The cost of diabetes chronic complications among Iranian people with type 2 diabetes mellitus

Abstract

BackgroundTo evaluate the cost of diabetes related micro- and macrovascular complications in Iranian people with type 2 diabetes mellitus.MethodsIn routine clinical practice, people with type 2 diabetes mellitus were assessed for 10 years at a diabetes care center. The type of medications and clinical data were extracted from patients’ documents. Mortality rate and the incidence of micro- and macrovascular complications recorded in patients’ documents were analyzed. Cost analysis was comprised of 1) para clinic costs as well as laboratory, medications, clinical visits and nonmedical costs 2) inpatient costs as well as hospital admission costs, disability, and mortality costs.ResultsFrom 1562 people with type 2 diabetes mellitus, a total of 1000 patients with mean duration disease of 11.2 years, who had completed information in their documents, were studied. All people were free from complications at baseline. Mean cumulative incidence of diabetes-related complications over 10 years were 10.9 ± 3.5%, 8.0 ± 3.1%, 4.6 ± 1.7%, 9.1 ± 3.6% and 2.3 ± 0.9% for peripheral neuropathy and diabetic foot ulcer, nephropathy, ophthalmic complications, cardiovascular disease and death, respectively. People with better glycemic control had less complication and also related expenditures. Average para clinic cost per patient was 393.6 ± 47.8 and average inpatient cost per patient was 1520.7 ± 104.5 USD.ConclusionsOur findings demonstrate considerable incidence of diabetes chronic complications and also high health care expenditure for related complications among our patients. As the number of people with diabetes continues to rise, early detection of the disease and implementation of timely and appropriate therapeutic strategies could decrease the burden of diabetes chronic complications and also huge related expenditures.

Annual direct medical costs associated with diabetes‐related complications in the event year and in subsequent years in Hong Kong

“…Patients newly diagnosed with end-stage renal [29], leading to a substantial decrease in the direct medical cost. The absolute health service costs of people with diabetes vary widely among different countries and healthcare systems [7,9,11,30], but relative costs of care for people with diabetes with a particular complication compared with an age-and sex-matched person without complications tend to vary less across different healthcare settings [6,8,11]. The multipliers of complications, rather than absolute dollar values, may be more appropriate for international comparison.…”

Diabetes Care in Iran: Where We Stand and Where We Are Headed

“…29 A retrospective cohort of 1000 patients with T2D demonstrated that over a period of 10 years, 10.9% developed peripheral neuropathy. 34 The 10-year incidence rates for diabetic foot ulcer, diabetic nephropathy, and ophthalmologic complications including retinopathy were 8%, 4.6%, and 9.1%, respectively. 34 Selected studies on the prevalence of diabetes complications are summarized in Table 1.…”

Changes in prevalence of diabetic complications and associated healthcare costs during a 10-year follow-up period among a nationwide diabetic cohort

“…For example, Woung et al (2010) reported significant increase of costs associated with diabetic retinopathy (US $1566in 2000to US $3326 in 2004). Some studies also were limited to incremental costs between diabetic cohort and their non-diabetic counterparts only (Brown, Pedula, & Bakst, 1999;Farshchi, Esteghamati, Sari, et al, 2014;Straka et al, 2009;Woung et al, 2010).…”

“…Furthermore, most longitudinal studies only included diabetic patients free of complications but not diabetic patients with different severity of complications at cohort entry (Farshchi et al, 2014;Woung et al, 2010). In addition, some of the existing studies were limited to data derived from simulation models (Zhuo, Zhang, & Hoerger, 2013) instead of "real-world" data (Brandle et al, 2003;Caro, Ward, & O'Brien, 2002).…”