Servicio de Endocrinología y Nutrición, Hospital Universitario Puerta de Hierro Majadahonda (Madrid), C/ Manuel de Falla, 1 Majadahonda 28220, Madrid, Spain.
Expert Rev Pharmacoecon Outcomes Res. 2010 Dec;10(6):649-60. doi: 10.1586/erp.10.73.
Diabetes mellitus has a major impact on costs for healthcare and society. The estimation for 2010 is that investment in diabetes will reach 11.6% of public healthcare expenses worldwide. The expected rise in the prevalence of diabetes over the coming decades may create problems for the sustainability of healthcare systems, such as those in Spain. The rise in direct costs is the main issue in diabetes, especially the treatment of acute and chronic complications that often need hospital care. Severe hypoglycemia (SH) is the most frequent acute complication. In Spain, the incidence of SH is estimated at two episodes per patient per year for Type 1 diabetes and one to two episodes for advanced Type 2 diabetes requiring insulin treatment. Although results vary, Spanish national data provide an estimated cost of approximately €3500 per SH episode. It also has a major influence on indirect costs, mainly related to reduced productivity, absenteeism and occasionally early retirement, and affects direct health, such as quality of life. As a result of SH, patients acquire a fear of new hypoglycemic episodes, which makes them modify their behavior and habits and, in the long term, has the potential to negatively impact metabolic control. Educational programs for healthcare professionals and patients with diabetes, increased involvement of patients in the management of their illness and regular self-measurement of blood glucose are all strategies aimed at minimizing the social and economic effects of severe hypoglycemia.
糖尿病对医疗保健和社会的成本有重大影响。据估计，2010 年全球用于糖尿病的投资将达到公共医疗支出的 11.6%。未来几十年糖尿病患病率的预计上升可能会给医疗保健系统的可持续性带来问题，例如西班牙的医疗保健系统。直接成本的上升是糖尿病的主要问题，特别是急性和慢性并发症的治疗，这些并发症往往需要住院治疗。严重低血糖（SH）是最常见的急性并发症。在西班牙，估计 1 型糖尿病患者每年每例发生 2 次 SH，需要胰岛素治疗的晚期 2 型糖尿病患者每年发生 1 到 2 次 SH。尽管结果有所不同，但西班牙的国家数据提供了大约每个 SH 发作 3500 欧元的估计成本。它还对间接成本有重大影响，主要与生产力下降、旷工和偶尔提前退休有关，并且会影响直接健康，如生活质量。由于 SH，患者产生了对新的低血糖发作的恐惧，这使他们改变了行为和习惯，从长远来看，可能会对代谢控制产生负面影响。针对医疗保健专业人员和糖尿病患者的教育计划、患者更多地参与疾病管理以及定期自我测量血糖，都是旨在将严重低血糖的社会和经济影响降到最低的策略。
