title: Association of good glycemic control and cost of diabetes care: Experience from a tertiary care hospital in Bangladesh.
abstract: OBJECTIVE
  The present study was undertaken to assess the cost-effectiveness of good glycemic control in a population of Bangladeshi people with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  A cross-sectional study was conducted among 496 registered patients with >1year duration of diabetes. Glycated hemoglobin A1c level <7% was judged as the cut-off value for good glycemic control. All treatment-related records from the last year were collected from patients' guide books and all cost components were calculated.
  
  
  RESULTS
  Among patients, 31% had good glycemic control. The average annual cost was US$ 314 per patient. Patients with poor glycemic control were significantly more likely to have complications [(p=0.049) OR 1.5] and comorbidities [(p=0.02) OR 1.5]. The annual cost increased rapidly with complications/comorbidities. In multivariable logistic regression analysis, gender (p=0.003) and cost of care (p=0.006) were significantly associated with glycemic control, and the presence of any comorbidities/complications was associated with 1.8-fold higher odds of poor glycemic control (p=0.013 95% CI: 1.131-2.786).
  
  
  CONCLUSIONS
  Good glycemic control can lead to substantial cost saving through prevention and control of complications.
authors.affiliation: Department of Biostatistics, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka 1216, Bangladesh. Electronic address: ar_tauras@yahoo.com.
authors.forename: Afsana
authors.initials: A
authors.lastname: Afroz
authors.affiliation: Department of Biostatistics, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka 1216, Bangladesh.
authors.forename: Hasina Akhter
authors.initials: HA
authors.lastname: Chowdhury
authors.affiliation: Department of Public Health, Daffodil International University, 102 Shukrabad, Dhanmondi, Dhaka 1207, Bangladesh.
authors.forename: Md
authors.initials: M
authors.lastname: Shahjahan
authors.affiliation: Department of Biostatistics, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka 1216, Bangladesh.
authors.forename: Md Abdul
authors.initials: MA
authors.lastname: Hafez
authors.affiliation: Institute of Nutrition & Food Science, University of Dhaka, Bangladesh.
authors.forename: Md Nazmul
authors.initials: MN
authors.lastname: Hassan
authors.affiliation: Department of Biochemistry & Cell Biology, Bangladesh University of Health Sciences (BUHS), 125/1, Darus Salam, Mirpur, Dhaka 1216, Bangladesh.
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
mesh_terms: D001459:Bangladesh; D001786:Blood Glucose / Q000032:analysis; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000191:economics* / Q000209:etiology / Q000517:prevention & control; D007003:Hypoglycemia / Q000191:economics* / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D063128:Tertiary Health Care
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Complication; Cost of diabetes care; Direct cost; Glycemic control; Indirect cost; Type 2 diabetes mellitus (T2DM)