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Published in: Diabetes Therapy 1/2016

Open Access 01-03-2016 | Original Research

The Economic Burden of Post-prandial Hyperglycemia (PPH) Among People with Type 1 and Type 2 Diabetes in Three Countries

Authors: Meryl Brod, Annie Nikolajsen, James Weatherall, Kathryn M. Pfeiffer

Published in: Diabetes Therapy | Issue 1/2016

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Abstract

Introduction

Post-prandial hyperglycemia (PPH) among people with diabetes is a well-known clinical challenge to diabetes management. While the economic burden of diabetes is well studied, little is known about economic costs specific to PPH. The purpose of this study was to investigate costs of PPH related to work, diabetes management, and use of healthcare resources among people with diabetes taking bolus insulin.

Methods

Data were collected in a web survey of 906 adults with type 1 (39%) and type 2 (61%) diabetes taking bolus insulin in Germany (34%), the UK (26%), and the USA (40%).

Results

Sixty-two percent of respondents experienced PPH in the past week, and respondents averaged 1.7 episodes per week. Working respondents indicated that PPH affected their work productivity: 27% missed work time and 71% experienced work productivity issues while at work due to a recent episode of PPH. In terms of diabetes management, respondents with PPH in the past week measured their blood glucose (BG) more frequently than those without PPH (3.7 vs. 2.5 times/day, P < 0.001). PPH was also significantly associated with greater use of healthcare resources. Compared to those without PPH, respondents with PPH reported greater contact with healthcare professionals related to diabetes in the past year (5.5 vs. 4.4 visits, P < 0.001; 2.7 vs. 1.4 calls/emails, P < 0.001) and were more likely to report medical complications related to diabetes (72% vs. 55%, P < 0.001). Average annual costs associated with PPH due to missed work time, additional BG test strips, and physician visits were estimated to be $1239 USD per employed person in the USA.

Conclusion

Results indicate that PPH is associated with greater economic costs and that reducing the incidence of PPH would help mitigate such costs. Additional research is needed to better understand costs associated with PPH that may be more difficult to measure, as well as more long-term impacts and costs.

