title: The Economic Burden of Post-prandial Hyperglycemia (PPH) Among People with Type 1 and Type 2 Diabetes in Three Countries.
abstract: BACKGROUND
  Post-prandial hyperglycemia (PPH) among people with diabetes is a well-known clinical challenge to diabetes management. While the economic burden of diabetes is well studied, little is known about economic costs specific to PPH. The purpose of this study was to investigate costs of PPH related to work, diabetes management, and use of healthcare resources among people with diabetes taking bolus insulin.
  
  
  METHODS
  Data were collected in a web survey of 906 adults with type 1 (39%) and type 2 (61%) diabetes taking bolus insulin in Germany (34%), the UK (26%), and the USA (40%).
  
  
  RESULTS
  Sixty-two percent of respondents experienced PPH in the past week, and respondents averaged 1.7 episodes per week. Working respondents indicated that PPH affected their work productivity: 27% missed work time and 71% experienced work productivity issues while at work due to a recent episode of PPH. In terms of diabetes management, respondents with PPH in the past week measured their blood glucose (BG) more frequently than those without PPH (3.7 vs. 2.5 times/day, P < 0.001). PPH was also significantly associated with greater use of healthcare resources. Compared to those without PPH, respondents with PPH reported greater contact with healthcare professionals related to diabetes in the past year (5.5 vs. 4.4 visits, P < 0.001; 2.7 vs. 1.4 calls/emails, P < 0.001) and were more likely to report medical complications related to diabetes (72% vs. 55%, P < 0.001). Average annual costs associated with PPH due to missed work time, additional BG test strips, and physician visits were estimated to be $1239 USD per employed person in the USA.
  
  
  CONCLUSIONS
  Results indicate that PPH is associated with greater economic costs and that reducing the incidence of PPH would help mitigate such costs. Additional research is needed to better understand costs associated with PPH that may be more difficult to measure, as well as more long-term impacts and costs.
  
  
  BACKGROUND
  Novo Nordisk.
authors.affiliation: The Brod Group, Mill Valley, CA, USA. mbrod@thebrodgroup.net.
authors.forename: Meryl
authors.initials: M
authors.lastname: Brod
authors.affiliation: Novo Nordisk A/S, Søborg, Denmark.
authors.forename: Annie
authors.initials: A
authors.lastname: Nikolajsen
authors.affiliation: Novo Nordisk, Inc., Plainsboro, NJ, USA.
authors.forename: James
authors.initials: J
authors.lastname: Weatherall
authors.affiliation: The Brod Group, Mill Valley, CA, USA.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Pfeiffer
keywords: Diabetes management; Diabetes mellitus; Economic costs; Healthcare resources; Post-prandial hyperglycemia; Work productivity