scholarly journals Productivity-adjusted life years lost due to type 2 diabetes in Germany in 2020 and 2040

Diabetologia ◽  
2021 ◽  
Author(s):  
Thaddäus Tönnies ◽  
Annika Hoyer ◽  
Ralph Brinks
Keyword(s):  
Type 2 Diabetes ◽  
Age Groups ◽  
Population Level ◽  
Future Trends ◽  
Productivity Losses ◽  
Life Years ◽  
Working Age ◽  
Life Years Lost ◽  
Age And Sex

Abstract Aims/hypothesis Type 2 diabetes can lead to reduced productivity during working age. We aimed to estimate productive life years lost associated with type 2 diabetes on the individual and population level in Germany in 2020 and 2040, while accounting for future trends in mortality. Methods Based on a mathematical projection model, we estimated age- and sex-specific productivity losses associated with type 2 diabetes during working age (20–69 years) in Germany in 2020 and 2040. Productivity losses in terms of excess mortality (years of life lost, YLL) and reductions in labour force participation, presenteeism and absenteeism (years of productivity lost, YPL) were summed to calculate productivity-adjusted life years (PALY) lost. Input data for the projection were based on meta-analyses, representative population-based studies and population projections to account for future trends in mortality. Results Compared with a person without type 2 diabetes, mean PALY lost per person with type 2 diabetes in 2020 was 2.6 years (95% CI 2.3, 3.0). Of these 2.6 years, 0.4 (95% CI 0.3, 0.4) years were lost due to YLL and 2.3 (95% CI 1.9, 2.6) years were lost due to YPL. Age- and sex-specific results show that younger age groups and women are expected to lose more productive life years than older age groups and men. Population-wide estimates suggest that 4.60 (95% CI 4.58, 4.63) million people with prevalent type 2 diabetes in 2020 are expected to lose 12.06 (95% CI 10.42, 13.76) million PALY (1.62 million years due to YLL and 10.44 million years due to YPL). In 2040, individual-level PALY lost are projected to slightly decrease due to reductions in YLL. In contrast, population-wide PALY lost are projected to increase to 15.39 (95% CI 13.19, 17.64) million due to an increase in the number of people with type 2 diabetes to 5.45 (95% CI 5.41, 5.50) million. Conclusions/interpretation On the population level, a substantial increase in productivity burden associated with type 2 diabetes was projected for Germany between 2020 and 2040. Efforts to reduce the incidence rate of type 2 diabetes and diabetes-related complications may attenuate this increase. Graphical abstract

scholarly journals Study of Relation between Serum Magnesium Levels and Vascular Complications in Patients of Type 2 Diabetes Mellitus

2019 ◽  
Vol 6 (09) ◽  
pp. 4574-4591
Author(s):  
Dineshbabu S ◽  
Tonk R S
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Serum Magnesium ◽  
Vascular Complications ◽  
Healthy Life ◽  
Loss Of Life ◽  
Healthy Life Years ◽  
Life Years ◽  
Life Years Lost

Diabetes mellitus is increasing alarmingly especially in developing country like India. The complications related to Diabetes lead to loss of life and also healthy life years lost. There are many factors contributing to the compications. The prevalance of magnisiuria in diabetics is long under reasearch. Magnesium is known to be important for endothelial function. We studied the prevalance of levels of magnesium in patients who had vascular complications associated with diabetes. We found a correlation that is not statistically significant.

scholarly journals Type 2 Diabetes-Related Health Economic Impact Associated with Increased Whole Grains Consumption among Adults in Finland

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3583
Author(s):  
Janne Martikainen ◽  
Kari Jalkanen ◽  
Jari Heiskanen ◽  
Piia Lavikainen ◽  
Markku Peltonen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Economic ◽  
Adult Population ◽  
Population Level ◽  
Economic Consequences ◽  
Life Years ◽  
Health Economic Model ◽  
Important Health ◽  
High Level

