Excess Health Care Costs of Obesity in Adults with Diabetes Mellitus: a Claims Data Analysis

Lengerke, Thomas von; Hagenmeyer, Ernst-Günther; Gothe, Holger; Schiffhorst, G.; Happich, Michael; Häussler, Bertram

doi:10.1055/s-0030-1253400

Cited by 17 publications

(11 citation statements)

References 24 publications

(31 reference statements)

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“…reported that the predicted total annual medical expenditures of individuals with diabetes increased non‐linearly with BMI, and that the relationship between BMI and medical expenditures was more pronounced than among those without diabetes. In Germany, obesity was associated with significant increases in healthcare costs in diabetes patients. The results of the present study are consistent with those of studies from Western countries, although Japanese patients with type 2 diabetes are relatively lean in comparison with those in Western countries.…”

Section: Discussionsupporting

confidence: 90%

Impact of obesity on annual medical expenditures and diabetes care in Japanese patients with type 2 diabetes mellitus

Kusunoki-Tsuji

Araki

Kume

et al. 2017

J of Diabetes Invest

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Aims/IntroductionDiabetes and obesity are important health and economic concerns. We investigated the influence of obesity on diabetes control, the annual medical expenditures and medications in Japanese patients with type 2 diabetes who were relatively lean in comparison with those in Western countries.Materials and MethodsA total of 402 Japanese patients with type 2 diabetes were enrolled and their annual medical expenditures investigated. Obesity was defined as body mass index ≥25 kg/m2, according to the obesity classifications from the Japan Society for the Study of Obesity.ResultsA total of 165 patients (41.0%) were classified as obese. The obese group was younger, had poor glycemic control and higher frequency of hypertension than the non‐obese group. The median total annual medical expenditures for all participants was ¥269,333 (interquartile range ¥169,664–437,437), which was equivalent to approximately $US2,450. The annual medical expenditure was significantly higher in patients with obesity than in non‐obese patients (P < 0.001). This difference was mainly attributed to the annual expenditures for medication and hospitalization. In particular, the medication expenditures and the average number of drug classes for hyperglycemia and hypertension were significantly higher in the obese group.ConclusionsJapanese patients with type 2 diabetes and obesity had higher annual medical expenditures and a larger number of medications, but their diabetes control care was insufficient in comparison with those without obesity. Further studies are required to assess the effect of reducing bodyweight on diabetes control and costs.

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Section: Discussionsupporting

confidence: 90%

Impact of obesity on annual medical expenditures and diabetes care in Japanese patients with type 2 diabetes mellitus

Kusunoki-Tsuji

Araki

Kume

et al. 2017

J of Diabetes Invest

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“…per year in Germany. This figure is by far higher than previous estimates [14][15][16][17][18][19][20], and the reason for this from our perspective is the more detailed and comprehensive data set that was used, as well as the fact that we added cost components that were in part not assessed by previous studies. With this in mind, it is however not possible to compare this estimation with other published figures, for example, the costs of tobacco or alcohol consumption, since the methods differ so vastly.…”

Section: Discussionmentioning

confidence: 59%

“…In line with smoking and alcohol consumption, an early onset of obesity in childhood or adolescence increases the likelihood of staying obese as an adult [12]. Several past studies have dealt with the costs of obesity in Europe [13]: seven [14][15][16][17][18][19][20] have focused on the situation in Germany, but employ different methods to assess obesity and thus yield estimations that constitute a large bandwidth. Konnopka et al [14] sum the direct and indirect costs of obesity to €9.9 billion annually.…”

Section: Health Economic Aspects Regarding Obesitymentioning

confidence: 99%

“…Von Lengerke et al [18] estimate excess medical costs depending on the socioeconomic background and severity of obesity range from €538.62 to €3120.87 for extremely obese individuals. Another study by Von Lengerke et al [19] finds significant incremental costs for different types of diabetes between €454 and €812 if additionally the individuals are obese. Pendergast et al [20] obtain similar estimates using waist circumferences as main focus of their analysis.…”