Funding

Novo Nordisk.
Appendix
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Literature
1.
go back to reference American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37(Suppl 1):S14–80.CrossRef American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37(Suppl 1):S14–80.CrossRef
3.
go back to reference Nathan DM, DCCT/EDIC Research Group. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview. Diabetes Care. 2014;37(1):9–16.CrossRefPubMedPubMedCentral Nathan DM, DCCT/EDIC Research Group. The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview. Diabetes Care. 2014;37(1):9–16.CrossRefPubMedPubMedCentral
4.
go back to reference Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405–12.CrossRefPubMedPubMedCentral Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405–12.CrossRefPubMedPubMedCentral
5.
go back to reference Ceriello A. The glucose triad and its role in comprehensive glycaemic control: current status, future management. Int J Clin Pract. 2010;64(12):1705–11.CrossRefPubMedPubMedCentral Ceriello A. The glucose triad and its role in comprehensive glycaemic control: current status, future management. Int J Clin Pract. 2010;64(12):1705–11.CrossRefPubMedPubMedCentral
6.
go back to reference Peter R, Rees A. Postprandial glycaemia and cardiovascular risk. Br J Diab Vasc Dis. 2008;8(1):8–14.CrossRef Peter R, Rees A. Postprandial glycaemia and cardiovascular risk. Br J Diab Vasc Dis. 2008;8(1):8–14.CrossRef
7.
go back to reference Lawton J, Rankin D, Cooke D, Elliott J, Amiel S, Heller S, et al. Patients’ experiences of adjusting insulin doses when implementing flexible intensive insulin therapy: a longitudinal, qualitative investigation. Diabetes Res Clin Pract. 2012;98(2):236–42.CrossRefPubMed Lawton J, Rankin D, Cooke D, Elliott J, Amiel S, Heller S, et al. Patients’ experiences of adjusting insulin doses when implementing flexible intensive insulin therapy: a longitudinal, qualitative investigation. Diabetes Res Clin Pract. 2012;98(2):236–42.CrossRefPubMed
8.
go back to reference Aryangat AV, Gerich JE. Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk. Vasc Health Risk Manag. 2010;6:145–55.PubMedPubMedCentral Aryangat AV, Gerich JE. Type 2 diabetes: postprandial hyperglycemia and increased cardiovascular risk. Vasc Health Risk Manag. 2010;6:145–55.PubMedPubMedCentral
9.
go back to reference Cavalot F, Pagliarino A, Valle M, Di Martino L, Bonomo K, Massucco P, et al. Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care. 2011;34(10):2237–43.CrossRefPubMedPubMedCentral Cavalot F, Pagliarino A, Valle M, Di Martino L, Bonomo K, Massucco P, et al. Postprandial blood glucose predicts cardiovascular events and all-cause mortality in type 2 diabetes in a 14-year follow-up: lessons from the San Luigi Gonzaga Diabetes Study. Diabetes Care. 2011;34(10):2237–43.CrossRefPubMedPubMedCentral
10.
go back to reference Cavalot F, Petrelli A, Traversa M, Bonomo K, Fiora E, Conti M, et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab. 2006;91(3):813–9.CrossRefPubMed Cavalot F, Petrelli A, Traversa M, Bonomo K, Fiora E, Conti M, et al. Postprandial blood glucose is a stronger predictor of cardiovascular events than fasting blood glucose in type 2 diabetes mellitus, particularly in women: lessons from the San Luigi Gonzaga Diabetes Study. J Clin Endocrinol Metab. 2006;91(3):813–9.CrossRefPubMed
11.
go back to reference Ceriello A. Cardiovascular effects of acute hyperglycaemia: pathophysiological underpinnings. Diab Vasc Dis Res. 2008;5(4):260–8.CrossRefPubMed Ceriello A. Cardiovascular effects of acute hyperglycaemia: pathophysiological underpinnings. Diab Vasc Dis Res. 2008;5(4):260–8.CrossRefPubMed
12.
13.
go back to reference Rizzo MR, Marfella R, Barbieri M, Boccardi V, Vestini F, Lettieri B, et al. Relationships between daily acute glucose fluctuations and cognitive performance among aged type 2 diabetic patients. Diabetes Care. 2010;33(10):2169–74.CrossRefPubMedPubMedCentral Rizzo MR, Marfella R, Barbieri M, Boccardi V, Vestini F, Lettieri B, et al. Relationships between daily acute glucose fluctuations and cognitive performance among aged type 2 diabetic patients. Diabetes Care. 2010;33(10):2169–74.CrossRefPubMedPubMedCentral
14.
