Increasing expenditure on health care incurred by diabetic subjects in a developing country: a study from India.

Abstract:

OBJECTIVE:This study aimed to assess the direct cost incurred by diabetic subjects who were in different income groups in urban and rural India, as well as to examine the changing trends of costs in the urban setting from 1998 to 2005. RESEARCH DESIGN AND METHODS:A total of 556 diabetic subjects from various urban and rural regions of seven Indian states were enrolled. A brief uniform coded questionnaire (24 items) on direct cost was used. RESULTS:Annual family income was higher in urban subjects (rupees [Rs] 100,000 or $2,273) than in the rural subjects (Rs 36,000 or $818) (P < 0.001). Total median expenditure on health care was Rs 10,000 ($227) in urban and Rs 6,260 ($142) in rural (P < 0.001) subjects. Treatment costs increased with duration of diabetes, presence of complications, hospitalization, surgery, insulin therapy, and urban setting. Lower-income groups spent a higher proportion of their income on diabetes care (urban poor 34% and rural poor 27%). After accounting for inflation, a secular increase of 113% was observed in the total expenses between 1998 and 2005 in the urban population. The highest increase in percentage of household income devoted to diabetes care was in the lowest economic group (34% of income in 1998 vs. 24.5% in 2005) (P < 0.01). There was a significant improvement in urban subjects in medical reimbursement from 2% (1998) to 21.3% (2005). CONCLUSIONS:Urban and rural diabetic subjects spend a large percentage of income on diabetes management. The economic burden on urban families in developing countries is rising, and the total direct cost has doubled from 1998 to 2005.

journal_name

Diabetes Care

journal_title

Diabetes care

authors

Ramachandran A,Ramachandran S,Snehalatha C,Augustine C,Murugesan N,Viswanathan V,Kapur A,Williams R

doi

10.2337/dc06-0144

subject

Has Abstract

pub_date

2007-02-01 00:00:00

pages

252-6

issue

2

eissn

0149-5992

issn

1935-5548

pii

30/2/252

journal_volume

30

pub_type

杂志文章
  • Impaired mitochondrial function and insulin resistance of skeletal muscle in mitochondrial diabetes.

    abstract:OBJECTIVE:Impaired muscular mitochondrial function is related to common insulin resistance in type 2 diabetes. Mitochondrial diseases frequently lead to diabetes, which is mostly attributed to defective beta-cell mitochondria and secretion. RESEARCH DESIGN AND METHODS:We assessed muscular mitochondrial function and li...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-2078

    authors: Szendroedi J,Schmid AI,Meyerspeer M,Cervin C,Kacerovsky M,Smekal G,Gräser-Lang S,Groop L,Roden M

    更新日期:2009-04-01 00:00:00

  • Lipid, glycemic, and insulin responses to meals rich in saturated, cis-monounsaturated, and polyunsaturated (n-3 and n-6) fatty acids in subjects with type 2 diabetes.

    abstract:OBJECTIVE:The recommendations for dietary fats in patients with type 2 diabetes are based largely on the impact of fatty acids on fasting serum lipid and glucose concentrations. How fatty acids affect postprandial insulin, glucose, and triglyceride concentrations, however, remains unclear. The objective of this study w...

    journal_title:Diabetes care

    pub_type: 杂志文章,随机对照试验

    doi:10.2337/dc07-1026

    authors: Shah M,Adams-Huet B,Brinkley L,Grundy SM,Garg A

    更新日期:2007-12-01 00:00:00

  • The evaluation of a pocket computer as an aid to insulin dose determination by patients.

    abstract::A small and inexpensive computer was programmed to assist patients in making decisions regarding insulin delivery using constant subcutaneous infusion systems. Insulin dosage was based on gender, pre- and postprandial blood glucose, between-meal blood glucose, patient weight, time of day, and when appropriate, the car...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.8.2.172

    authors: Chanoch LH,Jovanovic L,Peterson CM

    更新日期:1985-03-01 00:00:00

  • Clinical correlates of plantar pressure among diabetic veterans.

