Diabetes cases projected to nearly double in next 25 years.

Source: AMA Morning Rounds 11/30/09

Diabetes cases projected to nearly double in next 25 years.

The Chicago Tribune (11/27, Shelton) reported that, according to a study published Nov. 27 in the journal Diabetes Care, "diabetes cases will nearly double in the US in the next 25 years and the cost of treating the disease will almost triple." University of Chicago researchers "found the number of people with diagnosed and undiagnosed diabetes will climb from almost 24 million this year to about 44 million in 2034. Over the same period, annual diabetes-related treatment costs are expected to increase from $113 billion to $336 billion in 2007 dollars."

        Bloomberg News (11/27, Waters) reported, "Diabetes prevents people from breaking down sugar in their blood and can lead to complications, including heart disease, kidney disease, vision loss, and amputation of limbs. While some people have an inherited form of the condition, the majority of cases are linked to obesity."

        HealthDay (11/27, Thomas) reported that, besides obesity, another "factor driving the soaring costs" is "the number of people living with diabetes for lengthy periods, the researchers said. Over time, the cost of caring for someone with diabetes tends to rise along with their risk for developing complications, such as end-stage renal disease, which requires dialysis." Notably, "among Medicare beneficiaries, the number with diabetes is expected to rise from 8.2 million to 14.6 million in 2034, with an accompanying rise in spending from $45 billion to $171 billion."

        "As a result, by 2034, half of all direct spending in diabetes care is projected to occur in the Medicare population," WebMD (11/27, Boyles) reported. Still, "although little can be done about the aging of the population, much can be done about the other major risk factor for type 2 diabetes -- obesity." MedPage Today (11/27, Gever) and CNN (11/27, Hellerman) also covered the study.

        Rituximab seen as promising for type 1 diabetes. Bloomberg News (11/26, Doherty) reported that, according to a study in the Nov. 26 issue of the New England Journal of Medicine, the "arthritis and lymphoma medicine Rituxan [rituximab] cut the need for insulin treatment among patients with type 1 diabetes after a year."

        In a phase 2 trial, researchers from Indiana University randomly assigned "87 patients with newly diagnosed type 1 diabetes...to receive rituximab infusions or a placebo at one-week intervals for four weeks," HealthDay (11/25, Gardner) reported. The investigators discovered that "after one year, C-peptide levels -- an indicator of how much insulin is being produced by the body -- were higher in people taking rituximab versus those in the placebo group," with "those in the rituximab group also" needing "less external insulin." In other words, rituximab "helped patients keep producing some of their own insulin."

        WebMD (11/25, DeNoon) noted, however, that "a single course of Rituxan wasn't enough to stop diabetes. After a year, B cells in treated patients increased to 69% of their original values." Nevertheless, "the study does show that a treatment targeting B cells can preserve beta-cell function in early type 1 diabetes."

        MedPage Today (11/25, Gever) reported that Joel Zonszein, MD, of the Albert Einstein College of Medicine, cautioned, "The molecule [rituximab] is not free of side effects, and" that "important long-term side effects are unknown." Dr. Zonszein, who was not involved in the study, agreed, however, that the "study opens a new pathway of exploration."