Exp Clin Endocrinol Diabetes 2010; 118(4): 220-225
DOI: 10.1055/s-0029-1246216
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Direct Costs for Care and Glycaemic Control in Patients with Type 2 Diabetes in Sudan

H. Elrayah-Eliadarous1 , K. Yassin2 , M. Eltom3 , S. Abdelrahman4 , R. Wahlström1 , C.-G. Östenson2
  • 1Division of International Health (IHCAR), Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  • 2Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  • 3Mulazmin Diabetes Centre, Omdurman, Sudan
  • 4Diabetes Program, Ministry of Health Khartoum State, Khartoum, Sudan
Further Information

Publication History

received 20.05.2009 first decision 02.10.2009

accepted 07.01.2010

Publication Date:
05 February 2010 (online)

Abstract

The aim of this study was to estimate the contribution by type 2 diabetic patients in a low-income country from their own income in attempting to control the disease and to prevent chronic diabetes complications through good glycaemic control. Socio-economic and demographic data for study subjects were obtained from 822 adult diabetic patients attending public or private diabetic clinics in Khartoum State, Sudan. The average annual income of diabetic patients was estimated as USD 1.923. The direct cost of diabetes control was USD 175 per year. This included cost of drugs and ambulatory care, although drug supply was insufficient for 52% of the patients. Glycosylated hemoglobin as a measure of glycaemic control was determined to be unsatisfactory in 77% of patients. This gives an immediate indication that current practices in diabetes control in urban Sudan are not cost-effective. Patients attending private clinics had a higher income and cost of diabetes control than those attending public clinics. However, both groups had similar proportion of poor glycaemic control, which reflects the insufficient care given to diabetic patients, mainly due to deficient resources and inefficient utilization of what is scarcely available.

References

  • 1 Abdelgadir M, Elbagir M, Eltom A. et al . Factors affecting perinatal morbidity and mortality in pregnancies complicated by diabetes mellitus in Sudan.  Diabetes Res Clin Pract. 2003;  60 41-47
  • 2 Abdelgadir M, Elbagir M, Eltom M. et al . The influence of glucose self-monitoring on glycaemic control in patients with diabetes mellitus in Sudan.  Diabetes Res Clin Pract. 2006;  74 90-94
  • 3 Chale SS, Swai AB, Mujinja PG. et al . Must diabetes be a fatal disease in Africa? Study of costs of treatment.  BMJ. 1992;  304 1215-1218
  • 4 Chan BS, Tsang MW, Lee VW. et al . Cost of type 2 diabetes mellitus in Hong Kong Chinese.  Int J Clin Pharmacol Ther. 2007;  45 455-468
  • 5 Elbagir MN, Eltom MA, Mahadi EO. et al . Pattern of long-term complications in Sudanese insulin-treated diabetic patients.  Diabetes Res Clin Pract. 1995a;  30 59-67
  • 6 Elbagir MN, Eltom MA, Rosling H. et al . Glycaemic control of insulin-dependent diabetes mellitus in Sudan: Influence of insulin shortage.  Diabetes Res Clin Pract. 1995b;  30 43-52
  • 7 Elbagir MN, Eltom MA, Elmahadi EM. et al . A population-based study of the prevalence of diabetes and impaired glucose tolerance in adults in northern Sudan.  Diabetes Care. 1996;  19 1126-1128
  • 8 Elrayah H, Eltom M, Bedri A. et al . Economic burden on families of childhood type 1 diabetes in urban Sudan.  Diabetes Res Clin Pract. 2005;  70 159-165
  • 9 Eltom M, Thompson C. Management of diabetes in Sudan.  Diabetes Form, Norwegian Diabetes Association. 2005;  2 32-34
  • 10 Federal Ministry of Health, . Sudan. Sudan strategy plan.  2007; 
  • 11 Habbani K, Groot W, Jelovac I. Household health-seeking behaviour in Khartoum, Sudan: The willingness to pay for public health services if these services are of good quality.  Health Policy. 2006;  75 140-158
  • 12 Henriksson F, Jonsson B. Diabetes: The cost of illness in Sweden.  J Intern Med. 1998;  244 461-468
  • 13 Henriksson F, Agardh CD, Berne C. et al . Direct medical costs for patients with type 2 diabetes in Sweden.  J Intern Med. 2000;  248 387-396
  • 14 Jonsson B. Revealing the cost of type 2 diabetes in Europe.  Diabetologia. 2002;  45 S5-12
  • 15 Redekop WK, Koopmanschap MA, Rutten GE. et al . Resource consumption and costs in Dutch patients with type 2 diabetes mellitus. Results from 29 general practices.  Diabet Med. 2002;  19 246-253
  • 16 UK Prospective Diabetes Study group (UKPDS 33) . Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes.  Lancet. 1998;  352 837-853
  • 17 Wild S, Roglic G, Green A. et al . Global prevalence of diabetes: Estimates for the year 2000 and projections for 2 030.  Diabetes Care. 2004;  27 1047-1053

Correspondence

Prof. C.-G. Östenson

Department of Molecular

Medicine and Surgery

Karolinska Institutet

Karolinska University Hospital

17176 Stockholm

Sweden

Phone: +46-8-51776200

Fax: +46-8-51773096

Email: claes-goran.ostenson@ki.se

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