Mohan Viswanathan, Mapari Jayashree A, Karnad Pratibha D, Mann Jasdeep S, Maheshwari Vikalp K
Dr. Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamil Nadu, India.
Ethicon Surgical Care & Diabetes Care, Johnson & Johnson Pvt. Ltd, Mumbai, Maharashtra, India.
Indian J Endocrinol Metab. 2018 Jul-Aug;22(4):461-465. doi: 10.4103/ijem.IJEM_216_17.
The objective of the study was to understand the role of self-monitoring of blood glucose (SMBG) for better management of glycemic fluctuations, reducing the risk of complications, and the associated cost benefits for diabetes patients in India.
An Excel-based Cost Impact Model was developed to analyze the impact of SMBG by calculating the savings over a 10-year time period. A literature review was undertaken to model the impact of SMBG on the risk of complications and cardiovascular morbidities. The model was developed based on inputs from previous studies.
In the base case, SMBG cohort was associated with a 10-year discounted cost of INR 718,340, resulting in an estimated saving of INR 120,173 compared to no SMBG cohort. Implementation of a once-daily SMBG protocol, for a decade, can reduce the complication-related costs. More frequent SMBG and tri-monthly hemoglobin A1c tests along with lifestyle changes can significantly reduce the financial burden on the patient over the lifespan.
Our study has shown that proactive management of diabetes with SMBG can improve treatment outcomes and reduce morbidity and mortality associated with this disease. Near-normal blood glucose levels can bring in cost savings in the form of reduced long-term complications and avoidance of repeated hospitalization for the management of such complications, along with an improved quality of life.
本研究的目的是了解自我血糖监测(SMBG)在更好地管理血糖波动、降低并发症风险以及印度糖尿病患者相关成本效益方面的作用。
开发了一个基于Excel的成本影响模型,通过计算10年期间的节省情况来分析自我血糖监测的影响。进行了文献综述,以模拟自我血糖监测对并发症风险和心血管疾病发病率的影响。该模型是根据先前研究的输入数据开发的。
在基础案例中,自我血糖监测队列的10年贴现成本为718,340印度卢比,与无自我血糖监测队列相比,估计节省了120,173印度卢比。实施每日一次的自我血糖监测方案十年,可以降低与并发症相关的成本。更频繁的自我血糖监测和每三个月一次的糖化血红蛋白检测,以及生活方式的改变,可以在患者的整个生命周期内显著减轻其经济负担。
我们的研究表明,通过自我血糖监测对糖尿病进行积极管理可以改善治疗效果,降低与该疾病相关的发病率和死亡率。接近正常的血糖水平可以通过减少长期并发症以及避免因管理此类并发症而反复住院的形式节省成本,同时提高生活质量。