Economic Impact Of Diabetes Research Articles

Assessment of Diabetes Mellitus Prevalence and Associated Complications among Patients at Jinja Regional Referral Hospital

In recent years, Africa has witnessed a notable shift in its disease landscape from acute infectious conditions to chronic non-communicable diseases like diabetes. The economic impact of diabetes and its complications has become a significant concern, affecting individuals, families, healthcare systems, and national economies through direct medical costs and productivity loss. Uganda, in particular, has observed a rising prevalence of diabetes, with the Uganda Diabetes Association reporting a 1.4% prevalence, accounting for approximately 500,000 individuals affected. This surge in diabetes presents a dual challenge as both a public health issue and an economic burden, necessitating vigilant monitoring and stringent management. Recognizing its profound public health implications in terms of morbidity, mortality, and cost, a comprehensive investigation into the prevalence and complications of diabetes mellitus was conducted at Jinja Regional Referral Hospital (JRRH). Using a retrospective facility-based cross-sectional study design encompassing qualitative and quantitative approaches, this research reviewed 784 patient records admitted to JRRH from January 2018 to December 2018. The findings revealed a notably high prevalence of diabetes mellitus at 8.2%. Noteworthy gender disparities were observed, with a higher prevalence among males (12%) than females (6%) within the studied population. Moreover, urban dwellers exhibited a higher susceptibility to diabetes compared to rural counterparts, and the risk was observed to escalate with age. Complications associated with diabetes mellitus were alarmingly prevalent, reaching 89.23%, predominantly characterized by microvascular complications, accounting for 56.90%. Despite the severity of complications, the case fatality rate stood at 1.54%, lower than the documented 4%, possibly influenced by a spectrum of contributing factors both positive and negative. The study underscores the urgency for increased focus on diabetes care in Jinja, emphasizing the imperative for further research, robust health education initiatives, and enhanced funding allocation toward managing this escalating health concern. Keywords: Diabetes Mellitus, Diseases, Public Health, Complications, Males and Females.

Clinical and Economic Rationale for the Early use of SGLT2 Inhibitors in Patients with Type 2 Diabetes

Type 2 diabetes (T2D) is a chronic disease associated with a high epidemiological and economic burden. It is associated with a high risk of developing both macrovascular and microvascular complications and cardiovascular diseases represent the main cause of mortality and morbidity in T2D patients. The economic impact of diabetes is primarily due to the cost and duration of treatment and secondary complications of diabetes and associated costs. Sodium-glucose co-transporter-2 (SGLT2) inhibitors are an effective therapy for providing a long-term improvement of glucose control, thus contributing to the long-term prevention of diabetic (particularly microvascular) complications. Furthermore, SGLT-2 inhibitors seem to lead to significant reductions in hospital admissions due to heart failure and progression of renal disease, regardless of baseline atherosclerotic risk category or history of heart failure. Evidence from randomized controlled trials, observational and pharmacoeconomic studies suggest that SGLT2 inhibitors should be considered not only in patients with established cardiovascular disease and incipient nephropathy but also in earlier stages of T2D in order to prevent the first onset of cardiovascular and renal complications and contain the cost of illness.

Costs and Length of Stay of Hospitalizations due to Diabetes-Related Complications.

Background Diabetes mellitus (DM) has become a significant worldwide public health problem and economic burden because a great proportion of healthcare costs has been spent on the treatment of DM and its related complications. The aim of this study was to examine the costs and length of stay (LoS) of hospitalizations due to diabetes-related complications in Taiwan. Methods This study is a retrospective claim database analysis using the Longitudinal Cohort of Diabetes Patients, with 2012 used as the base year. The hospitalization costs and LoS per admission were estimated for each complication of interest using data from the LHDB 2004 to 2012 cohorts. The presence of eight DM-related complications were identified using the ICD-9-CM codes and procedure codes. ANOVA was used to examine the relationships of diabetes duration with the LoS and costs of the complications. Results A total of 27,473 DM patients who were hospitalized in 2012 due to one of the examined DM-related complications were identified. The most common complications that caused the hospitalizations were nonfatal stroke (34.7%) and nonfatal ischemic heart disease (IHD) (28.7%). Amputation was the complication with the longest hospital stay, with a mean ± SD of 21.6 ± 14.1 days, followed by nonfatal stroke (13.6 ± 11.3), ulcer (12.7 ± 11.8), and fatal IHD (12.2 ± 13.6). The complications with the greatest hospitalization cost were fatal IHD (mean = TWD 306,209.8; median = TWD 221,417.0; 1TWD = 0.034USD) and fatal myocardial infarction (mean = TWD 272,840.1; median = TWD 174,008). Conclusions This study indicates that DM-related complications are associated with significant hospital LoS and costs. The study results could be useful for economic evaluations of diabetes treatments and the estimation of the overall economic impact of diabetes.

