title: Short-term cost analysis of complications related to glycated hemoglobin in patients with type 1 diabetes in the Italian setting.
abstract: OBJECTIVE
  The aim of this study is to assess the impact of the diabetes-related complications on costs and to shed light on the potential savings that could be obtained by the National Healthcare System if better glycemic control was to be achieved in the type 1 diabetes population.
  
  
  METHODS
  Epidemiologic data were used to distribute diabetes type 1 patients into A1c levels, and the relative risk of diabetes-related complications associated with the level of A1c was extrapolated from published risk curves. The costs associated with all complications in the Italian settings, retrieved from published literature, were used to estimate the economic impact of complications in each A1c level from the NHS perspective and the potential savings that could be obtained should a treatment strategy allow to achieve better metabolic control.
  
  
  RESULTS
  The reduction in the number of complications translates into consistent monetary savings compared to current scenario. Within 5 years, €29 and €33 million would be saved if all patients reduced their A1c level by 1 % and within the range 7-8 % (53-64 mmol/mol), respectively.
  
  
  CONCLUSIONS
  This work allows focusing on the impact of managing the diabetes-related complications on the overall costs, not yet reported in the literature. It was shown that the potential savings for the National Healthcare Service associated with a more effective glycemic control are substantial.
authors.affiliation: Mario Negri Sud Institute, Santa Maria Imbaro, Chieti, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Nicolucci
authors.affiliation: Medtronic Italia S.p.A., Via Varesina 162, 20156, Milan, Italy. giorgio.buseghin@medtronic.com.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Buseghin
authors.affiliation: Medtronic International Trading Sarl, Tolochenaz, Switzerland.
authors.forename: Simona
authors.initials: S
authors.lastname: De Portu
mesh_terms: D001786:Blood Glucose; D003365:Costs and Cost Analysis; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis* / Q000191:economics*; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis* / Q000191:economics* / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000191:economics / Q000628:therapy; D003929:Diabetic Neuropathies / Q000191:economics / Q000628:therapy; D003930:Diabetic Retinopathy / Q000191:economics / Q000628:therapy; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D018570:Risk Assessment
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Budget impact; Complications; Costs; Diabetes; Glycated hemoglobin