Higher medical care costs accompany impaired fasting glucose
Higher medical care costs accompany impaired fasting glucose
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DOI：
10.2337/diacare.28.9.2223
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发表时间：
2005-09-01
期刊：
影响因子：
16.2
通讯作者：
Brown, JB
中科院分区：
文献类型：
--
作者：
Nichols, GA;Brown, JB
目的-本研究的目的是估计与空腹血糖（FPG）升高相关的医疗费用，并确定符合2003年（？）100 mg/dl）对1.997（？研究设计和方法-我们确定了28，335名患者，在1994年1月1日至2003年12月31日期间，两次或多次FPG测试结果至少为100 mg/dl。那些在第二次测试之前有糖尿病证据的人被排除在外。我们将患者分为两个阶段的血糖异常（100-109 mg/dl和110-125 mg/dl），并将这些受试者中的每一个与年龄，性别和FPG测试年份正常的FPG测试（< 100 mg/dl）患者进行匹配。所有受试者随访至FPG检测合格进入更高阶段、分发降糖药物、终止健康计划或2003年12月31日。结果-FPG正常患者的调整后年成本为4，357美元，1期患者为4，580美元，2期患者为4，960美元（所有比较均P < 0.001）。在排除FPG测试正常的患者后，其病情进展到更高阶段或糖尿病，正常FPG阶段的成本为3，799美元。在这两个阶段1和2的患者有更多的心血管合并症比患者与正常FPG.CONCLUSIONS-我们的研究结果表明，异常的葡萄糖代谢与较高的医疗费用。大部分超额费用是由于并发心血管疾病。2003年ADA临界点确定了一组患者的费用和合并症高于血糖正常的患者，但费用和合并症低于FPG高于1997年临界点的患者。
OBJECTIVE- The purpose of this study was to estimate medical costs associated with elevated fasting plasma glucose (FPG) and to determine whether costs differed for patients who met the 2003 (? 100 mg/dl) versus the 1.997 (? 110 mg/dl) American Diabetes Association (ADA) cut point for impaired fasting glucose.RESEARCH DESIGN AND METHODS- We identified 28,335 patients with two or more FPG test results of at least 100 mg/dl between 1 January 1994 and 31 December 2003. Those with evidence of diabetes before the second test were excluded. We categorized patients into two stages of abnormal glucose (100-109 mg/dl and 110-125 mg/dl) and matched each of these subjects to a patient with a normal FPG test (< 100 mg/dl) on age, sex, and year of FPG test. All subjects were followed until an FPG test qualified them for a higher stage, dispensing of an antihyperglycemic drug, health plan termination, or 31 December 2003.RESULTS- Adjusted annual costs were $4,357 among patients with normal FPG, $4,580 among stage 1 patients, and $4,960 among stage 2 patients (P < 0.001, all comparisons). After removing patients with normal FPG tests whose condition progressed to a higher stage or diabetes, costs in the normal FPG stage were $3,799. Patients in both stages 1 and 2 had more cardiovascular comorbidities than patients with normal FPG.CONCLUSIONS- Our results demonstrate that abnormal glucose metabolism is associated with higher medical care costs. Much of the excess cost was attributable to concurrent cardiovascular disease. The 2003 ADA cut point identifies a group of patients with greater costs and comorbidity than normoglycemic patients but with lower costs and less comorbidity than patients with FPG above the 1997 cut point.