TRENTON, N.J. — As diabetes is rapidly becoming one of the world's most common diseases, its financial cost is mounting, too, to well over $200 billion a year in the U.S. alone, according to a new study.

The study, released yesterday, puts the total at $218 billion last year — the first comprehensive estimate of the financial toll diabetes takes, according to Danish drugmaker Novo Nordisk A/S, which paid for the study.

That figure includes direct medical care costs, from insulin and pills for controlling patients' blood sugar to amputations and hospitalizations, plus indirect costs such as lost productivity, disability and early retirement.

The $218 billion amounts to about 10 percent of all U.S. healthcare spending by government and the public, about $2.1 trillion in 2006, and nearly half the $448.5 billion cost of heart disease and stroke.

The study, conducted by the Lewin Group consultants, estimates costs for people known to have type 1 or type 2 diabetes at $174.4 billion combined, a total previously reported by Novo Nordisk, the world's top producer of insulin and the maker of diabetes pills such as NovoNorm and Prandin. That study was done with the American Diabetes Association.

The new study adds estimates for people who haven't been diagnosed yet ($18 billion), women who develop diabetes temporarily during pregnancy ($636 million) and those on track to develop diabetes, an increasingly common condition called pre-diabetes ($25 billion).

"Diabetes has not seen a decline or even a plateauing, and the death rate from diabetes continues to rise," said Dana Haza, senior director of the National Changing Diabetes Program, an effort Novo Nordisk began in 2005 to improve diabetes care and prevention in the U.S.

"The numbers just keep going higher and higher, and what we want to say is, 'It's time for government and businesses to focus on it.' "

$85 BILLION TO TREAT

Already, the federal government spends more than $85 billion a year — about one in eight healthcare dollars — on treatment of people with diabetes, disability payments to them, research and related efforts.

Drugmakers such as Novo Nordisk also see diabetes as an important — and lucrative — disease.

The Health Services Research Network, an academic consortium that does research using data from health information firm IMS Health, yesterday released data showing the average number of diabetes medications prescribed per patient rose from 1.14 in 1994 to 1.63 in 2007.

Over the same period, estimated yearly patient visits for diabetes care increased from 25 million to 36 million.

Novo Nordisk presented its data yesterday at a healthcare conference for corporate executives and plans to publish a full report in a professional journal. The calculations are based on numbers from sources including databases on treatment of people with commercial insurance, Medicare and Medicaid, federal public health surveys and other sources.

'POWERFUL ARGUMENT'

Andrew Webber, president and chief executive of the National Business Coalition on Health, said the study is the first he's seen estimating diabetes costs, including indirect costs, which "add up and create such a powerful argument as to why employers need to take this challenge on."

"This study gives a very persuasive argument to employers to invest in a culture of health in their workforce," Webber said, calling the worsening diabetes epidemic "the tsunami that is coming."

Plenty of companies have started efforts on diabetes, said Webber, whose group includes 61 business coalitions providing health coverage to 35 million people.

Six coalitions are running programs giving participating employees diabetes medicines without a co-pay, six more pay doctors extra for helping patients control their diabetes, and one offers both types of programs.

Among people known to have diabetes, the new study estimated $10.5 billion in medical costs and $4.4 billion in indirect costs, or a total of $14.9 billion, for people with type 1 diabetes, which generally begins in youth and can have a genetic link. Nearly 6 percent of the 17.9 million Americans diagnosed with diabetes have type 1.

The study estimated $105.7 billion in medical costs and $53.8 billion in indirect costs, totaling $159.5 billion, for people with type 2 diabetes, previously called adult-onset diabetes because of its link to the bigger waistlines and sedentary lifestyles of middle age.