Objective: Type 2 diabetes has grown to epidemic proportions in the U.S. and physical activity levels in the population continues to remain low, although it is a major primary preventive strategy for diabetes. The objectives of this study were to estimate the direct medical costs of type 2 diabetes attributable to not meeting physical activity Guidelines and to physical inactivity in the U.S. in 2012.
Methods: This was a cross sectional study that used physical activity prevalence data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS). Estimates of relative risk of type 2 diabetes for subjects not engaging in any leisure time physical activity and those not meeting physical activity guidelines were obtained for multiple studies published in the literature. Using the prevalence of not meeting physical activity guidelines, physical inactivity and the respective relative risks, the population attributable risk percentage (PAR%) for type 2 diabetes was estimated by Levin’s formula. These data were combined with the prevalence and cost data of type 2 diabetes (in 2012) to estimate the cost of type 2 diabetes attributable to not meeting physical activity Guidelines, and to physical inactivity in 2012. Sensitivity analyses were done for i) varying the prevalence of not meeting physical activity guidelines from 30-70%, and ii) varying the average annual cost of type 2 diabetes from $4394 (for person less than 45 years of age) to $11825 (for person greater than 65 years of age).
Results: The prevalence of U.S. population meeting physical activity guidelines and engaging in no leisure time activity was 50% and 30% respectively in 2012. The average annual cost attributable to type 2 diabetes in the US, was $7888 per person. The cost of type 2 diabetes in the U.S. in 2012, attributable to not meeting physical activity guidelines was estimated to be $18.6 billion, and that attributable to physical inactivity was estimated to be $5.9 billion. Based on sensitivity analyses, these estimates ranged from $10.36 billion to $27.9 billion for not meeting physical activity guidelines and $3.3 billion to $8.87 billion for physical inactivity in the year 2012.
Conclusions: This study shows that billions of dollars could be saved annually just in terms of type 2 diabetes cost in the U.S., if the entire adult population was active enough to meet physical activity guidelines. Physical activity promotion, particularly at the environmental and policy level should be a priority in the population.