Updated November 2013
According to the Centers for Disease Control and Prevention (CDC), in 2007, the medical costs associated with diabetes were $116 billion and the indirect costs (disability, work loss, premature mortality) were $58 billion. State legislatures throughout the country are actively exploring policy options to deal with this growing problem. An estimated 26 million people in the United States—8.3 percent of the population—have diabetes, a serious and chronic condition. Of those, 25 percent do not yet know that they have the condition. In addition, an estimated 79 million U.S. adults have pre-diabetes—an elevated blood sugar level that is not high enough to be classified as diabetes, but which greatly raises their risk of developing type 2 diabetes and its complications. Diabetes is the seventh leading cause of death in the U.S. It's complications, including heart disease, stroke, amputations, blindness and kidney disease, are both serious and expensive. The cost to treat an individual with diabetes is more than 200 percent higher than the cost to treat a non-diabetic.
As of mid-2013, there have been at least 130 diabetes-related bills proposed across 20 states, territories, and D.C.
States Address the Cost of Diabetes: A 50-State Budget Survey for Fiscal Year 2012. As a means to assess how states are responding to the diabetes epidemic, the National Conference of State Legislatures (NCSL) conducted a 50-state analysis of appropriations for fiscal year 2012. This analysis reviewed state budgets and related state budget documents that explicitly identified diabetes programmatic appropriations.
States Fight Diabetes - NCSL's April 2013 State Legislatures magazine highlighting state action to prevent and treat diabetes.
Chronic Cost of Diabetes - NCSL's April 2012 State Legislatures magazine highlights issues and challenges.
Diabetes Health Coverage: State Laws and Programs - This report covers all state diabetes mandates and minimum coverage requirements for state-regulated health insurance policies. Online edition updated in May 2011.
Diabetes State Legislation Overview - Many state legislatures considered diabetes related legislation between 2007 and 2012. This page contains information about legislative options to address diabetes considered or enacted during these sessions.
Disparities in Health - African American, Hispanic, American Indian and Alaskan Native adults are twice as likely as white adults to have diabetes. Other diabetes risk factors include being over age 45, overweight, inactive or having had gestational diabetes. Even those at highest risk benefit from prevention and treatment. Cutting calories to lose 5 percent to 7 percent of body weight and increasing physical activity—walking for 30 minutes five days per week—reduced diabetes onset by 58 percent in a major study. Click here to learn more about diabetes health disparities.
Women's Health - Diabetes is the fifth leading cause of death among women ages 45-54 in the United States and a major cause of disability. An estimated 9.1 million women have diabetes, but one-third of them are unaware of their illness.
Gestational diabetes happens in a woman who develops diabetes during pregnancy. Poor control of gestational diabetes increases the chance for birth defects and other problems.
LegisBrief - States Address Diabetes in Minority Populations
This LegisBrief highlights actions of states and public-private partnerships to tackle type 1 and type 2 diabetes (June 2012).
Public Health Herald- Preventing and Controlling Diabetes
To address the increasing burden of diabetes, and disparities in health care coverage for the condition, CDC funds state-based diabetes prevention and control programs in all states, the District of Columbia, and eight territories. Several of these programs encourage Medicaid reimbursement for patients’ education on the self-management of diabetes (November 2011).
LegisBrief- State Approaches to Prevent and Control Diabetes
Diabetes accounts for 10 percent of all U.S. health care spending and is expected to become even more prevalent. State programs can help prevent the disease and improve its treatment (September 2011).
Report- Diabetes in State Budgets
This National Conference of State Legislatures report provides a 50-state survey of diabetes funding in the states and CDC funding for Diabetes Prevention and Control Programs (May 2011).
Report- Federal Health Reform Provisions Related to Diabetes
This National Conference of State Legislatures report provides an overview of the components of the Affordable Care Act that related to diabetes (May 2011).
Postcard - Diabetes Prevalence: County Level
This National Conference of State Legislatures postcard provides the latest national data released and available by the CDC in 2010 about county level diabetes prevalence (July 2010).
