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肥胖对日本 2 型糖尿病患者的年度医疗支出和糖尿病治疗的影响。

Impact of obesity on annual medical expenditures and diabetes care in Japanese patients with type 2 diabetes mellitus.

机构信息

Department of Medicine, Shiga University of Medical Science, Otsu, Shiga, Japan.

Kusatsu General Hospital, Kusatsu, Shiga, Japan.

出版信息

J Diabetes Investig. 2018 Jul;9(4):776-781. doi: 10.1111/jdi.12766. Epub 2017 Nov 22.

Abstract

AIMS/INTRODUCTION: Diabetes and obesity are important health and economic concerns. We investigated the influence of obesity on diabetes control, the annual medical expenditures and medications in Japanese patients with type 2 diabetes who were relatively lean in comparison with those in Western countries.

MATERIALS AND METHODS

A total of 402 Japanese patients with type 2 diabetes were enrolled and their annual medical expenditures investigated. Obesity was defined as body mass index ≥25 kg/m , according to the obesity classifications from the Japan Society for the Study of Obesity.

RESULTS

A total of 165 patients (41.0%) were classified as obese. The obese group was younger, had poor glycemic control and higher frequency of hypertension than the non-obese group. The median total annual medical expenditures for all participants was ¥269,333 (interquartile range ¥169,664-437,437), which was equivalent to approximately $US2,450. The annual medical expenditure was significantly higher in patients with obesity than in non-obese patients (P < 0.001). This difference was mainly attributed to the annual expenditures for medication and hospitalization. In particular, the medication expenditures and the average number of drug classes for hyperglycemia and hypertension were significantly higher in the obese group.

CONCLUSIONS

Japanese patients with type 2 diabetes and obesity had higher annual medical expenditures and a larger number of medications, but their diabetes control care was insufficient in comparison with those without obesity. Further studies are required to assess the effect of reducing bodyweight on diabetes control and costs.

摘要

目的/引言:糖尿病和肥胖是重要的健康和经济问题。我们研究了肥胖对日本 2 型糖尿病患者糖尿病控制、年医疗支出和药物治疗的影响,这些患者与西方国家的患者相比相对较瘦。

材料和方法

共纳入 402 例日本 2 型糖尿病患者,调查其年医疗支出。根据日本肥胖学会的肥胖分类标准,将肥胖定义为体重指数≥25kg/m²。

结果

共有 165 例(41.0%)患者被归类为肥胖。与非肥胖组相比,肥胖组年龄较小,血糖控制较差,高血压发生率较高。所有参与者的总年医疗支出中位数为 269333 日元(四分位距 169664-437437),相当于约 2450 美元。肥胖患者的年医疗支出明显高于非肥胖患者(P<0.001)。这种差异主要归因于药物治疗和住院治疗的年度支出。特别是,肥胖组在治疗高血糖和高血压的药物支出和平均药物种类方面明显更高。

结论

与无肥胖的患者相比,日本 2 型糖尿病合并肥胖患者的年医疗支出更高,用药更多,但糖尿病控制护理不足。需要进一步研究来评估减轻体重对糖尿病控制和成本的影响。

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