title: The quality of life and economic burden of neuropathy in diabetic patients in Germany in 2002--results from the Diabetic Microvascular Complications (DIMICO) study.
abstract: OBJECTIVE
  To describe the health-related quality of life (HRQOL), the resource utilization and annual costs associated with diabetic neuropathy (DN) in Germany.
  
  
  METHODS
  In this retrospective, observational study German internists, diabetologists and general practitioners provided information on 185 adult type 1 and type 2 diabetic patients with DN. Health-related quality of life (HRQOL) was assessed using generic and disease specific questionnaires. Socio-demographic and resource use data were assessed from medical charts and through patient interviews. Based on these results, national-level cost estimates were calculated using German unit costs.
  
  
  RESULTS
  The majority of DN patients were severely impaired with regard to general physical HRQOL. Disease specific HRQOL decreased continuously with increasing DN severity. In accordance, costs associated with DN increased as DN progressed, with costs from the societal perspective increasing about 50-fold from the lowest severity stage (patients with sensory-motor neuropathy without symptoms) (euro431) to patients with lower extremity amputation in the year 2002 (euro21,476). The German statutory health insurance covered more than two thirds of the total costs of DN.
  
  
  CONCLUSIONS
  The results described in this report show that diabetic neuropathy in adults with type 1 or type 2 diabetes generates significant reductions in the patient's quality of life and a substantial economic burden both for society and health insurance.
authors.affiliation: Lilly Deutschland GmbH, Saalburgerstr. 153, 61350 Bad Homburg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Happich
authors.forename: Jürgen
authors.initials: J
authors.lastname: John
authors.forename: Sabine
authors.initials: S
authors.lastname: Stamenitis
authors.forename: Johannes
authors.initials: J
authors.lastname: Clouth
authors.forename: Dorit
authors.initials: D
authors.lastname: Polnau
mesh_terms: D000368:Aged; D017281:Cost of Illness; D003925:Diabetic Angiopathies / Q000191:economics* / Q000503:physiopathology* / Q000523:psychology; D017719:Diabetic Foot / Q000191:economics / Q000503:physiopathology; D003929:Diabetic Neuropathies / Q000191:economics* / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D016523:Foot Ulcer / Q000191:economics / Q000503:physiopathology; D005858:Germany; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D011788:Quality of Life; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology