title: Clinical and economic characteristics associated with type 2 diabetes.
abstract: OBJECTIVE
  Type 2 diabetes mellitus (DM2) is usually accompanied by various comorbidities that can increase the cost of treatment. We are not aware of studies that have determined the costs associated with treating DM2 patients with co-morbidities such as overweight (OW), obesity (OBE) or arterial hypertension (AHT). The aim of the study was to examine the health-related costs and the incidence of cardiovascular disease (CVD) in these patients.
  
  
  METHODS
  Multicenter, observational retrospective design. We included patients 40-99 years of age who requested medical attention in 2010 in Badalona (Barcelona, Spain). There were two study groups: those with DM2 and without DM2 (reference group/control), and six subgroups: DM2-only, DM2-AHT, DM2-OW, DM2-OBE; DM2-AHT-OW and DM2-AHT-OBE. The main outcome measures were: co-morbidity, metabolic syndrome (MS), complications (hypoglycemia, CVD) and costs (health and non-health). Follow-up was carried out for two years.
  
  
  RESULTS
  A total of 26,845 patients were recruited. The prevalence of DM2 was 14.0%. Subjects with DM2 were older (67.8 vs. 59.7 years) and more were men (51.3 vs. 43.0%), P<.001. DM2 status was associated primarily with OBE (OR=2.8, CI=2.4-3.1), AHT (OR=2.4, CI=2.2-2.6) and OW (OR=1.9, CI=1.7-2.2). The distribution by subgroups was: 6.7% of patients had only DM2, 26.1% had DM2, AHT and OW, and 34.1% had DM2, AHT, and OBE. Some 75.4% had MS and 37.5% reported an episode of hypoglycemia. The total cost/patient with DM2 was €4,458. By subgroups the costs were as follows: DM2: €3,431; DM2-AHT: €4,075; DM2-OW: €4,057; DM2-OBE: €4,915; DM2-AHT-OW: €4,203 and DM2-AHT-OBE: €5,021, P<.001. The CVD rate among patients with DM2 was 4.7 vs. 1.7% in those without DM2 P<.001.
  
  
  CONCLUSIONS
  Obesity is a comorbidity associated with DM2 that leads to greater healthcare costs than AHT. The presence of these comorbidities causes increased rates of CVD.
authors.affiliation: Dirección de planificación, Badalona Serveis Assistencials SA, Badalona, Barcelona, España. Electronic address: asicras@bsa.cat.
authors.forename: A
authors.initials: A
authors.lastname: Sicras-Mainar
authors.affiliation: Documentación médica, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: R
authors.initials: R
authors.lastname: Navarro-Artieda
authors.affiliation: Dirección médica, Badalona Serveis Assistencials SA, Badalona, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Ibáñez-Nolla
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D006973:Hypertension / Q000191:economics / Q000453:epidemiology; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000191:economics / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000191:economics / Q000453:epidemiology*; D050177:Overweight / Q000191:economics / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
keywords: Cardiovascular disease; Costes sanitarios; Diabetes; Enfermedad cardiovascular; Health care costs; Hipoglucemias; Hypoglycemia; Metabolic syndrome; Síndrome metabólico