    abstract:OBJECTIVE:To assess the relationship between diabetes characteristics, medical history, foot deformity, sensory neuropathy, and plantar foot pressure. RESEARCH DESIGN AND METHODS:There were 517 subjects from a cohort of diabetic veterans enrolled in a prospective study of risk factors for foot complications who contri...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.22.6.965

    authors: Ahroni JH,Boyko EJ,Forsberg RC

    更新日期:1999-06-01 00:00:00

  • Costs and consequences associated with newer medications for glycemic control in type 2 diabetes.

    abstract:OBJECTIVE:Newer medications offer more options for glycemic control in type 2 diabetes. However, they come at considerable costs. We undertook a health economic analysis to better understand the value of adding two newer medications (exenatide and sitagliptin) as second-line therapy to glycemic control strategies for p...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-1488

    authors: Sinha A,Rajan M,Hoerger T,Pogach L

    更新日期:2010-04-01 00:00:00

  • Are sulfonylurea and insulin therapies associated with a larger risk of cancer than metformin therapy? A retrospective database analysis.

    abstract:OBJECTIVE:Several meta-analyses of observational studies suggested that metformin use reduces cancer risk in type 2 diabetes. However, this result was not confirmed by the few available randomized controlled trials (RCTs), and many observational studies on metformin and cancer were potentially afflicted with time-relat...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc14-0977

    authors: Kowall B,Rathmann W,Kostev K

    更新日期:2015-01-01 00:00:00

  • Insulin, pancreatic polypeptide, and glucagon antibodies in insulin-dependent diabetes mellitus.

    abstract::To assess the possible value of the use of high-purity pork insulin (HPPI) in the United States, the serum insulin (I), pancreatic polypeptide (PP), glucagon (G), and somatostatin (SRIF) antibody binding characteristics have been determined in 90 conventional insulin-treated diabetic subjects and related to their degr...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.4.3.337

    authors: Asplin CM,Hollander P,Pecoraro RE,Brodsky J,Palmer JP

    更新日期:1981-05-01 00:00:00

  • Plasma growth differentiation factor-15 independently predicts all-cause and cardiovascular mortality as well as deterioration of kidney function in type 1 diabetic patients with nephropathy.

    abstract:OBJECTIVE:Growth deferentiation factor-15 (GDF-15) is involved in inflammation and apoptosis. Expression is induced in the heart in response to ischemia and in atherosclerotic plaques. The aim of this study was to investigate GDF-15 levels in relation to all-cause mortality, cardiovascular mortality and morbidity, decl...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-2174

    authors: Lajer M,Jorsal A,Tarnow L,Parving HH,Rossing P

    更新日期:2010-07-01 00:00:00

  • Association Between Inflammatory Markers and Progression to Kidney Dysfunction: Examining Different Assessment Windows in Patients With Type 1 Diabetes.

    abstract:OBJECTIVE:To determine whether biomarkers of inflammation and endothelial dysfunction are associated with the development of kidney dysfunction and the time frame of their association. RESEARCH DESIGN AND METHODS:Biomarkers were measured at four time points during 28 years of treatment and follow-up in patients with t...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc17-0867

    authors: Baker NL,Hunt KJ,Stevens DR,Jarai G,Rosen GD,Klein RL,Virella G,Lopes-Virella MF,DCCT\/EDIC Research Group.

    更新日期:2018-01-01 00:00:00

  • Evaluation of capillary collection system for HbA1c specimens.

    abstract:OBJECTIVE:We evaluated the accuracy and stability of a capillary HbA1c collection system for use with a high-performance liquid chromatography analyzer. RESEARCH DESIGN AND METHODS:The collection system requires that 5 ul blood is drawn into a calibrated capillary tube, which is then placed into a vial of stabilizing ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.15.5.700

    authors: Voss EM,Cembrowski GS,Clasen BL,Spencer ML,Ainslie MB,Haig B

    更新日期:1992-05-01 00:00:00

  • Long-term metabolic and immunological follow-up of nonimmunosuppressed patients with type 1 diabetes treated with microencapsulated islet allografts: four cases.

