Healthcare and associated costs related to type 2 diabetes in youth and adolescence: the TODAY clinical trial experience
Year: 2019
Type: article
Abstract: The economic issues related to medical treatments in youth with type 2 diabetes (T2D) are rarely reported and thus not fully understood. The Treatment Options for type 2 Diabetes in Adolescents and Youth clinical trial of youth recently diagnosed with T2D collected healthcare and related cost information from the largest cohort studied to date. Costs related to medical treatments and expenses faced by caregivers were identified over a 2-year period from 496 participants. Data were collected by surveys and diaries to document frequency of use of diabetes care (excluding study laboratory tests), non-diabetes care services and treatments, caregiver time, and expenses related to exercise and dietary activities recommended for patients. Economic costs were derived by applying national cost values to the reported utilization frequency data. Annual medical costs in the first year varied by the treatment group, averaging $1798 in those assigned to metformin alone (M), $2971 to combination drug therapy with metformin + rosiglitazone (M + R), and $2092 to metformin + an intensive lifestyle and behavior change program (M + L). Differences were primarily due to costs related to combination drug therapy. Adult caregiver support costs were higher for participants in the lifestyle program, which was delivered in weekly sessions in the first 6 months. Expenses for purchases to enhance diet and exercise change did not vary by treatment assignment. In year 2, medication costs increased in M and M + L due to the initiation of insulin in subjects who failed to maintain glycemic control on the assigned treatment. Data are reported for use by researchers and those providing healthcare to this vulnerable patient population.
Source: Pediatric Diabetes
DOI: 10.1111/pedi.12869
Authors: Thomas J. Songer, Morey W. Haymond, Judith E. Glazner, Georgeanna J. Klingensmith, Lori M. Laffel, Ping Zhang, Kathryn Hirst, for the TODAY Study Group
Institutions: University of Pittsburgh, Baylor College of Medicine, Children's Nutrition Research Center at Baylor College of Medicine, Colorado School of Public Health, University of Colorado Anschutz, University of Colorado Health, Joslin Diabetes Center, Harvard University, Centers for Disease Control and Prevention, George Washington University
Language: English
Subfield: Endocrinology, Diabetes and Metabolism
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: G1415791185, G1444064448, Management of Pediatric Type 2 Diabetes Mellitus, Multi-Center Study of the Treatment of T2DM in Youth, G1908270963, G20328578, G2540315505, G3568430941, Type 2 Diabetes in Youth: Beta Cell Preservation, G4211906693, G4549954026, Treatment Alternatives in Pediatric Type 2 Diabetes, TODAY2 Phase 2 (T2P2): Long-Term Post-Intervention Follow-Up, G5886479391, G6879181497, G733747580, G800374514, Diabetes Research Center
OpenAlex ID: W2946467607
