High cost, renal complications in diabetes management

The cost of managing diabetes patients is extremely high, and many patients still experience poor glycemic control and renal complications, according to results of a study published online Dec. 13, 2012 in the journal Diabetes Care.

“The cost of caring for people with diabetes is substantial and is associated with suboptimal glycemic control, abnormal kidney function, and proteinuria,” wrote Fiona Clement, PhD, of the University of Calgary, in Calgary, Alberta, Canada, and colleagues.

The researchers compared laboratory-derived measures of glycemic control, the presence of renal complications, and the 5-year cost of caring for diabetes patients.

The authors identified 138,662 adults diagnosed diabetes as of May 1, 2004 to estimate a 5-year cost of care, which included physician visits, hospitalizations, ambulatory care, and drug costs. The researchers used linked laboratory and administrative clinical and costing data to determine the association between that 5-year cost and baseline glycemic control (HbA_1c), proteinuria, and kidney function (eGFR).

The researchers determined the 5-year cost of care in Canadian dollars was $26,978 per patient, excluding drug costs. For patients 65 and older, the cost of care was $44,511, including drug costs. They noted that cost increased with worsening kidney function, presence of proteinuria, and suboptimal glycemic control (HbA_1c >7.9%). Other characteristics that were linked with increasing cost included increasing age, Aboriginal status, socioeconomic status, duration of diabetes, and the presence of other illnesses.

“Future studies should assess if improvements in the management of diabetes, assessed with laboratory-derived measurements, result in cost reductions,” Dr. Clement and colleagues concluded.