    abstract:OBJECTIVE:To assess long-term metabolic and immunological follow-up of microencapsulated human islet allografts in nonimmunosuppressed patients with type 1 diabetes (T1DM). RESEARCH DESIGN AND METHODS:Four nonimmunosuppressed patients, with long-standing T1DM, received intraperitoneal transplant (TX) of microencapsula...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc11-0731

    authors: Basta G,Montanucci P,Luca G,Boselli C,Noya G,Barbaro B,Qi M,Kinzer KP,Oberholzer J,Calafiore R

    更新日期:2011-11-01 00:00:00

  • Cellular ions in NIDDM: relation of calcium to hyperglycemia and cardiac mass.

    abstract:OBJECTIVE:To investigate the role of hyperglycemia in mediating the clinical association of NIDDM with hypertension and left ventricular dysfunction and hypertrophy. RESEARCH DESIGN AND METHODS:Since hyperglycemia elevates cytosolic free calcium (Cai) both in myocardial and vascular smooth muscle cells, we utilized nu...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.19.12.1393

    authors: Barbagallo M,Gupta RK,Resnick LM

    更新日期:1996-12-01 00:00:00

  • Management of the pregnant, insulin-dependent diabetic woman.

    abstract::An intensive care program was offered to all insulin-dependent, pregnant diabetic women who presented to The New York Hospital Obstetrical Clinic in their eighth week or less of gestation. The patients were hospitalized for 1 wk to normalize their blood glucose and to teach the technique of self-monitored glucose dete...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.3.1.63

    authors: Jovanovic L,Peterson CM

    更新日期:1980-01-01 00:00:00

  • Normal glucose values are associated with a lower risk of mortality in hospitalized patients.

    abstract:OBJECTIVE:Hyperglycemia is a common condition in hospitalized patients. The aim of this study was to investigate the relationships between glycemia upon admission and mortality in a heterogeneous group of adult patients. RESEARCH DESIGN AND METHODS:The 3-year records released from a general hospital were associated wi...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-0672

    authors: Bruno A,Gregori D,Caropreso A,Lazzarato F,Petrinco M,Pagano E

    更新日期:2008-11-01 00:00:00

  • Insulin gene mutations as cause of diabetes in children negative for five type 1 diabetes autoantibodies.

    abstract:OBJECTIVE:Heterozygous, gain-of-function mutations of the insulin gene can cause permanent diabetes with onset ranging from the neonatal period through adulthood. The aim of our study was to screen for the insulin gene in patients who had been clinically classified as type 1 diabetic but who tested negative for type 1 ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc08-0783

    authors: Bonfanti R,Colombo C,Nocerino V,Massa O,Lampasona V,Iafusco D,Viscardi M,Chiumello G,Meschi F,Barbetti F

    更新日期:2009-01-01 00:00:00

  • Controlled trial of a multifaceted intervention for improving quality of care for rural patients with type 2 diabetes.

    abstract:OBJECTIVE:Despite good evidence and clinical practice guidelines, studies document that treatment of type 2 diabetes is less than optimal. Lack of resources or limited access may put patients in rural communities at particular risk for suboptimal care. RESEARCH DESIGN AND METHODS:We conducted a prospective, before/aft...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.26.11.3061

    authors: Majumdar SR,Guirguis LM,Toth EL,Lewanczuk RZ,Lee TK,Johnson JA

    更新日期:2003-11-01 00:00:00

  • Urinary estriols: are they of value in normoglycemic diabetic pregnancy?

    abstract::The purpose of the study was to assess the value of 24-h urinary estriols in the management of diabetic pregnancies. Twenty-seven pregnant diabetic patients (White's class B through R) received insulin dosages twice daily as a combination of NPH and regular insulin. Laboratory and home monitored blood glucose was main...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.5.3.316

    authors: Fern PE,Grunert GM,Lewis SB

    更新日期:1982-05-01 00:00:00

  • Gestational diabetes mellitus: NICE for the U.S.? A comparison of the American Diabetes Association and the American College of Obstetricians and Gynecologists guidelines with the U.K. National Institute for Health and Clinical Excellence guidelines.