Economic Impact of Diabetes in South Asia: the Magnitude of the Problem.

To critically assess and identify gaps in the current literature on the economic impact of diabetes in South Asia. The total annual (direct medical and non-medical and indirect) costs for diabetes care in South Asia range from $483-$2637 per patient, and on an average 5.8% of patients with diabetes suffer catastrophic spending i.e. when households reduce basic expenditure by 40% to cope with healthcare costs. The mean direct costs per patient are positively associated with a country's gross domestic product (GDP) per capita, although there is wide heterogeneity across South Asian countries. With an estimated 84 million people suffering from diabetes in South Asia, diabetes imposes a substantial economic burden on individuals, families, and society. Since the disease burden increasingly occurs in the most productive midlife period, it adversely affects workforce productivity and macroeconomic development. Diabetes-related complications lead to markedly higher treatment costs, causing catastrophic medical spending for many households, thus underscoring the importance of preventing diabetes-related complications.

Economic Impact of Diabetes in Africa.

This review seeks to address knowledge gaps around the economic burden of diabetes in Africa. Africa is home to numerous endemic infections and also prevalent non-communicable diseases including diabetes. It is projected that the greatest increases in diabetes prevalence will occur in Africa. The importance of this review therefore lies in providing adequate knowledge on the economic challenges that diabetes poses to the continent and describe the way forward in tackling this epidemic. Diabetes contributes to a huge amount of the global health expenditure in the world. There is a dearth of information on the economic burden of diabetes in Africa with very limited number of studies in the area. Predictions do show that Africa has the greatest predicted increase in both the burden of diabetes and associated diabetic complications but yet contributes the lowest in the global annual healthcare expenses with regard to diabetes care. In 2017, the International Diabetes Federation (IDF) estimated the total health expenditure due to diabetes at $3.3 billion. In Nigeria, the national annual direct costs of diabetes was estimated in the range of $1.071 billion to $1.639 billion per year while the estimated monthly direct medical costs per individual in Cameroon stands at $148. In Sudan, the direct cost of type 2 diabetes control was $175 per year which only included the cost of medications and ambulatory care. People with diabetes are likely to experience one or more chronic illness and a significant portion of the costs associated with these complications are attributed to the underlying diabetes. The growing epidemics of diabetes and associated diabetic complications worldwide poses catastrophic financial costs, especially in Africa where most of the expenses are paid by patients and families. The most common method used for the estimation of the economic burden of a public health problem like diabetes is the cost-of-illness approach. Cost-of-illness studies traditionally divide costs into three categories: direct, indirect, and intangible. The IDF estimated the total health expenditure due to diabetes at $3.3 billion worldwide in 2017. Most of the existing studies in Africa estimated only the direct costs. The medical direct cost of type 1 diabetes was higher than type 2. However, the estimations of costs of diabetes in many countries in Africa may be underestimated due to absence of data on the relative contribution of cost of diabetes complications.

Long-term cost-effectiveness analysis shows that IDegLira is associated with improved outcomes and lower costs compared with insulin glargine U100 plus insulin aspart in the US

Aims: The clinical and economic impact of diabetes is growing in the US. Choosing therapies that are both effective and cost-effective is becoming increasingly important. The aim of the present analysis was to assess the long-term cost-effectiveness of IDegLira for treatment of patients with type 2 diabetes mellitus not meeting glycemic targets on basal insulin, vs insulin glargine U100 plus insulin aspart, in the US setting.Materials and methods: Long-term projections of cost-effectiveness outcomes were made using the IQVIA CORE Diabetes Model. Clinical inputs were based on the DUAL VII trial, with costs (accounted from a healthcare payer perspective) and utilities based on published sources. Future costs and clinical benefits were discounted at 3% annually.Results: IDegLira was associated with increased discounted life expectancy by 0.02 years and increased discounted quality-adjusted life expectancy by 0.22 quality-adjusted life years compared with insulin glargine U100 plus insulin aspart. Evaluation of direct medical costs suggested that the mean cost per patient with IDegLira was $3,571 lower than with insulin glargine U100 plus insulin aspart. The cost saving was driven predominantly by the lower acquisition cost of IDegLira compared with insulin glargine U100 plus insulin aspart, with further cost savings identified as a result of avoided treatment of diabetes-related complications. IDegLira was associated with improved clinical outcomes at a reduced cost compared with insulin glargine U100 plus insulin aspart.Conclusions: Based on clinical trial data, the present analysis suggests that IDegLira is associated with improved clinical outcomes and cost savings compared with treatment with insulin glargine U100 plus insulin aspart for patients with type 2 diabetes not achieving glycemic control on basal insulin in the US. Therefore, IDegLira is likely to be considered dominant (cost saving and more effective) and, consequently, highly cost-effective in the US setting.

