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Clin Med Insights Endocrinol Diabetes. 2015 Mar 24;8:13-9. doi: 10.4137/CMED.S20906. eCollection 2015.

Health economic evaluation of type 2 diabetes mellitus: a clinical practice focused review.

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Department for Internal Medicine, Center for Diabetes and Metabolism, m&i-Fachklinik Bad Heilbrunn, Woernerweg 30, D-83670 Bad Heilbrunn, Germany.
Leicester Diabetes Centre, University of Leicester, Leicester, UK.
Cathedra of Family Medicine, Clinical Medicine Department, University Miguel Hernandez, San Juan de Alicante, Spain.
McGill Nutrition Centre, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.


Type 2 diabetes mellitus (T2D) is a growing healthcare burden primarily due to long-term complications. Strict glycemic control helps in preventing complications, and early introduction of insulin may be more cost-effective than maintaining patients on multiple oral agents. This is an expert opinion review based on English peer-reviewed articles (2000-2012) to discuss the health economic consequences of T2D treatment intensification. T2D costs are driven by inpatient care for treatment of diabetes complications (40%-60% of total cost), with drug therapy for glycemic control representing 18% of the total cost. Insulin therapy provides the most improved glycemic control and reduction of complications, although hypoglycemia and weight gain may occur. Early treatment intensification with insulin analogs in patients with poor glycemic control appears to be cost-effective and improves clinical outcomes.


cost-effectiveness; healthcare economics (operational domain); hyperglycemia; hypoglycemia; insulin; oral antidiabetic agents; type 2 diabetes (clinical domain)

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