[Direct cost of the ambulatory management of diabetes at the outpatient clinic of the National Social Security Fund of Sfax (Tunisia)].

The direct costs were determined by conducting a retrospective study on the files of 100 diabetics (selected at random) who had attended the clinic at least once in 1991. Another study was conducted simultaneously under the same conditions on 100 non-diabetic patients. Diabetic patients attend on average 8 times a year, twice as often as nondiabetics, generally at the department of general medicine (6 times). They undergo more biological tests and receive more care procedures than nondiabetics. Drug prescriptions cost on average US$ 62 per year for the diabetic, 3 times as much as for the non-diabetic (US$ 20/year). The total direct cost of outpatient care is US$ 117 per year for the diabetic, as against only US$ 48 for the nondiabetic. The cost is much higher for diabetics with degenerative complications (US$ 144 as against US$ 92). Reduction of the cost of care requires early detection of diabetes and education of the diabetic, so as to ensure better control of blood sugar levels and freedom from complications that lead to a sharp increase in consultations and treatment procedures.