Telemedicine is Cost Effective Compared with Standard Care in Type 2 Diabetes Mellitus - A Randomized Trial with an Economic Analysis in an Outpatient Clinic

2017 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Ole Winther Rasmussen ◽  
Finn Friis Lauszus ◽  
Mette Lokke ◽  
Morten Sall Jensen
Author(s):  
Néboa Zozaya ◽  
Margarita Capel ◽  
Susana Simón ◽  
Alfonso Soto-González

The approval of new non-insulin treatments has broadened the therapeutic arsenal, but it has also increased the complexity of choice for the treatment of type 2 diabetes mellitus (DM2). The objective of this study was to systematically review the literature on economic evaluations associated with non-insulin antidiabetic drugs (NIADs) for DM2. We searched in Medline, IBECS, Doyma and SciELO databases for full economic evaluations of NIADs in adults with DM2 applied after the failure of the first line of pharmacological treatment, published between 2010 and 2017, focusing on studies that incorporated quality-adjusted life years (QALYs). The review included a total of 57 studies, in which 134 comparisons were made between NIADs. Under an acceptability threshold of 25,000 euros per QALY gained, iSLGT-2 were preferable to iDPP-4 and sulfonylureas in terms of incremental cost-utility. By contrast, there were no conclusive comparative results for the other two new NIAD groups (GLP-1 and iDPP-4). The heterogeneity of the studies’ methodologies and results hindered our ability to determine under what specific clinical assumptions some NIADs would be more cost-effective than others. Economic evaluations of healthcare should be used as part of the decision-making process, so multifactorial therapeutic management strategies should be established based on the patients’ clinical characteristics and preferences as principal criteria.


2015 ◽  
Vol 8 ◽  
pp. CMED.S20906 ◽  
Author(s):  
Andreas Liebl ◽  
Kamlesh Khunti ◽  
Domingo Orozco-Beltran ◽  
Jean-Francois Yale

Type 2 diabetes mellitus (T2D) is a growing healthcare burden primarily due to long-term complications. Strict glycemic control helps in preventing complications, and early introduction of insulin may be more cost-effective than maintaining patients on multiple oral agents. This is an expert opinion review based on English peer-reviewed articles (2000–2012) to discuss the health economic consequences of T2D treatment intensification. T2D costs are driven by inpatient care for treatment of diabetes complications (40%–60% of total cost), with drug therapy for glycemic control representing 18% of the total cost. Insulin therapy provides the most improved glycemic control and reduction of complications, although hypoglycemia and weight gain may occur. Early treatment intensification with insulin analogs in patients with poor glycemic control appears to be cost-effective and improves clinical outcomes. Key Messages • Type 2 diabetes mellitus is a growing burden on healthcare services. • Despite the high cost of drug therapy versus diet and lifestyle interventions, treatment intensification with insulin analog therapy is a cost-effective strategy for improving clinical outcomes in patients with poor glycemic control.


Author(s):  
Beata Dziedzic ◽  
Zofia Sienkiewicz ◽  
Anna Leńczuk-Gruba ◽  
Ewa Kobos ◽  
Wiesław Fidecki ◽  
...  

Introduction: A sharp rise in the population of elderly people, who are more prone to somatic and mental diseases, combined with the high prevalence of type 2 diabetes mellitus and diabetes-associated complications in this age group, have an impact on the prevalence of depressive symptoms. Aim of the work: The work of the study was the evaluation of the prevalence of depressive symptoms in the elderly population diagnosed with type 2 diabetes mellitus. Materials and methods: The pilot study was conducted in 2019 among 200 people diagnosed with type 2 diabetes mellitus, aged 65 years and above, receiving treatment in a specialist diabetes outpatient clinic. The study was based on a questionnaire aimed at collecting basic sociodemographic and clinical data and the complete geriatric depression scale (GDS, by Yesavage) consisting of 30 questions. Results: The study involved 200 patients receiving treatment in a diabetes outpatient clinic. The mean age of the study subjects was 71.4 ± 5.0 years. The vast majority of the subjects (122; 61%) were women, with men accounting for 39% of the study population (78 subjects). A statistically significant difference in the GDS (p < 0.01) was shown for marital status, body mass index (BMI), duration of diabetes, and the number of comorbidities. Patients with results indicative of symptoms of mild and severe depression were found to have higher BMI, longer disease duration, and a greater number of comorbidities. There were no statistically significant differences in the level of HbA1c. Conclusions: In order to verify the presence of depressive symptoms in the group of geriatric patients with diabetes mellitus, an appropriate screening programme must be introduced to identify those at risk and refer them to specialists, so that treatment can be promptly initiated. Screening tests conducted by nurses might help with patient identification.


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