J Obes Metab Syndr.  2018 Dec;27(4):238-247. 10.7570/jomes.2018.27.4.238.

Treatment Costs and Factors Associated with Glycemic Control among Patients with Diabetes in the United Arab Emirates

• Lee SM
• Song I
• Suh D
• Chang C
• Suh DC

• KMID: 2436616
• DOI: http://doi.org/10.7570/jomes.2018.27.4.238

Abstract

BACKGROUND
We aimed to estimate the proportion of patients with diabetes who achieved target glycemic control, to estimate diabetes-related costs attributable to poor control, and to identify factors associated with them in the United Arab Emirates.
METHODS
This retrospective cohort study used administrative claims data handled by Abu Dhabi Health Authority (January 2010 to June 2012) to determine glycemic control and diabetes-related treatment costs. A total of 4,058 patients were matched using propensity scores to eliminate selection bias between patients with glycosylated hemoglobin (HbA1c) < 7% and HbA1c ≥7%. Diabetes-related costs attributable to poor control were estimated using a recycled prediction method. Factors associated with glycemic control were investigated using logistic regression and factors associated with these costs were identified using a generalized linear model.
RESULTS
During the 1-year follow-up period, 46.6% of the patients achieved HbA1c < 7%. Older age, female sex, better insurance coverage, non-use of insulin in the index diagnosis month, and non-use of antidiabetic medications during the follow-up period were significantly associated with improved glycemic control. The mean diabetes-related annual costs were $2,282 and $2,667 for patients with and without glycemic control, respectively, and the cost attributable to poor glycemic control was $172 (95% confidence interval [CI], $164-180). The diabetes-related costs were lower with mean HbA1c levels < 7% (cost ratio, 0.94; 95% CI, 0.88-0.99). The costs were significantly higher in patients aged ≥65 years than those aged ≤44 years (cost ratio, 1.45; 95% CI, 1.25-1.70).
CONCLUSION
More than 50% of patients with diabetes had poorly controlled HbA1c. Poor glycemic control may increase diabetes-related costs.

Keyword

Diabetes mellitus; Blood glucose; Glycosylated hemoglobin A; Health care costs; Administrative claims

MeSH Terms

Blood Glucose
Cohort Studies
Diabetes Mellitus
Diagnosis
Female
Follow-Up Studies
Health Care Costs*
Hemoglobin A, Glycosylated
Humans
Insulin
Insurance Coverage
Linear Models
Logistic Models
Methods
Propensity Score
Retrospective Studies
Selection Bias
United Arab Emirates*
Blood Glucose
Hemoglobin A, Glycosylated
Insulin