The prevalence of type 2 diabetes (T2D) is increasing rapidly worldwide. A healthy diet supporting the control of energy intake and body weight has major importance in the prevention of T2D. For example, a high intake of whole grain foods (WGF) has been shown to be inversely associated with risk for T2D. The objective of the study was to estimate the expected health economic impacts of increased WGF consumption to decrease the incidence of T2D in the Finnish adult population. A health economic model utilizing data from multiple national databases and published scientific literature was constructed to estimate these population-level health economic consequences. Among the adult Finnish population, increased WGF consumption could reduce T2D-related costs between 286€ and 989€ million during the next 10-year time horizon depending on the applied scenario (i.e., a 10%-unit increase in a proportion of daily WGF users, an increased number (i.e., two or more) of WGF servings a day, or alternatively a combination of these scenarios). Over the next 20–30 years, a population-wide increase in WGF consumption could lead to much higher benefits. Furthermore, depending on the applied scenario, between 1323 and 154,094 quality-adjusted life years (QALYs) could be gained at the population level due to decreased T2D-related morbidity and mortality during the next 10 to 30 years. The results indicate that even when the current level of daily WGF consumption is already at a relatively high-level in a global context, increased WGF consumption could lead to important health gains and savings in the Finnish adult population.

scholarly journals Diabetes free life expectancy and years of life lost associated with type 2 diabetes: projected trends in Germany between 2015 and 2040

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Thaddäus Tönnies ◽  
Jens Baumert ◽  
Christin Heidemann ◽  
Elena von der Lippe ◽  
Ralph Brinks ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Incidence Rate ◽  
Excess Mortality ◽  
Premature Mortality ◽  
Population Level ◽  
Years Of Life Lost ◽  
German Population ◽  
Life Years ◽  
Incidence And Mortality

Abstract Background Type 2 diabetes (T2D) causes substantial disease burden and is projected to affect an increasing number of people in coming decades. This study provides projected estimates of life years free of type 2 diabetes (T2D) and years of life lost ($${\mathrm{YLL}}$$ YLL ) associated with T2D for Germany in the years 2015 and 2040. Methods Based on an illness-death model and the associated mathematical relation between prevalence, incidence and mortality, we projected the prevalence of diagnosed T2D using currently available data on the incidence rate of diagnosed T2D and mortality rates of people with and without diagnosed T2D. Projection of prevalence was achieved by integration of a partial differential equation, which governs the illness-death model. These projected parameters were used as input values to calculate life years free of T2D and $${\mathrm{YLL}}$$ YLL associated with T2D for the German population aged 40 to 100 years in the years 2015 and 2040, while accounting for different assumptions on future trends in T2D incidence and mortality. Results Assuming a constant incidence rate, women and men at age 40 years in 2015 will live approximately 38 years and 33 years free of T2D, respectively. Up to the year 2040, these numbers are projected to increase by 1.0 years and 1.3 years. Assuming a decrease in T2D-associated excess mortality of 2% per year, women and men aged 40 years with T2D in 2015 will be expected to lose 1.6 and 2.7 years of life, respectively, compared to a same aged person without T2D. In 2040, these numbers would reduce by approximately 0.9 years and 1.6 years. This translates to 10.8 million and 6.4 million $${\mathrm{YLL}}$$ YLL in the German population aged 40–100 years with prevalent T2D in 2015 and 2040, respectively. Conclusions Given expected trends in mortality and no increase in T2D incidence, the burden due to premature mortality associated with T2D will decrease on the individual as well as on the population level. In addition, the expected lifetime without T2D is likely to increase. However, these trends strongly depend on future improvements of excess mortality associated with T2D and future incidence of T2D, which should motivate increased efforts of primary and tertiary prevention.

Estimating cardiovascular disease-free life-years with the addition of semaglutide in people with type 2 diabetes using pooled data from SUSTAIN 6 and PIONEER 6

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Westerink ◽  
K Sommer Matthiessen ◽  
S Nuhoho ◽  
U Fainberg ◽  
M Lyng Wolden ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Funding Source ◽  
Cvd Risk ◽  
Private Company ◽  
Pooled Data ◽  
Patient Level ◽  
Life Years ◽  
Geographical Regions