Public Health Herald - Topic of the Quarter: Diabetes
Diabetes, the sixth leading cause of death in the United States, accounts for more than 200,000 deaths and also causes blindness, kidney failure, and lower-limb amputations among other ailments. Treating diabetes costs $116 billion annually—more than 5 percent of total health care spending—with a further $58 billion in indirect economic costs. Diabetes cases are often preventable (Fall 2008).
Postcard - Women and Diabetes
This National Conference of State Legislatures postcard provides some brief statistics about women and diabetes, costs, and control and prevention (March 2008).
LegisBrief - Diabetes: Rising Rates, Disability and Death (October 2006).
In the News
Diabetes Patients In PCMHs Well Served By Nonphysicians And Physicians Alike. In the first study to compare the effectiveness of physician assistant (PA) and nurse practitioner (NP) roles to physician-only care for patients with chronic disease, Christine Everett of Duke University and coauthors found that patient outcomes were generally the same in thirteen comparisons. In four comparisons, PA and NP care was found to be superior; in three, the physician-only outcomes were higher. For the Diabetes treatment study in the November issue of Health Affairs, the authors used Medicare claims and electronic health record data from a Midwestern county and identified 2,576 Medicare patients with diabetes. Results of the study support previous findings that PAs and NPs can perform a range of effective roles in primary care, yet they indicate that patient characteristics and other factors should inform precisely how these practitioners should be deployed.. The topic was discussed at a November 14, 2013 DC briefing. (audio available)
- World Diabetes Day is celebrated October 13, 2013
- Disparities in Diabetes Risk Often Overlooked. Med Page Today. March 22, 2013.
- Low Vitamin D Level Tied to Type 1 Diabetes. New York Times. November 26, 2012.
- Diabetes Surgery Tops Medical Innovation List. Med Page Today. October 31, 2012.
- Interactive Map Visualizes Correlation between Type 2 Diabetes and Access to Fresh Food, Poverty Levels. Healthline.com. April 15, 2012.
- Obesity-Linked Diabetes Harder to Treat in Children. New York Times. April 29, 2012.
- Telemedicine Tackles Diabetes Epidemic. Information Week. March 14, 2012.
- Health Beat: Planning and Managing Diabetes. U.S. Department of Health and Human Services. January 13, 2012.
- Type 1 Diabetes Checks Are Crucial for Students, School Staff. Los Angeles Times. November 7, 2011.
- Diabetes Prevention Programs Could Save Billions in Health Care Costs. Atlanta Journal-Constitution. October 5, 2011.
- Disparities in Diabetes Self-Management and Quality of Care in Rural Versus Urban Veterans. Journal of Diabetes Complications. November 2011.
- Move to Better Area Tied to Less Diabetes. Reuters. October 19, 2011.
- Electronic Health Records and Quality of Diabetes Care. New England Journal of Medicine. September 1, 2011.
- Creepy-crawlies may help heal diabetes wounds. Reuters. September 23, 2011.
- EHRs Improve Care Coordination For Diabetics. Information Week. June 23, 2011.
- Approximately $40 million in Affordable Care Act funds for statewide chronic disease prevention programs. U.S. Department of Health and Human Services. June 7, 2011.
- Colorado Clinic Aims to Stave Off Burdens of Diabetes with 1-stop Coordinated Care. PBS News Hour. February 5, 2011.
- Reducing drug co-pays might lower health-care costs for companies, new study finds. Orlando Sentinel. January 10, 2011.
- Diabetes May Affect as Many as 1 in 3 Americans by 2050. USA Today. October 10, 2010.
- Strong Link between Diabetes and Air Pollution Found in National US Study. Science Daily. September 30, 2010.
- Lifestyle Intervention Improves Risk Factors in Type 2 Diabetes. National Institutes of Health. September 30, 2010.
- Breastfeeding Cuts Moms Diabetes Risk. Reuters. September 30, 2010.
- Combating Childhood Obesity May Start in the Womb. Reuters. May 14, 2010.
- An Insurer’s New Approach to Diabetes. The New York Times. April 13, 2010.
NOTE: NCSL provides links to other Web sites from time to time for information purposes only. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.
This site is made possible with support from Novo Nordisk and the Centers for Disease Control and Prevention (CDC).