Introduction

Type 2 diabetes (T2D) is a complex chronic disease with an increasing prevalence worldwide. It is commonly associated with complications, such as cardiovascular disease (CVD). Patients with both T2D and established CVD are exposed to increased risk of further cardiovascular events, which means increased healthcare costs and impairments to quality of life and survival. To determine the added burden of CVD for T2D patients, we have analyzed the consumption and costs of healthcare and mortality in two T2D patient cohorts, with and without established CVD, respectively, during a 5-year follow-up in a Swedish region.

Methods

Patients with T2D on 1 January 2012 were identified using the administrative database of Region Östergötland and the Swedish National Diabetes Register. Established CVD was defined as the presence of a CVD-related healthcare visit in the period 2002–2011. Identified T2D patients were then followed retrospectively for 5 years (2012–2016) and data collected on utilization of healthcare resources, healthcare costs, and survival. Data pertinent to the study were retrieved from regional databases and national registries.

Results

On the index date (1 January 2012) there were 19,731 patients with T2D (prevalence 4.5%) in Region Östergötland, of whom 5490 had established CVD. Those patients with established CVD were older, more often men, and had longer diabetes duration and worse kidney function than those without. Compared to T2D patients without CVD, those with CVD had a significantly higher healthcare consumption, experienced higher costs, and had lower survival during the follow-up.

Conclusion

This study confirms that established CVD is common among patients with T2D (approximately 30%). Established CVD has negative effects on the utilization of healthcare resources, healthcare costs, and mortality. It is therefore very important to improve the treatment strategy of this patient group.

中文翻译：

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瑞典有或没有心血管疾病的T2D患者的疾病负担和医疗保健费用：一项回顾性队列研究。

介绍

2型糖尿病（T2D）是一种复杂的慢性疾病，在世界范围内患病率不断上升。它通常与并发症（例如心血管疾病（CVD））相关。患有T2D和既定CVD的患者面临进一步心血管事件的风险增加，这意味着医疗保健成本增加以及生活质量和生存受损。为了确定T2D患者的CVD增加的负担，我们在瑞典地区进行了5年的随访，分析了两个有和没有建立CVD的T2D患者队列的医疗，消费和成本以及死亡率。

方法

使用地区Östergötland的行政数据库和瑞典国家糖尿病登记簿确定了2012年1月1日患有T2D的患者。建立的CVD定义为在2002年至2011年期间存在与CVD相关的医疗保健就诊。然后对确定的T2D患者进行了为期5年（2012-2016年）的随访，收集了有关医疗资源利用，医疗成本和生存率的数据。有关研究的数据是从区域数据库和国家注册机构中检索的。

结果

在索引日（2012年1月1日），Östergötland地区有19,731例T2D患者（患病率4.5％），其中5490例已建立CVD。那些确诊为CVD的患者比那些没有CVD的患者年龄更大，男性更多，并且糖尿病持续时间更长，肾脏功能更差。与没有CVD的T2D患者相比，患有CVD的T2D患者的医疗保健消耗明显更高，费用更高，并且在随访期间生存率较低。

结论

这项研究证实，确定的CVD在T2D患者中很常见（约30％）。建立的CVD对医疗资源的利用，医疗成本和死亡率具有负面影响。因此，改善该患者组的治疗策略非常重要。