Abstract Introduction Cardiovascular disease (CVD) is the leading cause of disability and death in people with type 2 diabetes (T2D). In a post hoc analysis of pooled data (POOLED cohort) from two phase 3, randomized CV outcomes trials, SUSTAIN 6 (NCT01720446) and PIONEER 6 (NCT02692716), the addition of the glucagon-like peptide-1 analogue semaglutide to standard of care (SoC) in people with T2D at high risk of CVD significantly reduced the risk of major adverse CVD events (3-point MACE: CV death, non-fatal stroke and non-fatal myocardial infarction). Purpose To estimate the effect of adding semaglutide to SoC on CVD-free life-years and 10-year CVD risk in patients with T2D by predicting individual patient-level risk of CVD events in the POOLED cohort using the DIAL CVD risk model. Methods The 3-point MACE hazard ratio from the POOLED cohort (N=6480; HR = 0.76 [95% confidence interval [CI]: 0.62–0.92]) was applied to the patient-level lifetime risk of CVD events derived from the DIAL model. CVD-free life-years and 10-year CVD risk were then calculated based on the age-specific risks of CVD events and non-vascular mortality, using standard actuarial methods. Both new and recurrent CVD events were considered. The DIAL model was validated by comparing the predicted and observed number of CVD events after 1 year. The DIAL model was previously developed using data from people with T2D in the Swedish National Diabetes Registry and validated across geographical regions. Results The DIAL model was considered valid for use in the POOLED cohort because the predicted number of CVD events at 1 year was within 5% of the number observed. Adding semaglutide to SoC was associated with a mean reduction in 10-year CVD risk of 20.0% (95% CI: 6.4–32.6%) and a mean increase of 1.72 (95% CI: 0.52–2.96) CVD-free life-years. The number of mean CVD-free life-years gained ranged from 0.62–2.91 years between age groups (Table). For a 60-year-old male with baseline characteristics matched to the average male from the POOLED cohort, adding semaglutide to SoC reduced 10-year CVD risk by 20.8% and provided 2.53 additional CVD-free life-years. The number of CVD-free life-years decreased when baseline age was increased (Figure). Conclusions The addition of semaglutide to SoC was associated with a gain in CVD-free life-years. This analysis helps contextualize the results of CV outcomes trials and may help to inform clinical decision-making. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novo Nordisk A/S

82 The Significant Burden of Burn Injuries in the Middle East: An Epidemiological Study of Nineteen Countries over 27 Years

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S56-S57
Author(s):  
Zachary J Collier ◽  
Yasmina Samaha ◽  
Priyanka Naidu ◽  
Katherine J Choi ◽  
Christopher H Pham ◽  
...  
Keyword(s):  
Middle East ◽  
Age Groups ◽  
Mortality Rates ◽  
Burn Injuries ◽  
Burn Care ◽  
Life Years ◽  
Significant Burden ◽  
Mortality Ratio ◽  
Incident Cases ◽  
Age And Sex

Abstract Introduction Despite ongoing improvements in burn care around the world, the burden of burn morbidity and mortality has remined a significant challenge in the Middle East due to ongoing conflicts, economic crises, social disparities, and dangerous living conditions. Here, we examine the epidemiology of burn injuries in the Middle East (ME) relative to socio-demographic index (SDI), age, and sex in order to better define regional hotspots that may benefit most from sustainability and capacity building initiatives. Methods Computational modeling from the 2017 Global Burden of Disease (GBD17) database was used to extrapolate burn data about the nineteen countries that define the ME. Using the GBD17, the yearly incidence, deaths, and Disability-Adjusted Life Years (DALYs) from 1990 to 2017 were defined with respect to age and sex as rates of cases, deaths, and years per 100,000 persons, respectively. Mortality ratio represents the percentage of deaths relative to incident cases. Data from 2017 was spatially mapped using heat-mapping for the region. Results Over 27 years in the ME, an estimated 18,289,496 burns and 308,361 deaths occurred causing 24.5 million DALYs. Burn incidence decreased by 5% globally but only 1% in the ME. Although global incidence continued to decline, most ME countries exhibit steady increases since 2004. Compared to global averages, higher mortality rates (2.8% vs 2.0%) and DALYs (205 vs 152 years) were observed in the Middle East during this time although the respective disparities narrowed by 95% and 42% by 2017. Yemen had the worst death and DALY rates all 27 years with 2 and 2.2 times the ME average, respectively. Sudan had the highest morality ratio (3.7%) for most of the study, twice the ME average (1.8%), followed by Yemen at 3.6%. Sex-specific incidence, deaths, and DALYs in the ME were higher compared to the global cohorts. ME women had the worst rates in all categories. With respect to age, all rates were worse in the ME age groups except in those under 5 years. Conclusions For almost three decades, ME burn incidence, deaths, DALYs, and mortality rates were consistently worse than global average. Despite the already significant differences for burn frequency and severity, especially in women and children, underreporting from countries who lack sufficient registry capabilities likely means that the rates are even worse than predicted.

