Background: Lifetime direct medical cost of treating type 2 diabetes and diabetic complications in the U.S. is unknown.

Purpose: This study provides nationally representative estimates of lifetime direct medical costs of treating type 2 diabetes and diabetic complications in people newly diagnosed with type 2 diabetes, by gender and by age at diagnosis.

Methods: A type 2 diabetes simulation model was used to simulate the disease progression and direct medical costs among a cohort of newly diagnosed type 2 diabetes patients. The study sample used for the simulation was based on data from the 2009-2010 National Health and Nutritional Examination Survey. The costs of treating type 2 diabetes and diabetic complications were derived from published literature. Annual medical costs were accumulated over the life span of type 2 diabetes to determine the lifetime medical costs. All costs were calculated from a healthcare system perspective, and expressed in 2012 dollars.

Results: In men diagnosed with type 2 diabetes at ages 25-44 years, 45-54 years, 55-64 years, and ≥ 65 years, the lifetime direct medical costs of treating type 2 diabetes and diabetic complications were $124,700, $106,200, $84,000, and $54,700, respectively. In women, the costs were $130,800, $110,400, $85,500, and $56,600, respectively. The age-gender weighted average of the lifetime medical costs was $85,200, of which 53% was due to treating diabetic complications. The cost of managing macrovascular complications accounted for 57% of the total complication cost.

Conclusions: Over the lifetime, type 2 diabetes imposes a substantial economic burden on healthcare systems. Effective interventions that prevent or delay type 2 diabetes and diabetic complications might result in substantial long-term savings in healthcare costs.