Short-term economic impact of body weight change among patients with type 2 diabetes treated with antidiabetic agents: analysis using claims, laboratory, and medical record data

Yu, Andrew P.; Wu, Eric Q.; Birnbaum, Howard G.; Emani, Sirisha; Fay, Madeleine; Pohl, Gerhardt; Wintle, Matthew; Yang, Elaine; Oglesby, Andalan

doi:10.1185/0300799007x219544

Cited by 63 publications

(64 citation statements)

References 34 publications

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Section: Introductionmentioning

confidence: 99%

“…Nevertheless, a vicious circle may ensue with antidiabetic agents, with increases in weight resulting in a secondary increase in insulin resistance, which subsequently necessitates an increase in medication requirements to maintain glucose homeostasis. Weight gain with antidiabetic agents can pose a significant psychological barrier to the initiation or intensification of treatment, leading to patient noncompliance [48].Given the strong association between excess weight and type 2 diabetes, the prevention of weight gain in people with diabetes, as well as in individuals with impaired glucose tolerance (IGT), should be a cardinal focus in treatment strategies. In this review, the multifactorial and progressive nature of type 2 diabetes is discussed with a view to understanding the aetiology and treatment of diabetes and associated obesity, leading to an examination of the range of antidiabetic therapeutics available to treat it.…”

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confidence: 99%

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Diabesity: therapeutic options

Colagiuri¹

2010

Diabetes Obesity Metabolism

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A pathogenic relationship exists between type 2 diabetes and obesity. Over the last decade, the escalation in diabetes cases has paralleled the rapid increase in obesity rates, constituting a global health crisis. Environmental risk factors attributed to the global increase in obesity include the consumption of high-calorie, high-fat foods and inadequate physical activity. Obese individuals may also have a genetic predisposition for obesity. Both diabetes and obesity confer an elevated risk of developing a range of complications and comorbidities, including cardiovascular disease, hypertension and stroke, which can complicate disease management. This review examines the aetiology of the linkages between diabetes and obesity and the range of available therapies. Recent clinical evidence substantiating the efficacy and safety of incretin-based antidiabetic therapies is analysed, in addition to data on antiobesity therapeutic strategies, such as antiobesity agents, behaviour modification and bariatric surgery. Glucose control is often accompanied by weight-neutral or modest weight reduction effects with DPP-4 inhibitor treatment (sitagliptin, vildagliptin, saxagliptin) and weight loss with GLP-1 receptor agonist therapy (exenatide, liraglutide). Studies of antiobesity agents including orlistat, sibutramine and rimonabant have shown attrition rates of 30-40%, and the long-term effects of these agents remain unknown. Bariatric surgical procedures commonly performed are laparoscopic adjustable banding of the stomach and the Roux-en-Y gastric bypass, and have produced type 2 diabetes remission rates of up to 73%. Therapeutic strategies that integrate glycaemic control and weight loss will assume greater importance as the prevalence of diabetes and obesity increase. Keywords: DPP-4, exenatide, GLP-1 analogue, human, incretin, liraglutide, once-daily, type 2 diabetes mellitus Date submitted 2 June 2009; date of first decision 2 November 2009; date of final acceptance 4 November 2009 IntroductionThe term 'diabesity', coined by Sims and colleagues [1] in the 1970s, describes the strong link between type 2 diabetes and obesity [1,2]. As evidence of this pathogenic interrelationship continues to accumulate, so does the appearance of the term in the clinical literature. A large body of clinical evidence attests to the relationship between being overweight or obese and being at an elevated risk for development of type 2 diabetes [3][4][5][6][7]. The risk escalates with the degree of excess weight, increasing threefold with a body mass index (BMI) of 25.0-29.9 kg/m 2 and 20-fold with a BMI over 30 kg/m 2 [4]. In particular, abdominal fat accumulation exacerbates insulin resistance and confers a strong, independent risk of developing diabetes [8]. Global diabetes prevalence is estimated at 171 million and is projected to more than double, to 366 million, by 2030 [9]. Countries with the highest numbers of diabetes cases include India, China, USA, Indonesia and Japan [9][10][11]. The greatest relative increases in diabetes incide...

