabetes between regions and countries. More than 80% of the global expenditures on diabetes are made in the world's economically richest countries, not in the low- and middle-income countries where 80% of people with diabetes live. The North American and Caribbean Region used up USD214 billion, or 57% of the global total on diabetes where , in contrast, the African Region spent 0.4% of the global total in 2010. The United States of America (USA), alone spent 52.7% of global expenditure. India, the country with the largest population of people living with less than 1.0% of the global total. An average of USD 7,383 per person with diabetes spent on diabetes-related care in the USA but less than USD10 per person spent in many under developed countries in Asia and Africa .
Recent studies drew three major conclusions on overall economic impact of diabetes First, diabetes imposes a large financial burden on people with diabetes and their families. The size of this burden depends on their economic status and the social insurance policies of the countries in which they live. Individuals with diabetes and their families in developing countries pay a larger share of the expenditure because of the poorer organised systems of medical care insurance and/or lack of governmental provision of medical services. In the poorest countries, people with diabetes and their families bear almost the whole cost of whatever medical care they can afford. In Bangladesh, exceptionally, clinical cum social services (a certain percentage of free services ) are offered to diabetes patient through chain hospitals and healthcare centers of Diabetic Association . In India, the poorest persons with diabetes spend an average of 25% of their total income on healthcare.
Second, at the societal level, diabetes leads to loss in productivity and economic growth. The American Diabetes Association estimated that the US economy lost USD$58 billion, equivalent to about an half of the direct health care expenditure on diabetes in 2007, as a result of lost earnings due to lost work days, restricted activity days, lower productivity at work, mortality and permanent disability caused by diabetes. Such losses are found relatively larger in poorer countries because premature death due to diabetes occurs at much younger ages. The World Health Organization (WHO) predicts net losses in national income from diabetes and cardiovascular disease of ID557.7 billion in China, ID303.2 billion in the Russian Federation, ID336.6 billion in India, ID49.2 billion in Brazil and ID2.5 billion in Tanzania (2005 ID), between 2005 and 2015.