Complications, co-morbidity, and blood glucose control in type 2 diabetes mellitus patients in Germany - results from the CODE-2^TM study

Abstract

In this study, prevalence and incidence of complications as well as co-morbidity in type 2 diabetes patients in Germany were evaluated as part of a cost-of-illness study (CODE-2(TM), Costs of Diabetes in Europe - Type 2)In a pre-study, 197 general practitioners and diabetes specialists all over Germany provided data on the complication status of 2701 randomly selected patients with type 2 diabetes. The patients were grouped into five mutually exclusive strata. This pre-study was performed to generate a general overview on complication status to select proper patients for the main study. The main study was performed on stratified samples derived from the pre-study. Irrespective of the real prevalence of the five strata, an equal number of 160 were randomly selected from each stratum. Thus, rare complications were also covered in the study. Data from 809 patients were collected retrospectively on the basis of medical files during interviews with the physician. To achieve representative estimates of absolute prevalence and incidence of diabetes-related complications in Germany, results were weighted using frequencies of the strata. Severe complications were diagnosed in 50% of these patients. Prevalences were: 10.56% myocardial infarction, 6.66% stroke, 3.97% foot ulcer, 2.30% amputations and 1.34% blindness. Overall incidences in the diabetes population were estimated at 0.78% myocardial infarction, 1.28% stroke and 0.80% amputations. 23% of the diabetes patients suffered from 2 or more complications. The complication status became considerably worse with increasing time since the diagnosis of diabetes. The mean HbA1c level was 7.51% (i.e. 122% of the upper limit of the respective normal ranges). The presence of complications and co-morbidity in type 2 diabetes patients was a frequent finding. This underlines the importance of complications in diabetes patients and the necessity to increase any means of prevention in order to relieve the personal and economic burden of type 2 diabetes.

Cost of illness of atopic asthma and seasonal allergic rhinitis in Germany: 1‐yr retrospective study

“…Variations in total average cost per patient between these economic studies are partly due to differences between inclusion/exclusion criteria, cost assessment, treatments and healthcare systems. The financial burden of allergic asthma and/or SAR from the TPPs perspective is further comparable to other chronic diseases, such as diabetes mellitus type 2, in Germany [20,21]. SCHULENBURG et al [10] collected data from 216 German patients.…”

Higher Accuracy of Self-Monitoring of Blood Glucose in Insulin-Treated Patients in Germany: Clinical and Economical Aspects

“…According to the German data of myocardial infarctions, [50][51][52] Costs for myocardial infarction in Germany, as assessed by the German epidemiological CoDiM Study, 20,53,54 were calculated to be €9767 per myocardial infarction and €4032 for costs related to the first year of follow-up after an acute myocardial infarction. Adding the two parameters of costs for myocardial infarction, €13,799 per successfully treated myocardial infarction were incorporated into the analysis.…”

“…50 The observation that 27% of all patients with myocardial infarction are diabetes patients was included in the analyses of frequency of myocardial infarctions in the diabetes population. 51,52 Costs related to diabetic cardiovascular complications were calculated based on the results of the German epidemiological CoDiM-Study published by the London School of Economics. 20,53,54 …”

Efficacious and safe control of glycemia using Apidra insulin

“…К моменту установления диагноза «СД 2 типа» (СД2) у большинства больных уже имеются те или иные осложнения. По данным исследования CODE-2 (Cost of Diabetes in EuropeType 2), различные осложнения имели 59% пациентов, причем у 23% было два и у 3% -три осложнения [2]. Сердечно-сосуди-стая и цереброваскулярная патология была обнаружена у 43 и 12% пациентов соответственно.…”