OBJECTIVE To analyze the differences in health care costs according to glycemic control in people with type 2 diabetes. RESEARCH DESIGN AND METHODS Data on health care resource utilization from 100,391 people with type 2 diabetes were extracted from the electronic database used at the Catalan Health Institute. Multivariate regression models were carried out to test the impact of glycemic control (HbA1c) on total health care, hospital admission, and medication costs; model 1 adjusted for a variety of covariates, and model 2 also included micro- and macrovascular complications. Glycemic control was classified as good for HbA1c <7%, fair for ≥7% to <8%, poor for ≥8% to <10%, and very poor for ≥10%. RESULTS Mean per patient annual direct medical costs were €3,039 ± 6,581 Euros (€). Worse glycemic control was associated with higher total health care costs: compared with good glycemic control, health care costs increased by 18% (509.82) and 23% (€661.35) in patients with very poor and poor glycemic control, respectively, when unadjusted and by €428.3 and €395.1, respectively, in model 2. Medication costs increased by 12% in patients with fair control and by 28% in those with very poor control (model 2). Patients with poor control had a higher probability of hospitalization than those with good control (5% in model 2) and a greater average cost when hospitalization occurred (€811). CONCLUSIONS Poor glycemic control was directly related to higher total health care, hospitalization, and medication costs. Preventive strategies and good glycemic control in people with type 2 diabetes could reduce the economic impact associated with this disease.

中文翻译：

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糖尿病患者血糖控制不良与医疗保健费用之间的关联：一项基于人群的研究。

目的分析血糖控制在2型糖尿病患者中的医疗费用差异。研究设计与方法从加泰罗尼亚卫生研究所使用的电子数据库中提取了100391名2型糖尿病患者的医疗资源利用率数据。进行了多元回归模型以检验血糖控制（HbA1c）对总体医疗保健，住院和药物费用的影响；模型1已针对各种协变量进行了调整，模型2还包含了微血管和大血管并发症。血糖控制被分类为HbA1c <7％，良好≥7％至<8％，不良≥8％至<10％，非常不良≥10％。结果每位患者的平均每年直接医疗费用为€3,039±6,581欧元（€）。较差的血糖控制与更高的总体医疗保健成本相关：与良好的血糖控制相比，血糖控制非常差和差的患者在未经调整的情况下的医疗成本分别增加了18％（509.82）和23％（€661.35）。在模型2中，费用分别增加了428.3欧元和395.1欧元。在控制正常的患者中，药物费用增加了12％，在控制非常差的患者中，药物费用增加了28％（模型2）。与控制良好的患者相比，控制不良的患者住院的可能性更高（模型2中为5％），住院时的平均费用更高（€811）。结论血糖控制不佳与总体医疗保健，住院和药物治疗费用增加直接相关。