The Cost of Diabetes Care-An Elephant in the Room.

Everyone dealing with health care today knows there is an elephant in the room, impossible to miss but frequently ignored—the cost of diabetes care. Although clinicians and scientists may wish to neglect the financial side of diabetes care and focus on less contentious and more familiar matters, this option is no longer viable. For people with diabetes and their families, the elephant stands in the way every day, and for those who plan health services and payment, it is a major concern. Fortunately, the scientific methods used in epidemiologic, clinical, and health services research can be applied to the economics of diabetes care. Collecting observations, identifying patterns, forming hypotheses, and prospectively testing the hypotheses can be just as relevant when one of the variables examined is the cost of care. It is the mission of Diabetes Care to present the best scientific studies related to diabetes. This issue of Diabetes Care has a special section focused on the economic impact of diabetes, including studies designed to understand it and to assess potential solutions. The American Diabetes Association (ADA) has previously reported the costs of diabetes in the U.S. for the years 2002 (1), 2007 (2), and 2012 (3). This issue of Diabetes Care includes a 2017 update (4). Because the methods used in these analyses are similar, comparisons are possible. The most noteworthy findings from the current report are the continuing increase and the remarkable magnitude of the total direct costs of diabetes in the U.S.: $116 billion in 2007, $176 billion in 2012, and $237 billion in 2017. The cost of care for people with diabetes now accounts for ∼1 in 4 health care dollars spent in the U.S. Care for a person with diabetes now costs an average of $16,752 per year. As in prior reports, the 2017 …

Expenditure pattern on diabetes care: A Community based longitudinal study in resettlement colony of East Delhi

Background: Diabetes mellitus is one of the expensive diseases in the world. The cost of care in diabetes is high mainly because of its chronic nature and complications. Moreover, it affects economically productive section of society. But studies on economic impact of diabetes are very limited in India. The present aims to estimate the annual out of pocket expenditure of diabetic care among diabetics living in an underprivileged community of East Delhi. Methodology: A community based one year longitudinal study was conducted in Kalyanpuri area of East Delhi. All the diabetes patients (consecutive sampling) aged more than 25 years and who were the permanent residents of Kalyanpuri, attending the Diabetic Clinic of Lal Bahadur Shastri Hospital in November-December 2014were selected for the study. A pre-tested semi-structured interview schedule was used as study tool. Each subject was followed up 3 monthly from January 2015-December 2015. Both direct and indirect expenditure were estimated. Results: Total 153 study subjects were selected out of which 2 migrated and 1 died. So, data from 150 study subjects were collected and analyzed. The Mean and median annual expenditure was Rs. 8,958 ±11,704 and Rs. 4,443 respectively. The mean per capita annual direct expenditure was estimated to be Rs 6,821 ± 9,832 and mean annual indirect expenditure was Rs. 2,137 ± 5,622. Inpatient treatment and medicine are two major heads of expenditure. Conclusion: Expenditure on diabetes care among diabetes patients living in underprivileged community was considerably high despite of having well-functioning government hospital in vicinity of study area.

The impact of diabetes mellitus on health and economy of Gulf Cooperation Council countries

SUMMARY Diabetes mellitus is a global health problem, where WHO recognized it as a chronic, debilitating and costly disease associated with severe complications, which poses severe risks for families, Member States and the entire world. This medical problem has put three Gulf Cooperation Council countries so far among the top ten countries facing high prevalence at a global level, to the extent that they could not meet the demand on health services or expenditure. Healthcare services in those countries need to be looked at, where primary care system should be empowered and health insurance is directed to have a better share in diabetes management. Despite this disease challenge, none of the Gulf Cooperation Council countries so far have managed to start primary or secondary prevention programs. Studies on economic impact of diabetes are badly needed, which will be the basis for future plan to stand against this disease and its economical burden.

