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Epidemiology/health services research
Resource use associated with type 2 diabetes in Africa, the Middle East, South Asia, Eurasia and Turkey: results from the International Diabetes Management Practice Study (IDMPS)
  1. Juan J Gagliardino1,
  2. Petar K Atanasov2,
  3. Juliana C N Chan3,
  4. Jean C Mbanya4,
  5. Marina V Shestakova5,6,
  6. Prisca Leguet-Dinville7,
  7. Lieven Annemans8
  1. 1CENEXA. Centro de Endocrinología Experimental y Aplicada (UNLP-CONICET), La Plata, Argentina
  2. 2Amaris, London, UK
  3. 3Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
  4. 4Faculty of Medicine and Biomedical Sciences, University of Yaounde, Yaounde, Cameroon
  5. 5Endocrinology Research Centre, Moscow, Russia
  6. 6I.M. Sechenov First Moscow State Medical University, Moscow, Russia
  7. 7Sanofi, Antony, France
  8. 8Department of Public Health, Ghent University, Ghent, Belgium
  1. Correspondence to Dr Juan J Gagliardino; cenexaar{at}yahoo.com.ar

Abstract

Objective Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey.

Research design and methods In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011–2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3–6 months. Negative binomial regression was used to identify parameters associated with HRU, using incidence rate ratios (IRRs) to express associations.

Results Patients in Africa (n=2220), the Middle East (n=2065), Eurasia (n=1843), South Asia (n=1195) and Turkey (n=842) experienced an annual hospitalization rate (mean±SD) of 0.6±1.9, 0.3±1.2, 1.7±4.1, 0.4±1.5 and 1.3±2.7, respectively. The annual number of diabetes-related inpatient days (mean±SD) was 4.7±22.7, 1.1±6.1, 16.0±30.0, 1.5±6.8 and 10.8±34.3, respectively. Despite some inter-regional heterogeneity, macrovascular complications (IRRs varying between 1.4 and 8.9), microvascular complications (IRRs varying between 3.4 and 4.3) and, to a large extent, inadequate glycemic control (IRRs varying between 1.89 and 10.1), were independent parameters associated with hospitalization in these respective regions.

Conclusions In non-Western countries, macrovascular/microvascular complications and inadequate glycemic control were common and important parameters associated with increased HRU.

  • Adult Diabetes
  • Economic Analysis
  • Resource Use

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2016-000297

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    Footnotes

    • Contributors JCNC, JJG, JCM, and MVS were research data collecting coordinators. PKA wrote the first manuscript draft. All authors reviewed and edited the manuscript. LA designed the analysis and reporting of the data. All authors are responsible for the content of this article.

    • Funding This study was funded by Sanofi.

    • Competing interests PKA reports other fees from Sanofi during the conduct of the study. JCNC reports grants and personal fees from Sanofi during the conduct of the study. JCM reports personal fees from Sanofi during the conduct of the study. MVS reports personal fees from Sanofi, Novo Nordisk, Novartis, Astra Zeneca, and Eli Lilly outside the submitted work. PL-D reports other fees from Sanofi during the conduct of the study. LA reports personal fees from Sanofi during the conduct of the study.

    • Ethics approval The IDMPS study was conducted across 18 countries and ethics approval was obtained within each one of them.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.