Abstract
BackgroundDiabetes type 2 and obesity are well-established global epidemics and contributors to clinical, social and economic health burdens. The prevalence rates of these diseases are still on the rise among countries resulting in a corresponding public health burden. The Mediterranean island of Malta, known for it’s high diabetes and obesity rates, provides a good fundamental basis to portray the economical health burden of these diseases.MethodA recent randomised stratified representative cross-sectional survey conducted in Malta tackling diabetes, obesity and other determinants, was used to work out the population prevalence of these diseases. The cost burden of diabetes and obesity, based on published data, was incorporated to the established population prevalence rates, in order to estimate the Maltese economical burden. Projections to the year 2050 by a bottom-up prevalence based design were performed.ResultsOne eight of the Maltese adults (25 to 64 years) suffered from diabetes out of which approximately 10,000 adults were unaware of the disease. Alarmingly, more than a third of the Maltese population suffer from obesity. The approximate health care costs (direct and indirect) for the diabetic adult population was of €29,159,217 (€21,994,676 - €38,919,121) annually, amounting to 3.64% (2.75–4.875%) of the total health expenditure in Malta. The obesity cost burden was of €23,732,781 (€21,514,972-€26,049,204) annually contributing for 2.97% (2.69–3.26%) of the total health expenditure. The projected prevalence and costs for 2050 exhibited an estimated cost burden increase of €33,751,487 (€25,458,606–€45,048,473) for the diabetes mellitus population and €46,532,294 (€42,183,889–€51,074,049) for the obese population. These projected cost burdens are expected to increase exponentially the total health care expenditure in Malta by 2050.ConclusionHaving an understanding of the prevalence and the economic cost burden of diabetes and obesity within a country, along with projections of the expected burden will enable policy and public health officials to clearly visualize this growing problem. It also helps in establishing effective preventive strategies and screening programs targeting these epidemics.
Highlights
Diabetes type 2 and obesity are well-established global epidemics and contributors to clinical, social and economic health burdens
One eight of the Maltese adults (25 to 64 years) suffered from diabetes out of which approximately 10,000 adults were unaware of the disease
Having an understanding of the prevalence and the economic cost burden of diabetes and obesity within a country, along with projections of the expected burden will enable policy and public health officials to clearly visualize this growing problem. It helps in establishing effective preventive strategies and screening programs targeting these epidemics
Summary
Diabetes type 2 and obesity are well-established global epidemics and contributors to clinical, social and economic health burdens. The link between obesity and type 2 diabetes is well established through the development of obesity related insulin resistance. It follows that the prevalence of the two diseases is directly proportional [3]. Only about 20–25% of the overweight and obese population is expected to develop diabetes [4] Both diseases lead to heavy increases in clinical, social and economic health burdens as well as to increments in morbidity and mortality [5, 6]. They impact on employment and productivity, both of which have significant direct impacts on a country’s productivity and economical growth [7]
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