Abstract
AimsDespite the frequent association of obesity with type 2 diabetes (T2D), the effect of the former on the cost of drug treatment of the latest has not been specifically addressed. We studied the association of overweight/obesity on the cost of drug treatment of hyperglycemia, hypertension and dyslipidemia in a population with T2D.MethodsThis observational study utilized data from the QUALIDIAB database on 3,099 T2D patients seen in Diabetes Centers in Argentina, Chile, Colombia, Peru, and Venezuela. Data were grouped according to body mass index (BMI) as Normal (18.5≤BMI<25), Overweight (25≤BMI<30), and Obese (BMI≥30). Thereafter, we assessed clinical and metabolic data and cost of drug treatment in each category. Statistical analyses included group comparisons for continuous variables (parametric or non-parametric tests), Chi-square tests for differences between proportions, and multivariable regression analysis to assess the association between BMI and monthly cost of drug treatment.ResultsAlthough all groups showed comparable degree of glycometabolic control (FBG, HbA1c), we found significant differences in other metabolic control indicators. Total cost of drug treatment of hyperglycemia and associated cardiovascular risk factors (CVRF) increased significantly (p<0.001) with increment of BMI. Hyperglycemia treatment cost showed a significant increase concordant with BMI whereas hypertension and dyslipidemia did not. Despite different values and percentages of increase, this growing cost profile was reproduced in every participating country. BMI significantly and independently affected hyperglycemia treatment cost.ConclusionsOur study shows for the first time that BMI significantly increases total expenditure on drugs for T2D and its associated CVRF treatment in Latin America.
Highlights
All groups showed comparable degree of glycometabolic control (FBG, hemoglobin A1c (HbA1c)), we found significant differences in other metabolic control indicators
Our study shows for the first time that body mass index (BMI) significantly increases total expenditure on drugs for type 2 diabetes (T2D) and its associated cardiovascular risk factors (CVRF) treatment in Latin America
To provide an answer to this last issue, we evaluated the association of overweight/obesity and BMI on the cost of drugs used for treatment of hyperglycemia and associated cardiovascular risk factors in people with T2D
Summary
Obesity represents a large and growing global health problem [1] significantly associated with increased morbidity and mortality [2,3,4,5], decreased quality of life [6], and increased healthcare costs [7].Body fat distribution, excess of visceral adipose tissue (VAT), usually called abdominal obesity (AO), has been associated with greater health risk [8] such as development of type 2 diabetes (T2D), cardiovascular disease (CVD), and serious hospitalization events [9,10,11].The Prospective Obesity Cohort of Economic Evaluation and Determinants (PROCEED) study, a multinational observational-prospective internet-based cohort study comparing healthcare utilization of overweight/obese people with and without AO, concluded that more obese people had an increasing gradient of medical conditions, metabolic risk factors, and healthcare utilization [12]. Obesity represents a large and growing global health problem [1] significantly associated with increased morbidity and mortality [2,3,4,5], decreased quality of life [6], and increased healthcare costs [7]. Excess of visceral adipose tissue (VAT), usually called abdominal obesity (AO), has been associated with greater health risk [8] such as development of type 2 diabetes (T2D), cardiovascular disease (CVD), and serious hospitalization events [9,10,11]. Milder et al reported that obese persons used more prescription drugs of several types, cardiovascular drugs (OR 3.83 in men and 2.80 in women) and diabetes drugs (OR 5.72 in men and 3.92 in women) than normal weight persons [14]. Future healthcare costs were higher for overweight persons, especially for those with BMIs ! 30 kg/m2 [15]
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