title: Costs of treatment and complications of adult type 1 diabetes.
abstract: OBJECTIVE
  Costs associated with diabetes represent a large burden for patients and the health-care system. However, few studies examined the costs for diabetes treatment in adults with type 1 diabetes (T1DM). This analysis was aimed to assess the costs of treatment associated with T1DM among adults in Italy from the national health-care system perspective.
  
  
  RESULTS
  Data were collected using a questionnaire assessing resource consumption retrospectively (drugs, visits, diagnostics, hospitalisations and self-monitoring of blood glucose (SMBG)). One-year costs were calculated for the 12 months preceding the survey. Cost estimation, referred to 2006, was carried out using univariate and multivariate Poisson regression models. Fifty-eight centres enrolled 1193 patients (49.5% women; aged between 18 and 55 years, average diabetes duration was 16.1 ± 9.8 years). The average annual cost for an adult patient with TDM1 was € 2450 (95% confidence interval (CI): 2358-2544). Insulin therapy and SMBG accounted together for 71.2% of total costs (35.6% and 35.6%, respectively); the remainder was shared by hospitalisations (18%), visits (4.0%), diagnostics (3.9%) and other drugs (2.9%). Univariate analyses showed that the presence of complications was associated with excess of costs, mainly related to the hospitalisation and drugs. Multivariate analyses confirmed these results showing that the presence of micro-vascular plus macrovascular complications doubles the cost of treatment.
  
  
  CONCLUSIONS
  Strategies of care for T1DM that can improve disease management and prevent or delay the onset of complications could represent the most important tool to reduce costs in the long term while improving clinical outcomes and quality of life.
authors: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/a, 66030 S. Maria Imbaro (CH), Italy. franciosi@negrisud.it
authors: M
authors: M
authors: Franciosi
authors: G
authors: G
authors: Lucisano
authors: R
authors: R
authors: Amoretti
authors: F
authors: F
authors: Capani
authors: D
authors: D
authors: Bruttomesso
authors: P
authors: P
authors: Di Bartolo
authors: A
authors: A
authors: Girelli
authors: F
authors: F
authors: Leonetti
authors: L
authors: L
authors: Morviducci
authors: E
authors: E
authors: Vitacolonna
authors: A
authors: A
authors: Nicolucci
mesh_terms: D000293:Adolescent; D000328:Adult; D015190:Blood Glucose Self-Monitoring / Q000191:economics; D016022:Case-Control Studies; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000191:economics; D003925:Diabetic Angiopathies / Q000191:economics / Q000517:prevention & control / Q000628:therapy*; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D007332:Insulin Infusion Systems / Q000191:economics; D007558:Italy; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin