ABSTRACT: The aim of study was to evaluate the possibilities of different diagnostic criteria for metabolic syndrome in identifying subjects with insulin resistance and to assess the prevalence of metabolic syndrome according to gender in one Lithuanian district.
A randomly selected sample of 1,115 subjects aged 45-96 years (562 men and 553 women) was formed from general population of Raseiniai district. Insulin resistance was estimated using the homeostasis model assessment. Metabolic syndrome was determined according to the definitions of the World Health Organization, National Cholesterol Education Program Adults Treatment Panel III, and International Diabetes Federation.
Using the World Health Organization criteria, metabolic syndrome was observed in 384 (34.4%) subjects (no difference between genders); according to the National Cholesterol Education Program--in 336 (30.1%) patients (in 107 men (19.0%) and 229 women (41.4%), p < 0.001); using International Diabetes Federation criteria--in 474 (42.5%) (175 men (31.1%) and 299 women (54.1%), p < 0.001). Overall, 314 (28.5%) subjects were insulin resistant (no difference between genders). The highest prevalence of insulin resistance was determined in subjects with metabolic syndrome diagnosed according to the World Health Organization criteria--70.3% (n = 267), p < 0.05. Odds ratios to identify insulin-resistant subjects with metabolic syndrome according to the World Health Organization criteria and the International Diabetes Federation criteria were 22.4 and 2.3, respectively.
The highest prevalence of metabolic syndrome was determined according to the International Diabetes Federation criteria. According to the National Cholesterol Education Program and International Diabetes Federation criteria metabolic syndrome was observed more frequently in women. The highest prevalence of insulin resistance was determined in metabolic syndrome group based on World Health Organization criteria. Using the World Health Organization and International Diabetes Federation criteria for metabolic syndrome provides more opportunities to identify subjects with insulin resistance.
Medicina (Kaunas, Lithuania) 02/2006; 42(6):455-63. · 0.42 Impact Factor
ABSTRACT: Type 2 diabetes mellitus is a severe, high-priced, and to date not curable, however, controllable disease. When diabetes mellitus is not treated or is poorly controlled, complications of small and large blood vessels arise, and the mortality increases. The costs of treatment of diabetes-related complications are very high. Estimates performed in other countries show that expenses on treatment of diabetes-related complications are considerably higher than the expenses paid for diabetes control itself. Type 2 diabetes mellitus is often diagnosed too late, when complications requiring expensive treatment are already present.
The aim of the study was to estimate the impact of well-timed diagnostics and early treatment of type 2 diabetes mellitus on total health care costs.
Direct and indirect costs of treatment of the disease and its complications were estimated using Markov model with a discount of 5% per annum.
It was calculated that with well-timed diagnostics and early initiation of treatment of type 2 diabetes mellitus the total costs to budget of the Compulsory Health Insurance Fund per one patient would be reduced by 1,736 Lt over 5 years and over 10 years our state would save 5,911 Lt. Not only direct but indirect costs would be reduced as well. The costs of 2,418 Lt would be saved per one patient over 5 years, and 7,061 Lt - over 10 years. With improvement of diagnostics of type 2 diabetes mellitus and with well-timed diagnostics in at least 50% of cases of diabetes mellitus in Lithuania, the health budget could save 34.7 million Lt over 5 years, and even 118.2 million Lt over 10 years. Diagnosis of type 2 diabetes mellitus made in time and administration of reimbursed drugs would prolong the life of a patient with type 2 diabetes mellitus by 2.67 months over 10 years.
Diagnosis of type 2 diabetes mellitus in time provides a possibility to reduce expenses of diabetes treatment and care and to prolong a patient's life.
Medicina (Kaunas, Lithuania) 02/2005; 41(10):877-84. · 0.42 Impact Factor
ABSTRACT: Diabetes is becoming one of the major public health problems because a great proportion of the healthcare expenditure has been spent on the treatment of its associated morbidity and mortality. Diabetes is also a major cause of premature mortality, stroke, cardiovascular disease, peripheral vascular disease, congenital malformations as well as long- and short-term disability. In addition, persons with diabetic complications have a lower quality of life compared with persons without diabetes. The goal of this paper is to review the studies on the costs of diabetes, to identify the strengths and limitations of currently available diabetes cost studies, and to identify future research areas that will help us to better understand the economic burden of diabetes. The economic burden of diabetes mellitus is enormous in the world. Cost or illness estimates are often cited as an important element in the choices made regarding diabetes care and management. Studying these economic aspects presents several challenges, such as collecting the appropriate epidemiological and cost data, determining the diabetes attributable factors for premature morbidity and mortality, and determining methods to account for premature morality, disability, and reduced quality of life. The cost to care for diabetes puts a tremendous burden on both the patient and the payer. The direct cost of diabetes increased from 1.7 billion US dollars in 1969 to 44.4 billion US dollars in 1997. Several studies over the years have found that indirect costs related to diabetes are higher than direct. Indirect costs during 28 years increased 33 times, from 1.6 billion US dollars in 1969 to 54.1 billion US dollars in 1997. The expenses of one diabetic patient highly vary in different countries: from 13 US dollars in Bangladesh to 11,157 US dollars in USA per one year. Most of diabetes expenditure is used to pay for inpatient services (60-85%); the biggest part of it is incurred because of late diabetes complications (70%). Diabetes accounted to 3-12% of total healthcare expenditure in different countries. In this era of limited resources and escalating costs, it is critical to have an understanding of the economics of diabetes in order to develop and implement sound public health and prevention policies.
Medicina (Kaunas, Lithuania) 02/2004; 40(1):16-26. · 0.42 Impact Factor