The economic impact of diabetes through lost labour force participation on individuals and government: evidence from a microsimulation model

BackgroundDiabetes is a costly and debilitating disease. The aim of the study is to quantify the individual and national costs of diabetes resulting from people retiring early because of this disease, including lost income; lost income taxation, increased government welfare payments; and reductions in GDP.MethodsA purpose-built microsimulation model, Health&WealthMOD2030, was used to estimate the economic costs of early retirement due to diabetes. The study included all Australians aged 45–64 years in 2010 based on Australian Bureau of Statistics’ Surveys of Disability, Ageing and Carers. A multiple regression model was used to identify significant differences in income, government welfare payments and taxation liabilities between people out of the labour force because of their diabetes and those employed full time with no chronic health condition.ResultsThe median annual income of people who retired early because of their diabetes was significantly lower (AU$11 784) compared to those employed full time without a chronic health condition who received almost five times more income. At the national level, there was a loss of AU$384 million in individual earnings by those with diabetes, an extra AU$4 million spent in government welfare payments, a loss of AU$56 million in taxation revenue, and a loss of AU$1 324 million in GDP in 2010: all attributable to diabetes through its impact on labour force participation. Sensitivity analysis was used to assess the impact of different diabetes prevalence rates on estimates of lost income, lost income taxation, increased government welfare payments, and reduced GDP.ConclusionsIndividuals bear the cost of lost income in addition to the burden of the disease. The Government endures the impacts of lost productivity and income taxation revenue, as well as spending more in welfare payments. These national costs are in addition to the Government’s direct healthcare costs.

Social and economic impact of diabetics in Bangladesh: protocol for a case–control study

BackgroundDiabetes affects both individuals and their families and has an impact on economic and social development of a country. Information on the availability, cost, and quality of medical care for diabetes is mostly not available for many low- and middle-income countries including Bangladesh. Complications from diabetes, which can be devastating, could largely be prevented by wider use of several inexpensive generic medicines, simple tests and monitoring and can be a cost saving intervention. This study will provide an in-depth and comprehensive picture of social and economic impacts of diabetes in Bangladesh and propose clear recommendations for improving prevention and management of diabetes. The objectives of the study are:1) To study the association between diabetes and other health problems and its social impacts2) To estimate the economic impact of diabetes including total direct and indirect costs3) To measure the impact of diabetes on quality of life among diabetes patients in Bangladesh4) To study the impact of diabetes on the health care systemMethodsThis is a case–control study comparing cases with type 2 diabetes to controls without diabetes matched on age, sex and place of residence. 564 cases and 564 controls will be selected from the outpatient department of a tertiary hospital in Dhaka, Bangladesh. Data on socioeconomic status, health utility index, direct and indirect costs for diabetes, medication adherence, quality of life, treatment satisfaction, diet, physical activity, mental state examination, weight, height, hip and waist circumference, blood pressure, pulse, medication history, laboratory data and physical examination will be conducted.Outcome measures: The primary outcome measures will be association between diabetes and other health problems, cost of diabetes, impact of diabetes on quality of life and secondary outcome measures are impact of diabetes on healthcare systems in Bangladesh.DiscussionThis study will provide an in-depth and comprehensive picture of social and economic impacts of diabetics in Bangladesh and propose clear recommendations for improving prevention and management of diabetics. It will help to develop programs and policies for better management of Diabetics and cost effective strategies in Bangladesh context.

Methods of accelerated atherosclerosis in diabetic patients

Diabetic patients have an increased risk of cardiovascular disease (CVD), which is a major contributor to morbidity and mortality in the aging population, and have a more than twofold increase...

Commentary on an analysis of the existing resources in relation to education and treatment of diabetes in four European Countries: Estonia, Finland, Ireland, and Lithuania