go back to reference Barr EL, Zimmet PZ, Welborn TA, Jolley D, Magliano DJ, Dunstan DW, et al. Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance, The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation. 2007;116(2):151–7.CrossRefPubMed Barr EL, Zimmet PZ, Welborn TA, Jolley D, Magliano DJ, Dunstan DW, et al. Risk of cardiovascular and all-cause mortality in individuals with diabetes mellitus, impaired fasting glucose, and impaired glucose tolerance, The Australian Diabetes, Obesity, and Lifestyle Study (AusDiab). Circulation. 2007;116(2):151–7.CrossRefPubMed
15.
go back to reference Gapstur SM, Gann PH, Lowe W, Liu K, Colangelo L, Dyer A. Abnormal glucose metabolism and pancreatic cancer mortality. JAMA. 2000;283(19):2552–8.CrossRefPubMed Gapstur SM, Gann PH, Lowe W, Liu K, Colangelo L, Dyer A. Abnormal glucose metabolism and pancreatic cancer mortality. JAMA. 2000;283(19):2552–8.CrossRefPubMed
16.
go back to reference Lowe LP, Liu K, Greenland P, Metzger BE, Dyer AR, Stamler J. Diabetes, asymptomatic hyperglycemia, and 22-year mortality in black and white men. The Chicago Heart Association Detection Project in Industry Study. Diabetes Care. 1997;20(2):163–9.CrossRefPubMed Lowe LP, Liu K, Greenland P, Metzger BE, Dyer AR, Stamler J. Diabetes, asymptomatic hyperglycemia, and 22-year mortality in black and white men. The Chicago Heart Association Detection Project in Industry Study. Diabetes Care. 1997;20(2):163–9.CrossRefPubMed
17.
go back to reference Nakagami T, DECODA Study Group. Hyperglycaemia and mortality from all causes and from cardiovascular disease in five populations of Asian origin. Diabetologia. 2004;47(3):385–94.CrossRefPubMed Nakagami T, DECODA Study Group. Hyperglycaemia and mortality from all causes and from cardiovascular disease in five populations of Asian origin. Diabetologia. 2004;47(3):385–94.CrossRefPubMed
18.
go back to reference Saydah SH, Miret M, Sung J, Varas C, Gause D, Brancati FL. Postchallenge hyperglycemia and mortality in a national sample of US adults. Diabetes Care. 2001;24(8):1397–402.CrossRefPubMed Saydah SH, Miret M, Sung J, Varas C, Gause D, Brancati FL. Postchallenge hyperglycemia and mortality in a national sample of US adults. Diabetes Care. 2001;24(8):1397–402.CrossRefPubMed
19.
21.
go back to reference Charmaz K. Premises, principles, and practices in qualitative research: revisiting the foundations. Qual Health Res. 2004;14(7):976–93.CrossRefPubMed Charmaz K. Premises, principles, and practices in qualitative research: revisiting the foundations. Qual Health Res. 2004;14(7):976–93.CrossRefPubMed
22.
go back to reference Endicott J, Nee J. Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects. Psychopharmacol Bull. 1997;33(1):13–6.PubMed Endicott J, Nee J. Endicott Work Productivity Scale (EWPS): a new measure to assess treatment effects. Psychopharmacol Bull. 1997;33(1):13–6.PubMed
26.
go back to reference Yeaw J, Lee WC, Aagren M, Christensen T. Cost of self-monitoring of blood glucose in the United States among patients on an insulin regimen for diabetes. J Manag Care Pharm. 2012;18(1):21–32.PubMed Yeaw J, Lee WC, Aagren M, Christensen T. Cost of self-monitoring of blood glucose in the United States among patients on an insulin regimen for diabetes. J Manag Care Pharm. 2012;18(1):21–32.PubMed
29.
go back to reference Bohrnstedt GW, Knoke D. Statistics for social data analysis. 3rd ed. Itasca, Illinois: FE Peacock Publishers; 1994. Bohrnstedt GW, Knoke D. Statistics for social data analysis. 3rd ed. Itasca, Illinois: FE Peacock Publishers; 1994.
30.
go back to reference Koopman C, Pelletier KR, Murray JF, Sharda CE, Berger ML, Turpin RS, et al. Stanford presenteeism scale: health status and employee productivity. J Occup Environ Med. 2002;44(1):14–20.CrossRefPubMed Koopman C, Pelletier KR, Murray JF, Sharda CE, Berger ML, Turpin RS, et al. Stanford presenteeism scale: health status and employee productivity. J Occup Environ Med. 2002;44(1):14–20.CrossRefPubMed
Metadata
Title
The Economic Burden of Post-prandial Hyperglycemia (PPH) Among People with Type 1 and Type 2 Diabetes in Three Countries
Authors
Meryl Brod
Annie Nikolajsen
James Weatherall
Kathryn M. Pfeiffer
Publication date
01-03-2016
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 1/2016
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-016-0154-2

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