The effects of hypertension and obesity on total health-care expenditures of diabetes patients in the United States

We identify a representative sample of US diabetes patients with comorbid hypertension and obesity and then evaluate health-care expenditures in this population across comorbidity categories. The underlying hypothesis is that the presence of comorbid obesity and hypertension poses an additional burden on patients with diabetes, thus impacting their overall resource utilization. More than one-third of diabetes patients suffer from comorbid obesity and hypertension, which outnumbers diabetes patients with neither or only one of these comorbidities. The results of multivariate regressions clearly show the significant impact these comorbidities have on the health-care expenditures of the diabetes population. For example, a person with diabetes and obesity has health-care expenditures 14% greater than a diabetes patient without obesity. Adding hypertension to a diabetes patient raises health-care expenditures by 26%. Finally, diabetes patients with both comorbid obesity and hypertension -- the fastest growing group of diabetes patients -- have health-care expenditures 40% higher than those without these comorbidities. Our results indicate that diabetes patients are placing an increasing strain on health-care resources, and health-care providers should consider the management of comorbid hypertension and/or obesity, as these have significant effects on resource utilization and expenditures beyond the underlying diabetes condition.