With diabetes at pandemic proportions worldwide (Hjelm, Mufunda, Nambozi, & Kemp, 2003), including throughout Europe (International Diabetes Federation [IDF], 2004a), both the human cost and the economic impact of diabetes are of great concern to all health care professionals. Nurses in particular can play a crucial role in caring for and educating patients with diabetes, with profound effects on both improving patient outcomes and decreasing the economic costs of diabetes (McDonald, Tilley, & Havstad, 1999; IDF, 2004b). However, evidence exists that patients may receive inadequate care because the health professionals caring for them lack the necessary up-to-date knowledge of diabetes care, a field that is changing rapidly as new treatments and counseling techniques are introduced (Chan & Zang, 2007). Burton et al. are addressing this knowledge gap through an innovative international project designed to provide online education for nurses about diabetes care, with the possibility of later using course content in regular courses. Nurses from schools in four countries are involved in planning and implementing this program: Estonia, Finland, Ireland, and Lithuania. The online courses will include content focused on counseling and education methods, as well as diabetes management, and will be delivered in each of the four languages used in the partner countries. Multiple teaching methods will be used in the online course, including lecture, Web-based learning assignments, interactive exercises, individual and group work, and online discussion. In preparation for the development of this curriculum, Burton et al. asked each of the partner schools to complete a

The relationship between diabetes and depression: improving the effectiveness of case management interventions.

Diabetes places an immense burden on U.S. healthcare delivery systems. The Centers for Disease Control and Prevention estimates the economic impact of diabetes at nearly 100 billion dollars a year. Diabetes affects 17 million people in the United States and ranks as the sixth leading cause of death. Diabetes is among the most psychologically and behaviorally demanding chronic medical illnesses and the presence of diabetes doubles the odds of comorbid depression. In addition, recent research demonstrates that depressive symptoms serve as a predictor of type 2 diabetes. Case managers should maintain a high index of suspicion for the possibility of depression in chronically ill clients, as the severity of depressive symptoms is associated with poorer treatment adherence and higher healthcare costs. Three valid and reliable tools available to support depression screening in the case management setting are presented.

Global policy: aspects of diabetes in India

Diabetes has already been described as an epidemic, but predictions for future increases in prevalence, especially in developing countries, point to a major healthcare crisis for the future. Very little is known about the economic impact of diabetes in the developing world where predicted increases in prevalence are greatest. This paper discusses the implications of a recent study of the economic aspects of diabetes in India. The study aims were to estimate the costs of diabetes care and to assess the awareness of patients and healthcare professionals about the prevention and treatment of diabetes. The findings confirm reports from earlier studies of the high costs of treatment amongst all socio-economic patient groups resulting in a serious burden on both patients and state resources alike. Both patients and medical practitioners displayed a lack of comprehension of the need for constant disease monitoring and consistent approaches to tight glycaemic control. The long term economic implications are worrying. With the Indian diabetic population predicted to rise to >80.9 million by the year 2030, immediate health policy restructuring and investment will be needed if the best use is to be made of the scarce healthcare resources.

The economic burden of diabetes and the benefits of improved glycemic control: the potential role of a continuous glucose monitoring system.

S-7 DIABETES MELLITUS is a serious metabolic disorder that places patients at increased risk of coronary and vascular disease, as well as debilitating conditions such as retinopathy, nephropathy, and neuropathy (Table 1).1–3 The attainment of tight glucose control can reduce the occurrence of deleterious long-term complications associated with the progression of both type 1 and type 2 diabetes mellitus.4–9 This relationship has been most convincingly demonstrated with microvascular complications (i.e., retinopathy, neuropathy, and nephropathy). In the Diabetes Control and Complications Trial (DCCT), intensive therapy reduced the risk of developing retinopathy by 76% in patients with type 1 diabetes mellitus.4 The United Kingdom Prospective Diabetes Study (UKPDS) showed a 25% risk reduction in microvascular endpoints with intensive therapy for type 2 diabetes,8 and every 1% decrease in HbA1C correlated with a 37% reduction in the risk of microvascular complications.10 Data are less definitive for macrovascular complications such as coronary heart disease and peripheral vascular disease, but current evidence suggests that hyperglycemia is associated with negative cardiovascular outcomes.10–12 In turn, improved control of blood glucose can reduce the costs associated with the treatment and long-term management of the common complications of diabetes. In the DCCT, the annual cost of therapy aimed at intensive control was $4,000–5,800 per patient—approximately threefold the cost of conventional therapy—but it was estimated that intensive treatment would begin to show savings within 5–7 years by decreasing the incidence of future complications.13 A retrospective study of a large HMO population determined that patients with either type 1 or type 2 diabetes (n 5 8,905) experienced higher incidence rates of various complications than ageand sex-matched controls without diabetes (n 5 36,520), which translated into excess costs (Fig. 1a,b).14 Similarly, a retrospective analysis of a large type 2 diabetes population (n 5 11,768) enrolled in an HMO found that per-person costs increased above baseline by 360% after a major cardiovascular event, by 195% for those with advanced renal disease, and by 771% for those with end-stage renal disease.15 In essence, long-term intensive treatment is cost-effective, a particularly important point given the size of the patient population and the clinical magnitude of the disease. Approximately 16 million Americans—or 5.9% of the U.S. population—have diabetes. However, 5.4 million are unaware that they have the disease.1 The economic impact of diabetes is staggering. For 1997, the direct and indirect costs of diabetes care were estimated to be $98 billion.16 The direct costs were $44 billion, including $27.5 billion for inpatient hospital care and $5.5 billion for nursing home care. The indirect costs were $54 billion, including $37.1 billion for disability and $16.9 billion attributed to mortality.

