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For patients with type 2 diabetes, lowering
blood sugar can be a difficult
and expensive endeavor. But a recent study
suggests that a 1% reduction in blood sugar sustained over several years
leads to substantial cost savings.
The report found that adults who kept their hemoglobin A1 C stable:
- were hospitalized
less often
- were less likely
to visit hospital emergency departments
This translated into a savings of $685
to $950 within 2 years.
"Improvements in glycemic control provide positive
reinforcement for the patient's efforts in managing their illness,
which may increase self-efficacy
and reduce dependency
on medical care for diabetes management," according to Dr. Edward
H. Wagner, from the University of Washington in Seattle, and colleagues.
Patients with type 2 diabetes do not respond to insulin,
the hormone that regulates blood sugar. High hemoglobin A1 C can lead to
a number of serious medical complications
including:
The study of more than 4,700 diabetics aged 18 years and older found
that those who sustained a 1% or more decrease in hemoglobin A1 C for more
than a year, lowered their average annual
healthcare costs. Costs rose for those whose
hemoglobin A1 C did not improve, the report indicates.
Those who lowered their hemoglobin A1 C had higher
rates of complications such as stroke, heart
disease and foot ulcers at the outset, suggesting that their disease was
more advanced. This might explain why those who managed to lower their
hemoglobin A1 C had slightly higher rates
of death after 3 years, the
authors note.
The Journal of the American Medical
Association 2001;285:182-189
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