scholarly journals Burden of Stroke in Myanmar

2021 ◽  
pp. 49-51
Author(s):  
Narayanaswamy Venketasubramanian ◽  
Yee Mon Khine ◽  
Ohnmar Ohnmar ◽  
Myat Po Po Kyaw Khin ◽  
Min Thit Win
Keyword(s):  
Rural Areas ◽  
Mechanical Thrombectomy ◽  
Disability Adjusted Life Years ◽  
Stroke Units ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Lower Blood ◽  
Life Years Lost ◽  
Standardized Mortality Rate ◽  
Age And Sex

Myanmar is home to over 51 million people. The age- and sex-standardized mortality rate due to stroke is 165.4/100,000, while the rate of age- and sex-standardized disability-adjusted life years lost due to stroke is 2971.3/100,000. The prevalence of stroke among adults aged 40–99 years is 1.5%. Stroke is the leading cause of morbidity and mortality and comprises 20% of the neurological workload. There are only 10 stroke units in the whole country. Doctors are aware of the importance of hypertension in stroke prevention and the need for physiotherapy after stroke, but, until recently and in rural areas, they also tend to use steroids and neuroprotectants, and lower blood pressure aggressively acutely after stroke; antiplatelets are not widely used. Thrombolysis service is available at some tertiary centers but mechanical thrombectomy is not yet available.

scholarly journals The fourth decade of life: the age for preventive strategies?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Cuschieri
Keyword(s):  
Type 2 Diabetes ◽  
Multiple Logistic Regression Analysis ◽  
Age Groups ◽  
Overweight And Obesity ◽  
Health Examination ◽  
Preventive Strategies ◽  
Preventive Action ◽  
Starting Point ◽  
Fourth Decade

Abstract Background Non-communicable diseases (NCDs) have been on the health agenda for decades. As the 2020's decade sets in, most of the set health strategies and targets are ending while new goals are expected. Investigating a European country hub known for its high prevalence of NCDs provides evidence-based data that can be used for these new strategies. The aim was to explore potential NCDs trends and associations that could provide evidence for new preventive strategies and goals. Methods Data was obtained from a national representative cross-sectional study through a health examination survey (2014-6). The self-reported data and the results of the examination were used to diagnose participants with type 2 diabetes, dyslipidaemia, hypertension, overweight and obesity. The study population was stratified by ten years and sex for both descriptive and analytic analyses. Results The male population was significantly more metabolically unhealthy that the female counterparts across all age groups (p = <0.01). The females had the highest newly diagnosed diabetes prevalence across all age groups. It was observed that type 2 diabetes, dyslipidaemia and hypertension were present as of the 30-39 years group. Conversely, on binary multiple logistic regression analysis, this age group was negatively associated with NCDs even after adjusting for confounders (Diabetes OR:0.06 CI95%:0.02-0.21 p = <0.01; hypertension OR: 0.16 CI 95%: 0.05-0.55 p = <0.01; overweight OR: 0.21 CI 95%: 0.11 - 0.40 p = <0.01). Conclusions The fourth decade of life might be the starting point for metabolic dysregulation. Hence, subject to long-term health and economic burdens, with a potential extension of the metabolic impact on their offspring. Although further research is recommended, this study sets the ball rolling whether preventive action including screening for dysglycaemia and dyslipidaemia should be implemented at a population level from a young age. Key messages Preventive action should start from fourth decade of life. Targeting the fourth decade of life would also ensure a healthier new generation.