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Diabesity: therapeutic options

Colagiuri¹

2010

Diabetes Obesity Metabolism

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“…The Food Standards Agency in the UK has calculated that 42 000 lives could be saved by increasing fruit and vegetable consumption to the five-a-day target (from about 3?5 portions) and 20 000 lives by reducing salt intake (from 9 to 6 g/d) (7) . In the USA, 1 % individual weight loss could result in an annual saving of $US 213 per diabetes patient (8) .…”

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Assessment of evaluations made to healthy eating policies in Europe: a review within the EATWELL Project

Pérez-Cueto

Aschemann‐Witzel

Shankar

et al. 2011

Public Health Nutr.

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Objective: To identify and assess healthy eating policies at national level which have been evaluated in terms of their impact on awareness of healthy eating, food consumption, health outcome or cost/benefit. Design: Review of policy documents and their evaluations when available. Setting: European Member States. Subjects: One hundred and twenty-one policy documents revised, 107 retained. Results: Of the 107 selected interventions, twenty-two had been evaluated for their impact on awareness or knowledge and twenty-seven for their impact on consumption. Furthermore sixteen interventions provided an evaluation of health impact, while three actions specifically measured any cost/benefit ratio. The indicators used in these evaluations were in most cases not comparable. Evaluation was more often found for public information campaigns, regulation of meals at schools/canteens and nutrition education programmes. Conclusions: The study highlights the need not only to develop harmonized and verifiable procedures but also indicators for measuring effectiveness and success and for comparing between interventions and countries. EU policies are recommended to provide a set of indicators that may be measured consistently and regularly in all countries. Furthermore, public information campaigns should be accompanied by other interventions, as evaluations may show an impact on awareness and intention, but rarely on consumption patterns and health outcome.

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“…However, studies have investigated the direct relationship of Body Mass Index (BMI)-based excess weight with the use of medicines and the need of hospitalization [18,19], and such studies found that BMI affects healthcare costs [20,21]. Recently, an extensive review of 32 original articles published between 1990 and 2009 [22] found that the direct healthcare costs of obese individuals (BMI ≥30kg/m 2 ) are approximately [23] found that a 1.0% reduction in body weight was directly associated with a 3.6% reduction in the costs of treating diabetics. Our results show that higher waist cicumfernce is associated with higher costs, regardless of BMI.…”

Section: Discussionmentioning

confidence: 99%

Abdominal obesity and healthcare costs related to hypertension and diabetes in older adults

et al. 2017

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A B S T R A C T ObjectiveTo analyze the association between excess abdominal fat and healthcare costs related to hypertension and diabetes Mellitus in older adults. MethodsThese cross-sectional analyses are part of the Health, Wellbeing and Aging Study conducted in São Paulo, Brazil, with 806 older adults with self-reported hypertension and diabetes Mellitus. The study included the annual costs with medicines, hospital admissions, and outpatient services for hypertension and diabetes Mellitus control. Excess abdominal fat was diagnosed based on waist circumference. Level of physical activity, age, and gender were considered covariates. The sample was divided into two groups according to waist circumference. Multiple logistic regression analyzed the associations between annual costs and waist circumference. ResultsThe cost of services and hospitalizations (R$551.05; 95%CI=418.27-683.83) and total costs (R$817.77; 95%CI=669.21-966.33) were higher in the excess abdominal fat group. Older adults with high waist

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Short-term economic impact of body weight change among patients with type 2 diabetes treated with antidiabetic agents: analysis using claims, laboratory, and medical record data

Cited by 63 publications

References 34 publications

Diabesity: therapeutic options

Diabesity: therapeutic options

Assessment of evaluations made to healthy eating policies in Europe: a review within the EATWELL Project

Abdominal obesity and healthcare costs related to hypertension and diabetes in older adults

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