Section: Health Economic Aspects Regarding Obesitymentioning

confidence: 99%

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The costs and consequences of obesity in Germany: a new approach from a prevalence and life-cycle perspective

Effertz

Engel²,

Verheyen³

et al. 2015

Eur J Health Econ

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With the steadily growing health burden of obesity in Germany, the measuring and quantification of its costs and relevant economic consequences have become increasingly important. The usual quantifications via previous cost-of-illness approaches mostly have several weaknesses, e.g., applying "indirect methods" by using "population-attributable fractions" to identify parts of costs that can be accrued to obesity, second using highly aggregated data and third often only displaying part of the costs. This article presents a new approach and a new estimation of the cost and consequences of obesity in Germany using claims data from a German health insurance company. A sample of 146,000 individuals was analyzed with both a prevalence and a life-cycle focus on the cost and consequences of obesity. With additional data sets, we calculate the deaths per year due to obesity, the excess costs per year and several intangible consequences usually referred to as "pain and suffering". Our results show that the cost estimations of obesity in Germany so far have been largely underestimated. The annual direct costs of obesity in Germany amount to approximately €29.39 billion and the indirect costs to an additional €33.65 billion. A total of 102,000 subjects die prematurely each year because of obesity, and there is a significant excess of unemployment, long-term nursing care, and pain and suffering due to obesity. From a lifetime perspective, every obese man is equal to an additional burden of €166,911 and each woman of €206,526 for the social security system in Germany. Obesity due to unhealthy eating is thus about to replace tobacco consumption in terms of costs and consequences as the main hazardous lifestyle factor and thus should be more intensively focussed by public health policy.

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“…In the general population, the overall relative risk of diabetes for obese people compared with those with normal weight is 7.19, and for overweight people it is 2.99 (1). Current evidence suggests that, among obese and overweight subjects, metabolic syndrome (MS) confers a further higher risk of type 2 diabetes mellitus by reducing glucose sensitivity.…”

Section: Introductionmentioning

confidence: 99%

Elevated plasma glucose-dependent insulinotropic polypeptide associates with hyperinsulinemia in metabolic syndrome

Calanna

Urbano²,

Piro³

et al. 2012

European Journal of Endocrinology

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Background and aims: Metabolic syndrome (MS) is a high-risk condition for type 2 diabetes, a disease characterized by insulin resistance and insulin secretion abnormalities. Insulin resistance has been widely characterized in MS subjects while insulin secretion has been poorly investigated. The present study was hence undertaken to further investigate the a and b cell function and entero-insular axis in this pre-diabetic condition. Materials and methods: Using 1200 oral glucose tolerance test (OGTT, 75 g) and 60 0 intravenous glucose tolerance test (IVGTT, 0.3 g/kg), we studied a and b cell function, insulin resistance, and incretin levels in 96 subjects with normal fasting glucose and normal glucose tolerance to OGTT, with (MSC, nZ29) and without MS (MSK, nZ67). Results: MSC individuals showed in comparison with MSK: higher insulinogenic index (IG30) and higher area under the curve (AUC) (0-120) for glucose and insulin during the OGTT, P!0.05; higher AUC (0-10) for glucose (P!0.05) but similar first phase insulin secretion (PZNS) as measured by DAIRG and AUC (0-10) for insulin during the IVGTT; increased AUC (0-60) for insulin during the IVGTT (PZ0.04); higher GIP levels at 30 0 (PZ0.03), 60 0 (PZ0.01), 90 0 (PZ0.003), and 120

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Excess Health Care Costs of Obesity in Adults with Diabetes Mellitus: a Claims Data Analysis

Cited by 17 publications

References 24 publications

Impact of obesity on annual medical expenditures and diabetes care in Japanese patients with type 2 diabetes mellitus

Impact of obesity on annual medical expenditures and diabetes care in Japanese patients with type 2 diabetes mellitus

The costs and consequences of obesity in Germany: a new approach from a prevalence and life-cycle perspective

Elevated plasma glucose-dependent insulinotropic polypeptide associates with hyperinsulinemia in metabolic syndrome

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