The total cost of diabetes to the nation was roughly $218 billion in 2007, according to a new report released on Tuesday. Diabetes prevalence is soaring in the general public, and among the nursing home population in particular.

Researchers at the Lewin Group included the costs of medical needs such as insulin and pill, procedures such as amputations, and hospital costs to arrive at that figure, the Associated Press reports. They also estimated the average costs in loss of productivity incurred by disabilities resulting from the disease. Direct medical costs averaged $116 billion last year, while indirect lost productivity costs approximated $58 billion.

Further costs were projected for undiagnosed diabetics and temporary diabetes incurred during pregnancy. The $218 billion total accounts for roughly 10% of all government healthcare spending, according to the AP. Novo Nordisk A/S, a Danish pharmaceutical company, paid for the research.