The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study

Bommer, Christian; Heesemann, Esther; Sagalova, Vera; Manne‐Goehler, Jennifer; Atun, Rifat; Bärnighausen, Till; Vollmer, Sebastián

doi:10.1016/s2213-8587(17)30097-9

Cited by 618 publications

(475 citation statements)

References 14 publications

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“…Finally, information on primary healthcare costs, indirect costs, including sick leave, and other costs associated with CV disease and T2D were not captured. It is estimated that primary healthcare costs and indirect costs for T2D patients account for approximately 25% and 35% of total healthcare‐related cost, respectively. Assuming that hospital and primary healthcare resources are positively correlated, the present study may have underestimated the cost differences.…”

Section: Discussionmentioning

confidence: 99%

Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Norhammar

Bodegård

Nyström

et al. 2019

Diabetes Obesity Metabolism

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Aims To investigate how the cardiovascular (CV) risk benefits of dapagliflozin translate into healthcare costs compared with other non‐sodium–glucose cotransporter‐2 inhibitor glucose‐lowering drugs (oGLDs) in a real‐world population with type 2 diabetes (T2D) that is similar to the population of the DECLARE‐TIMI 58 trial. Methods Patients initiating dapagliflozin or oGLDs between 2013 and 2016 in Swedish nationwide healthcare registries were included if they fulfilled inclusion and exclusion criteria of the DECLARE‐TIMI 58 trial (DECLARE‐like population). Propensity scores for the likelihood of dapagliflozin initiation were calculated, followed by 1:3 matching with initiators of oGLDs. Per‐patient cumulative costs for hospital healthcare (in‐ and outpatient) and for drugs were calculated from new initiation until end of follow‐up. Results A total of 24 828 patients initiated a new GLD; 6207 initiated dapagliflozin and 18 621 initiated an oGLD. After matching based on 96 clinical and healthcare cost variables, groups were balanced at baseline. Mean cumulative 30‐month healthcare cost per patient was similar in the dapagliflozin and oGLD groups ($11 807 and $11 906, respectively; difference, −$99; 95% CI, −$629, $483; P = 0.644). Initiation of dapagliflozin rather than an oGLD was associated with significantly lower hospital costs (−$658; 95% CI, −$1169, −$108; P = 0.024) and significantly higher drug costs ($559; 95% CI, $471, $648; P < 0.001). Hospital cost difference was related mainly to fewer CV‐ and T2D‐associated complications with use of dapagliflozin compared with use of an oGLD (−$363; 95% CI, −$665, −$61; P = 0.008). Conclusion In a nationwide, real‐world, DECLARE‐like population, dapagliflozin was associated with lower hospital costs compared with an oGLD, mainly as a result of reduced rates of CV‐ and T2D‐associated complications.

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Section: Discussionmentioning

confidence: 99%

Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Norhammar

Bodegård

Nyström

et al. 2019

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…Diabetes not only results in specific complications4 but also increases the risk of cardiovascular disease,5 cancer,6 and all cause mortality 78. The economic burden of diabetes in adults is substantial—roughly $245bn (£174bn; €199bn) in the United States in 20129 and $1.31tn worldwide in 2015 10…”

