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In developing countries such as India, where almost 51 million people
have T2DM, lack of access to health care services, as well as lack of
26
national welfare schemes and health insurance coverage for diabetes
make treatment unaffordable for the masses resulting in late diagnosis
and the early onset of complications, with their heavy economic burden. 31

In the United States, almost 27 million people have diabetes and an ad-
ditional 57 million are estimated to have pre-diabetes, putting them at
an increased risk for developing diabetes. 26 29 The total cost of diabetes
in 2007 was $174 billion, including $116 billion in excess medical expen-
ditures and $58 billion in reduced national productivity. Medical costs
32
attributed to diabetes include $27 billion for care to directly treat dia-
betes, $58 billion to treat the chronic complications that are attributed
to diabetes, and $31 billon in excess general medical costs. The larg-
32
est components of medical expenditures attributed to diabetes are
hospital inpatient care (50% of total cost), diabetes medication and
supplies (12%), retail prescriptions to treat complications of diabetes
(11%), and physician office visits (9%). Of the chronic complications
32
of diabetes, peripheral vascular disease accounts for the greatest pro-
portion of expenditure in that category (Figure 4). 32

Figure 4. Proportion of category expenditures associated with diabetes in the US. 32
In the UK, the cost of diabetes to the National Health Service is approxi-
mately £1 million per hour, and is increasing rapidly. Around 2.1 million
33
people in the UK have diabetes, which is forecast to rise to 2.5 million
by 2030. Diabetes accounts for approximately a tenth of the NHS’
26
budget each year, a total exceeding £9 billion. In 2004-2005, primary
33
care units in England dispensed by prescription 24.8 million items for the

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