At the Heart Attack Grill, 8,000-calorie "bypass burgers" are just the symptom of a larger problem.

Not long ago, a friend of mine told me that he had been diagnosed with “the sugar.” He had to explain to me that “the sugar” is slang for type 2 diabetes, which, as it turns out, is what a lot of people call it. In fact, there are so many people with diabetes today that there is an entire lexicon of diabetes-related slang used by people living with the disease. 

For a long time, diabetes was considered a rich person’s disease, the kind of thing you got by eating lots of overly indulgent food and not getting enough exercise. But as the global obesity epidemic shows, the disease is now everybody’s problem…and not just in the United States, Canada and the rest of the developed western nations, either. Diabetes is becoming a serious problem across the world. According to recent data from the World Health Organization, one in 10 people across the planet will have diabetes by 2030, thanks in large part to the increasingly common adoption of Western diets and technologies that free people from lives of lots of physical activity.

To get some perspective on this, the United Nations figures there will probably be eight billion people by 2030. That would mean some 700-800 million people dealing with some form of diabetes, but mostly type 2, which is the kind you get predominantly through poor diet and lack of exercise (as well as other factors). While this prospect has raised the question of whether diabetes could become the next AIDS, the question is moot. With numbers like these, diabetes is set to become the next malaria.

If this all sounds a bit hysterical, you’ll have to forgive me. But the last time I looked into the healthcare costs of obesity, it came out to some $60 billion a year for the United States alone. That is the GDP of Sweden. Now, that is not all medical cost. It includes things like extra cost of food, larger clothing, even extra funeral expenses for those who require plus-size coffins. But healthcare costs stemming from heart disease, diabetes, strokes, musculoskeletal disease and other obesity-related ailments factor in, too. Depending on who you talk to, when you look at how upwardly obesity rates are scaling, the costs of “diabesity” could explode up to $3.5 trillion over the next decade. Trillion. With a T.

And as I said then, I will say now: for all of the health insurance industry’s griping about the cost of heathcare being out of control, it is not doing a whole heck of a lot to incentivize healthy behavior to the point of actually containing claims costs. The extra insurance costs for the dental care of diabetics can be some $2,500 a year alone, and that is just the small change. Diabetes may not be killing people to the extent that cancer is, but it can definitely bleed healthcare financing white, and that is a clear and present danger to the health insurance industry.

Indeed, people need to be responsible for themselves, and that would be the first and most effective line of defense against diabetes. But let us be honest with ourselves. Not everybody is inclined to take their health seriously, even though they really should. And when they don’t, the health insurance industry ultimately picks up a substantial portion of the tab. Clearly, there is not very good risk management going on here, and it would be great to see the industry with the most to lose act like it and take some preventive action of their own. The food industry sure as hell won’t. The federal government won’t – or if it will, it’ll probably goof it up. No, the health insurance industry is poised to make the best inroads toward helping prevent diabetes and in so doing, head off claims costs in the long run. I am certain that for every dollar spent on preventive services and incentives, the long-term benefits that come back will be a multiple of the initial investment. Insurance is supposed to be a business with an eye to the long-term. So how come it treats diabetes and the cost of obesity like something that can be put off until tomorrow?