    abstract:OBJECTIVE:To compare recent U.S. and U.K. guidelines on gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS:The guidelines from the American Diabetes Association, the American College of Obstetricians and Gynecologists, and the National Institute for Health and Clinical Excellence (NICE) in the U.K. were ...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc09-1376

    authors: Simmons D,McElduff A,McIntyre HD,Elrishi M

    更新日期:2010-01-01 00:00:00

  • Transient neonatal diabetes, ZFP57, and hypomethylation of multiple imprinted loci: a detailed follow-up.

    abstract:OBJECTIVE:Transient neonatal diabetes mellitus 1 (TNDM1) is the most common cause of diabetes presenting at birth. Approximately 5% of the cases are due to recessive ZFP57 mutations, causing hypomethylation at the TNDM locus and other imprinted loci (HIL). This has consequences for patient care because it has impact on...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-0700

    authors: Boonen SE,Mackay DJ,Hahnemann JM,Docherty L,Grønskov K,Lehmann A,Larsen LG,Haemers AP,Kockaerts Y,Dooms L,Vu DC,Ngoc CT,Nguyen PB,Kordonouri O,Sundberg F,Dayanikli P,Puthi V,Acerini C,Massoud AF,Tümer Z,Temple IK

    更新日期:2013-03-01 00:00:00

  • Challenges to healthy eating for people with diabetes in a low-income, minority neighborhood.

    abstract:OBJECTIVE:This study used qualitative interviews with black and Latino participants with diabetes to further understanding about types of foods eaten, food preparation, sources of foods and meals, communication with providers, and effects of race and ethnicity on eating in this population. RESEARCH DESIGN AND METHODS:...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-1632

    authors: Breland JY,McAndrew LM,Gross RL,Leventhal H,Horowitz CR

    更新日期:2013-10-01 00:00:00

  • Systematic review of herbs and dietary supplements for glycemic control in diabetes.

    abstract:OBJECTIVE:To conduct a systematic review of the published literature on the efficacy and safety of herbal therapies and vitamin/mineral supplements for glucose control in patients with diabetes. RESEARCH DESIGN AND METHODS:We conducted an electronic literature search of MEDLINE, OLDMEDLINE, Cochrane Library Database, ...

    journal_title:Diabetes care

    pub_type: 杂志文章,评审

    doi:10.2337/diacare.26.4.1277

    authors: Yeh GY,Eisenberg DM,Kaptchuk TJ,Phillips RS

    更新日期:2003-04-01 00:00:00

  • Beneficial effect of low-glycemic index diet in overweight NIDDM subjects.

    abstract:OBJECTIVE:To determine whether low-glycemic index (GI) diets have clinical utility in overweight patients with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS:Six patients with NIDDM were studied on both high- and low-GI diets of 6-wk duration with metabolic diets with a randomized crossov...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.2337/diacare.15.4.562

    authors: Wolever TM,Jenkins DJ,Vuksan V,Jenkins AL,Wong GS,Josse RG

    更新日期:1992-04-01 00:00:00

  • The midregional fragment of pro-A-type natriuretic peptide, blood pressure, and mortality in a prospective cohort study of patients with type 2 diabetes (ZODIAC-25).

    abstract:OBJECTIVE:Evidence that midregional fragment of pro-A-type natriuretic peptide (MR-proANP) is a marker of mortality in patients with type 2 diabetes is limited. Therefore, we aimed to investigate the capabilities of MR-proANP in predicting mortality. We also investigated whether MR-proANP influences the relationship be...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc12-0428

    authors: van Hateren KJ,Landman GW,Kleefstra N,Groenier KH,Struck J,Navis GJ,Bakker SJ,Houweling ST,van der Meer K,Bilo HJ

    更新日期:2013-05-01 00:00:00

  • Treatment of osteomyelitis in the diabetic foot. Contribution of conservative surgery.

    abstract:OBJECTIVE:To compare the duration of healing of foot ulcers with osteomyelitis in diabetic patients treated by medical treatment versus medical treatment associated with conservative orthopedic surgery. RESEARCH DESIGN AND METHODS:We entered into the study 67 diabetic patients who had a foot ulcer with osteomyelitis w...

    journal_title:Diabetes care

    pub_type: 临床试验,杂志文章

    doi:10.2337/diacare.19.11.1257

    authors: Ha Van G,Siney H,Danan JP,Sachon C,Grimaldi A

    更新日期:1996-11-01 00:00:00

  • Markers of Collagen Formation and Degradation Reflect Renal Function and Predict Adverse Outcomes in Patients With Type 1 Diabetes.