Section: Introductionmentioning

confidence: 99%

Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study

Liu

Sun

et al. 2018

BMJ

433

248

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ObjectiveTo estimate the prevalence of diagnosed total diabetes, type 1 diabetes, and type 2 diabetes in the US general population and the proportions of each among US adults with a diagnosis of diabetes.DesignNationwide, population based, cross sectional survey.SettingNational Health Interview Survey, 2016 and 2017.ParticipantsAdults aged 20 years or older (n=58 186), as a nationally representative sample of the civilian, non-institutionalized US population.Main outcome measuresPrevalence of diagnosed diabetes, type 1 diabetes, and type 2 diabetes in the US general population, and the proportions of each subtype in participants with a diagnosis of diabetes.ResultsAmong the 58 186 included adults, 6317 had received a diagnosis of diabetes. The weighted prevalence of diagnosed diabetes, type 1 diabetes, and type 2 diabetes among US adults was 9.7% (95% confidence interval 9.4% to 10.0%), 0.5% (0.5% to 0.6%), and 8.5% (8.2% to 8.8%), respectively. Type 1 diabetes was more prevalent among adults with lower education level, and type 2 diabetes was more prevalent among older adults, men, and those with lower educational level, lower family income level, and higher body mass index (BMI). Among adults with a diagnosis of diabetes, the weighted percentage of type 1 and type 2 diabetes was 5.6% (4.9% to 6.4%) and 91.2% (90.4% to 92.1%), respectively. The percentage of type 1 diabetes was higher among younger adults (age 20-44 years), non-Hispanic white people, those with higher education level, and those with lower BMI, whereas the percentage of type 2 diabetes was higher among older adults (age ≥65 years), non-Hispanic Asians, those with lower education level, and those with higher BMI.ConclusionThis study provided benchmark estimates on the national prevalence of diagnosed type 1 diabetes (0.5%) and type 2 diabetes (8.5%) among US adults. Among US adults with diagnosed diabetes, type 1 and type 2 diabetes accounted for 5.6% and 91.2%, respectively.

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“…Diabetic nephropathy (DN) is one of the major serious complications of DM and has ranked the number one cause for end stage kidney disease (ESKD) in the most developed countries . The prevalence of DN is also expected to grow in parallel with the prevalence of DM, which, consequently, costs considerable socioeconomic resources . This highlights the urgent demand for a deeper understanding of DN which may provide more biomarkers about DN progression and improve the management of DN.…”

mentioning

confidence: 99%

Effects of neutrophil–lymphocyte ratio on renal function and histologic lesions in patients with diabetic nephropathy

Zhang

Wang

et al. 2019

Nephrology

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Aim Chronic low‐grade inflammation related to diabetic nephropathy (DN) may affect the serum neutrophil–lymphocyte ratio (NLR). We aimed to examine the cross‐sectional relationships of NLR with renal function and structural lesions of DN in patients with type 2 diabetes mellitus (T2DM). Methods The study retrospectively included 247 patients with T2DM and biopsy‐proven DN. The severity of different pathological lesions was evaluated based on the criteria of Renal Pathology Society. The patients were divided into two groups based on the median (2.42) of NLR level, group 1: NLR < 2.42 (n = 122) and group 2: NLR ≥ 2.42 (n = 125). Renal dysfunction was defined by estimated glomerular filtration rate less than 60 mL/min per 1.73 m2. The influence of NLR on renal dysfunction was evaluated using logistic regression analysis. Results The spearman's rank‐correlation test indicted that NLR was positively correlated with interstitial fibrosis and tubular atrophy (r = 0.170, P = 0.007) and serum fibrinogen (r = 0.261, P < 0.001), whereas negatively related with estimated glomerular filtration rate (r = −0.233, P < 0.001). However, the NLR level demonstrated no association with glomerular lesions, interstitial inflammation and arteriolar hyalinosis. A multivariate logistic regression analysis showed that higher level of NLR (≥2.42) was significantly associated with renal dysfunction when adjusting for some important baseline clinical and pathological variables (odds ratio, 2.46; 95% confidence interval, 1.21–4.97; P = 0.012). Conclusion Increased NLR affects renal function and histologic lesions in patients with T2DM and may be an important factor for the progression of DN.

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The global economic burden of diabetes in adults aged 20–79 years: a cost-of-illness study

Cited by 618 publications

References 14 publications

Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Dapagliflozin vs non‐SGLT‐2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE‐TIMI 58 trial: A nationwide observational study

Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study

Effects of neutrophil–lymphocyte ratio on renal function and histologic lesions in patients with diabetic nephropathy

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