Short-term effects of severe hypoglycaemia in children and adolescents with type 1 diabetes. A cost-of-illness study.
The aim of this study was to describe costs and other short-term effects of severe hypoglycaemia in children and adolescents with type 1 diabetes. The study comprised a geographic population of 129 patients <19 y of age with families prospectively registering detailed data after self-reported severe hypoglycaemia. In the period Jan.-Dec. 1998, 16 events were reported with unconsciousness and 95 events without unconsciousness but needing the assistance of another person. Of all events, 20-30% had effects requiring the assistance of people other than parents, school absence, parents' absence from work, extra transport and/or telephone calls. Patient (family) activities were cancelled after 10% (5%) of events. Increased worry for parents was reported after 8% and poor sleep after 7% of events. Hospital visits took place at 5% and hospitalizations at 3% of all events. Patients with severe hypoglycaemia indicated lower global quality of life (p=0.0114). The average socio-economic burden for events of severe hypoglycaemia was estimated at EURO 17,400 yearly per 100 type 1 diabetes patients. Average cost was estimated at EURO 239 per event of severe hypoglycaemia with unconsciousness or EURO 478 yearly per patient with unconsciousness, and EURO 63 per event of severe hypoglycaemia without unconsciousness but needing assistance from another person or EURO 307 yearly per patient in this category. These are conservative estimates and do not include unpaid time and other intangibles, possible road traffic accidents, disabling or premature deaths.


CONCLUSIONS
The results suggest the potential for socio-economic savings and increased quality of life for patients and families from severe hypoglycaemia prevention programs.
Nordfeldt
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S
Division of Child and Adolescent Psychiatry, Faculty of Health Sciences, Linköping, Sweden. SamNo@ihm.liu.se
Jonsson
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D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000191:economics*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000191:economics* / Q000628:therapy; D007328:Insulin / Q000191:economics / Q000627:therapeutic use; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
D007328:Insulin