Economic impact of diabetes in Slovakia: Direct costs are closely related to glycemic control

Economic impact of diabetes in Slovakia: Direct costs are closely related to glycemic control

Clinical and Economic Impact of Diabetes Following Coronary Artery Bypass

Background.Diabetes has been shown to have a negative impact on mortality following coronary artery bypass graft (CABG) surgery. This analysis examines the impact of diabetes on additional clinical and economic outcomes.Material and methods.Between May and October of 1996, 312 consecutive patients undergoing isolated primary CABG were followed through hospital discharge. A total of 114 diabetics (37%) and 198 nondiabetics (63%) was evaluated. Among the diabetics, 62 (54%) were insulin requiring and 52 (46%) were treated with oral hypoglycemic agents or with diet alone.Results.The incidences of major clinical complications including death, renal failure, stroke, reexploration for bleeding, and mediastinitis or sternal dehiscence were not significantly different among insulin-requiring diabetics, noninsulin-requiring diabetics, and nondiabetics. However, insulin-requiring diabetics had a significantly longer (P< 0.01) total length of stay compared to both noninsulin-requiring diabetics and nondiabetics (10.7 ± 12.7 days vs. 5.6 ± 1.5 days vs. 6.8 ± 5.4 days, respectively), a significantly longer (P< 0.01) intensive care unit length of stay (5.3 ± 12.4 days vs. 1.4 ± 0.8 days vs. 2.0 ± 3.9 days, respectively), and significantly greater (P< 0.01) total hospital charges (48.7 ± 56.1 thousand dollars vs. 29.3 ± 4.3 thousand dollars vs. 32.9 ± 18.9 thousand dollars, respectively). There were no significant differences between the noninsulin-requiring diabetics and the nondiabetics with regard to these clinical and economic outcomes.Conclusions.Diabetics treated with oral hypoglycemic agents or with diet alone have clinical and economic outcomes similar to nondiabetics following CABG. Insulin-requiring diabetes, however, predicts significantly increased hospital resource utilization. Future outcome assessment and resource utilization analyses must stratify diabetes by treatment to be completely accurate.

PMD3 Use of Administrative Data to Create Disease-Specific Datasets for Use in Health Economic Studies

Use of administrative health databases for exposure-outcome studies is becoming increasingly common. The Saskatchewan databases are well recognized as a resource for pharmacoepidemiological research. However, the databases have been underutilized for disease surveillance and health economic studies. OBJECTIVE: The objective of this project was to use Saskatchewan's health service databases to develop a disease-specific dataset for use in chronic disease surveillance and health economic studies. Diabetes was selected as the disease of interest and will be a prototype for future studies. METHODS: The government of Saskatchewan maintains comprehensive, linkable databases on health services provided to the population of approximately one million residents. All eligible beneficiaries with 1 hospitalization for diabetes, 2 physician visits for diabetes within two years, and/or 1 prescription for insulin or an oral hypoglycemic agent between 1991 and 1996 were defined as diabetic. For each subject, outpatient prescription drug, physician services, and hospitalization data were compiled to study the costs of care. RESULTS: During the study period, 45,716 Saskatchewan residents met the inclusion criteria. Of those, 52.1% were male and 46.8% were 65 years of age or older. The incidence and prevalence of diabetes in 1996 were 0.3% and 3.5%, respectively. During 1996, diabetic subjects had 768,122 physician services and 19,985 hospitalizations. Diseases of the circulatory system were the most common comorbidities responsible for hospitalizations and physician visits. DISCUSSION: Using administrative health services data, we were able to identify diabetic patients and compile information about their outpatient prescriptions, physician services, and hospitalizations as well as the costs associated with them. This dataset will facilitate analyses of the economic impact of diabetes from both the individual and societal perspectives.