    abstract:OBJECTIVE:Patients with type 1 diabetes (T1D) have a higher risk of developing chronic kidney disease, cardiovascular events (CVEs), and mortality than the general population. We hypothesized that two previously published biomarkers, namely PRO-C6, a biomarker of collagen type VI formation, and C3M, a biomarker of coll...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc18-2599

    authors: Pilemann-Lyberg S,Rasmussen DGK,Hansen TW,Tofte N,Winther SA,Holm Nielsen S,Theilade S,Karsdal MA,Genovese F,Rossing P

    更新日期:2019-09-01 00:00:00

  • Effect of High-Deductible Insurance on High-Acuity Outcomes in Diabetes: A Natural Experiment for Translation in Diabetes (NEXT-D) Study.

    abstract:OBJECTIVE:High-deductible health plans (HDHPs) are now the predominant commercial health insurance benefit in the U.S. We sought to determine the effects of HDHPs on emergency department and hospital care, adverse outcomes, and total health care expenditures among patients with diabetes. RESEARCH DESIGN AND METHODS:We...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc17-1183

    authors: Wharam JF,Zhang F,Eggleston EM,Lu CY,Soumerai SB,Ross-Degnan D

    更新日期:2018-05-01 00:00:00

  • Pancreas transplantation improves vascular disease in patients with type 1 diabetes.

    abstract:OBJECTIVE:Pancreas transplantation (PTX) normalizes glucose and improves microvascular complications, but its impact on macrovascular disease is still debated. RESEARCH DESIGN AND METHODS:Carotid intima-media thickness (IMT), shown to correlate with cardiovascular disease (CVD) risk and events, was determined prospect...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.27.7.1706

    authors: Larsen JL,Colling CW,Ratanasuwan T,Burkman TW,Lynch TG,Erickson JM,Lyden ER,Lane JT,Mack-Shipman LR

    更新日期:2004-07-01 00:00:00

  • Role of hemochromatosis C282Y and H63D mutations in HFE gene in development of type 2 diabetes and diabetic nephropathy.

    abstract:OBJECTIVE:In patients with clinical hemochromatosis, the frequency of diabetes ranges from 20 to 50%, and the heterozygosity for the C282Y mutation in the HFE gene might be associated with an increased risk for diabetes. There are also some reports that suggest that iron overload might cause diabetic nephropathy. RESE...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/diacare.24.7.1187

    authors: Moczulski DK,Grzeszczak W,Gawlik B

    更新日期:2001-07-01 00:00:00

  • High calorie intake is associated with worsening insulin resistance and β-cell function in Hispanic women after gestational diabetes mellitus.

    abstract:OBJECTIVE:To assess associations between dietary intake and rates of change in insulin resistance and β-cell function in Hispanic women with prior gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS:Sixty-two nondiabetic Hispanic women with pregnancies complicated by GDM completed oral and intravenous glu...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc14-1433

    authors: Chen Z,Watanabe RM,Stram DO,Buchanan TA,Xiang AH

    更新日期:2014-12-01 00:00:00

  • The development and utility of a novel scale that quantifies the glycemic progression toward type 1 diabetes over 6 months.

    abstract:OBJECTIVE:We developed a scale to serve as a potential end point for 6-month glycemic progression (PS6M) toward type 1 diabetes (T1D) in autoantibody-positive relatives of individuals with T1D. RESEARCH DESIGN AND METHODS:The PS6M was developed from Diabetes Prevention Trial-Type 1 (DPT-1) data and tested in the Trial...

    journal_title:Diabetes care

    pub_type: 杂志文章

    doi:10.2337/dc14-2787

    authors: Sosenko JM,Skyler JS,Beam CA,Boulware D,Mahon JL,Krischer JP,Greenbaum CJ,Rafkin LE,Matheson D,Herold KC,Palmer JP,Type 1 Diabetes TrialNet and Diabetes Prevention Trial–Type 1 Study Groups.

    更新日期:2015-05-01 00:00:00