Health claims on the rise for kids with Type 2 diabetes

It raises questions about solutions to halt climb.

January 24, 2017 at 10:21PM
Overweight and obese Americans between 40 and 70 years old should be tested for type 2 diabetes, the U.S. Preventive Services Task Force now says. (Photo courtesy Fotolia/TNS) ORG XMIT: 1176030
Claims for Type 2 diabetes among people 0 to 22 more than doubled between 2011 and 2015, an analysis showed. (The Minnesota Star Tribune)

It's no secret that American children have gotten fatter in recent decades.

Now a new study joins earlier research showing the consequences: a sharp rise in insurance claims for youth with Type 2 diabetes, high blood pressure and other conditions more often associated with older adults.

Claims for Type 2 diabetes — formerly known as "adult-onset" diabetes — among young people aged 0 to 22 years old more than doubled between 2011 and 2015, according to an analysis of a large national database of claims paid by about 60 insurers.

At the same time, claims for pre-diabetes among children and youth rose 110 percent, while high blood pressure claims rose 67 percent.

The findings "not only raise quality-of-life questions for children, but also the kind of resources that will be necessary to address this emerging situation," said Robin Gelburd, president of the nonprofit Fair Health, a national clearing house for claims data.

The analysis is certainly not the first to note a rise in obesity or Type 2 diabetes in this age group; nor does it explore the possible reasons behind the apparent increase in claims. One factor in the rise could simply be increased awareness and testing.

But the analysis is different from earlier research because it uses a database of actual claims for about 150 million people, all of whom have private insurance. The study focused on a subset of youth: those who had a diagnosis of obesity or Type 2 diabetes. Researchers analyzed claims data tied to those patients to determine what other conditions they experienced and the medical services provided to them.

Claims data is considered a good research tool because it reflects services actually provided. But, conversely, the Fair Health analysis is also limited because it does not include claims submitted by Medicaid or other government programs.

Even with those limitations, the findings "are frightening," said Stephen Pont, a pediatrician and medical director of the childhood obesity center at Dell Children's Medical Center in Austin, Texas. He did not work on the analysis.

"The vast majority of kids should never have high blood pressure or diabetes or sleep apnea. Now we're seeing those consequences in kids," he said. "That will result in shorter lives and lower quality of life."

The solution, he added, cannot be found solely in the doctor's office, but many insurers hamstring efforts to help children by limiting medical coverage of efforts to combat obesity. Most don't cover related costs such as those for weight management programs until a complication such as high blood pressure is developed, he said.

The Centers for Disease Control and Prevention estimates that only 0.25 percent of all children suffer from Type 2 diabetes. But when it does hit, patients can suffer serious health problems.

The Fair Health analysis found that during the four years that were analyzed, the number of claims tied to an obesity diagnosis among youth aged 0 to 22 also rose, jumping 94 percent in infants and toddlers to as much as 154 percent among 19- to 22-year-olds.

That contrasts with CDC findings that the prevalence of obesity among children and youth aged 2 to 19 years old remained relatively stable from 2011 to 2014.

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about the writer

Julie Appleby, Kaiser Health News

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