The Impact of Hypoglycemia on Productivity Loss and Utility in Type 2 Diabetes Patients Treated with Insulin in Real-World Canadian Practice: Protocol for a Prospective Study (Preprint)

2021 ◽  
Author(s):  
Veronique Lambert-Obry ◽  
Jean-Philippe Lafrance ◽  
Michelle Savoie ◽  
Jean Lachaine
Keyword(s):  
Type 2 Diabetes ◽  
Prospective Study ◽  
Real World ◽  
Productivity Loss ◽  
Economic Modeling ◽  
Economic Evaluations ◽  
Productivity Cost ◽  
Productivity Losses ◽  
The Impact

BACKGROUND Type 2 diabetes mellitus (T2DM) imposes a significant burden, with its increasing prevalence and life-threatening complications. In patients not achieving glycemic targets on oral antidiabetic drugs, initiation of insulin is recommended. However, a serious concern about insulin is drug-induced hypoglycemia. Hypoglycemia is known to affect quality of life and healthcare resource utilization. However, health economics and outcomes research (HEOR) data for economic modeling are limited, particularly in terms of utility values and productivity losses. OBJECTIVE The aim of this real-world prospective study is to assess the impact of hypoglycemia on productivity and utility in insulin-treated T2DM adults from Ontario and Quebec (Canada). METHODS This noninterventional, multicenter, 3-month prospective study will recruit patients from four medical clinics and two endocrinology/diabetes clinics. Patients will be identified using appointment lists, and enrolled through consecutive sampling during routinely scheduled consultations. To be eligible, patients must be ≥18 years of age, diagnosed with T2DM, and treated with insulin. Utility and productivity will be collected using the EQ-5D-5L questionnaire and the iMTA Productivity Cost Questionnaire (iPCQ), respectively. Questionnaires will be completed at 4, 8 and 12 weeks after recruitment. Generalized estimating equations (GEE) models will be used to investigate productivity losses and utility decrements associated with incident hypoglycemic events while controlling for individual patient characteristics. A total of 500 patients will be enrolled to ensure precision of HEOR estimates. RESULTS This study is designed to fill a gap in the Canadian evidence on the impact of hypoglycemia on HEOR outcomes. More specifically, it will generate productivity and utility inputs for economic modeling in T2DM. CONCLUSIONS Insulin therapies are expensive, and hypoglycemia is a significant component of economic evaluations. Robust HEOR data may help health technology assessment (HTA) agencies in future reimbursement decision making.

scholarly journals Estimating the disease burden of Korean type 2 diabetes mellitus patients considering its complications

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246635
Author(s):  
Juyoung Kim ◽  
Seok-Jun Yoon ◽  
Min-Woo Jo
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Markov Model ◽  
Burden Of Disease ◽  
Age Groups ◽  
Years Of Life Lost ◽  
Age Group ◽  
Disease Study

Background The burden of diabetes is considerable not only globally but also nationally within Korea. The Global Burden of Disease study derived the disability-adjusted life years (DALYs) of diabetes depending on its complications as individual severity using prevalence-based approach from 2017. Conversely, the Korean National Burden of Disease study based on an incidence-based approach does not incorporate the severity of diseases. This study aimed to simulate incidence-based DALYs of type 2 diabetes mellitus (T2DM), given diabetic complications as disease severity using a Markov model. Methods We developed a model with six Markov states, including incident and existing prevalent cases of diabetes and its complications and death. We assumed that diabetes and its complications would not be cured. The cycle length was one year, and the endpoint of the simulation was 100 years. A 5% discount rate was adopted in the analysis. Transition cases were counted by 5-year age groups above 30 years of age. Age- and sex-specific transition probabilities were calculated based on the incident rate. Results The total DALY estimates of T2DM were 5,417 and 3,934 per 100,000 population in men and women, respectively. The years of life lost in men were relatively higher than those in women in most age groups except the 80–84 age group. The distribution of years lived with disability by gender and age group showed a bell shape, peaking in the 55–59 age group in men and 65–69 age group in women. Conclusions The burden of T2DM considering its complications was larger compared to the outcomes from previous studies, with more precise morbid duration using the Markov model.

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