Complications of diabetes cost the health care system about $47,000 per patient over the course of the person’s life. According to a new study. In the first five years after diagnosis, 85 percent of the costs are due to macrovascular disease — problems with blood circulation resulting from conditions such as high blood pressure and high cholesterol.
Patients in the study who were receiving intensive treatment for their diabetes rather than conventional therapy, however, had reduced costs of complications over a 10-year period.
Researchers from the Care Research Institute in Concord, Mass. arrived at these findings after constructing a simulated model involving 10,000 patients with diabetes. They looked at a wide range of complications of the disease, including macrovascular disease, nephropathy, retinopathy, neuropathy and hypoglycemia.
For the study, researchers assumed all patients had been treated for their diabetes for five years and had a mean HbA1c (average blood sugar over three months) of 8.4. Then they looked at how these patients would progress based on a the typical increase in HbA1c of .15 percent per year.
Over a lifetime, the study found problems related to blood circulation would account for 52 percent of all costs related to complications, followed by nephropathy (21 percent), neuropathy (17 percent), and retinopathy (10 percent).
The researchers write: "As macrovascular disease costs arise early and represent the major component of lifetime costs, this study supports the initiatives by the National Diabetes Education Program to promote awareness of the benefits of optimizing blood pressure and cholesterol levels as well as blood glucose levels. Improving control of known risk factors for cardiovascular disease has an enormous potential for reducing the risk of developing complications and lowering health care costs associated with those complications." SOURCE: Diabetes Care, 2002;25:476-481