van der Linden Michiel W, Plat Arian W, Erkens Joelle A, Emneus Martha, Herings Ron M C
PHARMO Institute, Utrecht, The Netherlands.
Value Health. 2009 Sep;12(6):909-14. doi: 10.1111/j.1524-4733.2009.00506.x. Epub 2009 Mar 11.
To estimate the burden of diabetes mellitus (DM) and its complications in The Netherlands.
The PHARMO Record Linkage System comprised among others linked drug dispensing, hospital and clinical laboratory data from approximately 2.5 million individuals in The Netherlands. Patients with DM (type 1 and type 2) were included in the study cohort from 2000 to 2004 if they used antidiabetic drugs or had HbA1c >or= 6.5 mmol/L or had a hospitalization for DM or a diabetic complication in the measurement year or in the preceding year. Controls, defined as subjects without a diagnosis of DM and/or subjects not prescribed glucose-lowering medication, were 1:1 matched to patients with diabetes, on birth year, zip code, and gender. Complications (hospitalizations and dispensings for cardiovascular disease/eye problems/amputations) were classified into stages. Complications attributed to DM were estimated as complication stages 1 and 2 among patients minus those among controls. Drug costs were extrapolated to The Netherlands by direct standardization.
Among the total population in The Netherlands, the prevalence of DM increased from 2.8% in 2000 to 4.0% in 2004. Severe cardiovascular complications attributed to DM increased from 18,000 to 39,000 patients. Per DM patient the cost of direct treatment attributed to DM increased from Euro 974 in 2000 to Euro 1283 in 2004. Per 100 members of the total population, this increase was from Euro 2764 in 2000 to Euro 5140 in 2004. Most of these costs (65% in 2004) were because of hospitalizations.
Drug treatment, hospitalizations, and cost attributed to diabetes mellitus have almost doubled between 2000 and 2004, but so did the "background" costs in the general population, perhaps because of preventive efforts.
评估荷兰糖尿病（DM）及其并发症的负担。
PHARMO记录链接系统包含来自荷兰约250万人的药物配给、医院和临床实验室数据等。2000年至2004年期间，使用抗糖尿病药物、糖化血红蛋白（HbA1c）≥6.5 mmol/L、在测量年份或上一年因糖尿病或糖尿病并发症住院的1型和2型糖尿病患者被纳入研究队列。对照组定义为未诊断为糖尿病和/或未开具降糖药物的受试者，按出生年份、邮政编码和性别与糖尿病患者1:1匹配。并发症（心血管疾病/眼部问题/截肢的住院和配药情况）分为不同阶段。糖尿病所致并发症通过计算患者中1期和2期并发症的发生率减去对照组中的发生率来估算。药物成本通过直接标准化外推至荷兰全国范围。
在荷兰总人口中，糖尿病患病率从2000年的2.8%增至2004年的4.0%。糖尿病所致严重心血管并发症患者从18000例增至39000例。每位糖尿病患者的糖尿病直接治疗成本从2000年的974欧元增至2004年的1283欧元。每100名总人口中，这一成本从2000年的2764欧元增至2004年的5140欧元。这些成本中的大部分（2004年为65%）是由于住院费用。
2000年至2004年间，糖尿病的药物治疗、住院费用及相关成本几乎翻了一番，但普通人群的“背景”成本也是如此，这可能是预防措施的结果。
