The most recent and alarming prediction may even be a bit conservative. It is based on the assumption that the prevalence of the overweight and obese in the United States will remain relatively stable.

Although obesity levels have gone up steadily for many years, the authors predict that the obesity levels for the non-diabetic population will top out in the next decade, then decline slightly, from 30 percent today to about 27 percent by 2033. "Despite recent trends in obesity rates," Huang explained, "we anticipate that the population will reach an equilibrium in obesity levels, since we cannot all become obese."

The 2009 Diabetes Care study places increased emphasis on changes in demographics, advances in treatment, and the natural history of this disease, including the timing and frequency of its costly complications. Much of the increase in cases and in costs will be driven by aging "baby boomers," the 77 million Americans born between 1946 and 1957 who are approaching the age of retirement, diabetes complications, and federal health insurance.

Various characteristics of the modern natural history of diabetes and its treatments contribute to increasing the costs of diabetes for the population. People with diabetes are now being diagnosed at younger ages. Thanks to better treatments, they are living longer. This leads to a longer history of disease, opportunities for more aggressive therapies, and time to accumulate complicat
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