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The Diabetic Debate

WHY DIABETES NOW?

Type 2 Diabetes, which represents 95 per cent of the global burden of diabetes, poses a significant healthcare problem and its prevalence is continuing to rise at an alarming rate. In the US, “one out of every eight federal health care dollars (12.5 per cent) is spent treating people with diabetes” (1). The Centers for Disease Control estimate that 20.8 million people in the US – representing seven per cent of the total population – have diabetes. It is predicted that this number will double by 2025, further increasing the already-high financial burden of diabetes (2). This expected increase, driven largely by a corresponding rise in obesity, comes despite numerous efforts to control the far-reaching effect of diabetes, including the ‘Healthy People 2010’ goal (3).

The diabetes problem is not limited to the US. The World Health Organization (WHO) estimates that 171 million people have diabetes worldwide, and this is predicted to rise to 366 million by 2030 (2). This worldwide prevalence represents an unimaginable global economic toll. Managing and reducing the heavy burden of diabetes will require concerted efforts of policy makers, healthcare providers, researchers and healthcare payers. The issue of diabetes is compounded by the increasing risks associated with its complications and co-morbidities (C&Cs).

The presence of diabetes increases the risk of over 40 complications, including atherosclerosis, coronary heart disease and nephropathy (damage to or disease of the kidney). Additionally, the presence of other co-morbidities, including obesity, hypertension and dyslipidemia, in turn, increase the risk of diabetes. The growing risks associated with the presence of diabetes and its C&Cs interact to form a complex intertwined cause-effect landscape (see Figure 1). These cause-effect feedback loops among C&Cs have the dangerous potential to reinforce and exacerbate the severity of the downstream C&Cs.


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Nick Hughes is Global Head of Life Sciences and Healthcare at PA Consulting Group. His formal training is as a life scientist and a management scientist – he has degree qualifications in Biology and a Masters in Operational Research. He has experience of the entire pharma value chain and the nexus to the healthcare payer/provider communities and has has worked on some of PA’s largest change and transformation programmes. Nick has undertaken multiple strategy and implementation engagements in pharmaceutical companies – including AZ, Pfizer, and a number of other manufacturers of both drug and biomedical product – and developed novel approaches to strategic supply chain solutions.

Roger Edwards is Assistant Professor at Northeastern University, Boston Massachusetts. Prior to this, he was Managing Consultant in Life Sciences & Healthcare at PA Consulting Group. Roger has over two decades of experience in academia, industry and government in the diffusion of medical innovations. He holds an AB in Human Biology/MS Health Services Research from Stanford University and a ScD in Health Policy and Management from the Harvard School of Public Health.

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