PMID- 21641287
OWN - NLM
STAT- MEDLINE
DCOM- 20111121
LR  - 20221207
IS  - 1579-2021 (Electronic)
IS  - 1575-0922 (Linking)
VI  - 58
IP  - 6
DP  - 2011 Jun-Jul
TI  - [Direct health care costs in patients with type 2 diabetes mellitus six months 
      after starting insulin treatment in Spain: the INSTIGATE study].
PG  - 274-82
LID - 10.1016/j.endonu.2011.03.004 [doi]
AB  - BACKGROUND AND OBJECTIVES: The INSTIGATE study was designed to assess direct 
      health care costs incurred by patients with type 2 diabetes mellitus (T2DM) who 
      start insulin therapy in Spain. It was a multicenter, observational, 
      non-interventional, prospective study. METHODS: Direct costs per patient in 
      standard clinical practice were assessed for 6 months before and after the start 
      of insulin therapy from the perspective of the Spanish health care system 
      perspective. A total of 188 patients (42.6% women) with a mean age of 65.3 years, 
      a mean body mass index of 29.7 kg/m(2), and a mean disease duration of 10.7 years 
      were assessed. RESULTS: Before insulin therapy was started, mean (standard 
      deviation) values of various clinical parameters were: hemoglobin A(1c) (%), 9.22 
      (1.58); fasting plasma glucose (mmol/L), 12.03 (3.62); and total cholesterol 
      (mmol/L), 4.90 (1.1). These values decreased after insulin therapy was started. 
      Mean total direct health care costs per patient 6 months before and after insulin 
      start were euro639 and euro1,110, respectively. Mean total costs 6 months after insulin 
      was started included costs of hospitalization (30.5%, euro339), insulin (16.2%, 
      euro180), primary care (14.3%, euro159), blood glucose monitoring (13.8%, euro153), 
      specialized care (13.3%, euro148), oral antidiabetics (7.8%, euro87), and other 
      diabetes-related treatments (3.9%, euro43). CONCLUSIONS: The clinical outcomes of 
      T2DM patients improved after insulin therapy was started. This improvement was 
      associated to increases in resource utilization and direct health care costs in 
      the first 6 months of insulin therapy.
CI  - Copyright (c) 2010 SEEN. Published by Elsevier Espana. All rights reserved.
FAU - Costi, Maria
AU  - Costi M
AD  - Departamento de Investigacion Clinica, Lilly S.A., Alcobendas, Madrid, Espana.
FAU - Smith, Helen
AU  - Smith H
FAU - Reviriego, Jesus
AU  - Reviriego J
FAU - Castell, Conxa
AU  - Castell C
FAU - Goday, Alberto
AU  - Goday A
FAU - Dilla, Tatiana
AU  - Dilla T
LA  - spa
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
TT  - Costes directos sanitarios en pacientes con diabetes mellitus tipo 2 a los seis 
      meses de inicio del tratamiento con insulina en Espana: estudio INSTIGATE.
PL  - Spain
TA  - Endocrinol Nutr
JT  - Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y 
      Nutricion
JID - 100886482
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
SB  - IM
MH  - Aged
MH  - Blood Chemical Analysis/economics
MH  - Blood Glucose/analysis
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/drug therapy/*economics/epidemiology
MH  - Drug Costs/statistics & numerical data
MH  - Drug Therapy, Combination/economics
MH  - Europe/epidemiology
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - Health Expenditures/*statistics & numerical data
MH  - Hospitalization/economics
MH  - Humans
MH  - Hypoglycemic Agents/*economics/therapeutic use
MH  - Insulin/*economics/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Office Visits/economics
MH  - Prospective Studies
MH  - Spain/epidemiology
MH  - Treatment Outcome
EDAT- 2011/06/07 06:00
MHDA- 2011/12/13 00:00
CRDT- 2011/06/07 06:00
PHST- 2010/11/04 00:00 [received]
PHST- 2011/03/11 00:00 [revised]
PHST- 2011/03/14 00:00 [accepted]
PHST- 2011/06/07 06:00 [entrez]
PHST- 2011/06/07 06:00 [pubmed]
PHST- 2011/12/13 00:00 [medline]
AID - S1575-0922(11)00145-8 [pii]
AID - 10.1016/j.endonu.2011.03.004 [doi]
PST - ppublish
SO  - Endocrinol Nutr. 2011 Jun-Jul;58(6):274-82. doi: 10.1016/j.endonu.2011.03.004.