Diabetes Mellitus, Fasting Glucose, and Risk of Cause-Specific Death

Schinner, Sven

doi:10.1016/j.yend.2011.06.029

Cited by 2 publications

(1 citation statement)

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“…In 2018, T2DM prevalence in Italy was estimated as 6.2% of the total population and ∼approximately 67% of T2DM patients are aged ≥65 years ( ARNO diabetes observatory, 2019 ). The resulting health and economic impacts go beyond the condition itself because T2DM patients are subject to disabling complications, such as cardiovascular or renal diseases ( Van Dieren et al, 2010 ; Schinner, 2011 ), and incur very high costs to the Italian National Health Service ( Hutter et al, 2010 ; O’Shea et al, 2013 ; Lehnert et al, 2011 ). Piette and Kerr (2006) identified two types of T2DM-associated comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients

et al. 2020

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Objectives: Little is known about the specific comorbidities contributing to higher costs in patients with type-2 diabetes mellitus (T2DM), particularly in older cases. We aimed to evaluate the prevalence, type, and cost of comorbidities occurring in older T2DM patients versus older non-T2DM patients, and the factors associated with high cost (HC) T2DM patients.Methods: Retrospective cohort study using information from the Campania Region healthcare database. People aged ≥65 years who received ≥2 prescriptions for antidiabetic drugs were identified as “T2DM patients.” Comorbidities among T2DM and non-T2DM groups were assessed through the RxRiskV Index (modified version). T2DM individuals were classified according to the total cost distribution as HC or “non-high cost.” Two sub-cohorts of HC T2DM patients were assessed: above 90th and 80th percentile of the total cost. Age- and sex-adjusted logistic regression models were created.Results: Among the T2DM cohort, concordant and discordant comorbidities occurred significantly more frequently than in the non-T2DM cohort. Total mean annual cost per T2DM patient due to comorbidities was €7,627 versus €4,401 per non-T2DM patient. Among T2DM patients identified as being above 90th and 80th percentiles of cost distribution, the total annual costs were >€19,577 and >€2,563, respectively. The hospitalization cost was higher for T2DM cases. Strongest predictors of being a HC T2DM patient were having ≥5 comorbidities and renal impairment.Conclusion: HC patients accrued >80% of the total comorbidities cost in older T2DM patients. Integrated care models, with holistic and patient-tailored foci, could achieve more effective T2DM care.

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