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Medical expenditures substantial for diabetic ketoacidosis, severe hypoglycemia in youth
Shrestha SS. Diabetes Care. 2010;33:2617-2622.
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Predicted mean annual total medical expenditures for potentially preventable diabetic ketoacidosis exceed $14,000 for US youth with insulin-treated diabetes compared with $8,000 for youth without diabetic ketoacidosis, researchers reported.
In addition, total expenditures were significantly greater with two or more episodes of diabetic ketoacidosis, at $8,455, compared with just one episode, at $3,554.
The predicted costs of severe hypoglycemia in young patients with insulin-treated diabetes were substantial, although lower than for diabetic ketoacidosis. Mean annual total medical expenditures were $12,850 for youth with severe hypoglycemia vs. $8,970 without severe hypoglycemia. Again, the excess cost was higher among youth who reported two or more severe hypoglycemic episodes ($5,929) compared with those who reported one ($2,888).
“The estimated cost burden associated with diabetes acute complications among youth in the United States was substantial but not surprising. This is because when such complications occur, especially diabetic ketoacidosis, in most cases, patients have to be treated in inpatient settings, which is much costlier,” Sundar S. Shrestha, PhD, told Endocrine Today.
The results are from an analysis of insurance claims of 7,556 patients with insulin-treated diabetes aged 19 years and younger. All were continuously enrolled in fee-for-service health plans; claims were obtained from the 2007 US MarketScan Commercial Claims and Encounter database.
Of the 7,556 youth, 14.9% experienced at least one episode of diabetic ketoacidosis; more than 50% of this group experienced just one episode and 47% experienced two or more. Severe hypoglycemia was reported in 7.9% of the cohort; of those patients, 67% had one episode and 33% had two or more.
According to other results, the adverse episodes were more common in girls; youth with diabetic ketoacidosis were more likely to reside in the South; youth with severe hypoglycemia were less likely to reside in the West; and asthma was significantly more prevalent among youth who experienced diabetic ketoacidosis or severe hypoglycemia.
“Our study suggests that timely, improved quality of care to prevent diabetes acute complications among youth could prevent a substantial cost burden to health care systems,” Shrestha said.
The researchers said, however, that their estimates capture only the medical expenditures among youth who were privately insured and under fee-for-service plans.
Disclosure: Dr. Shrestha has no direct financial interest in any of the products mentioned in this article nor is he/she a paid consultant for any companies mentioned.
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