Association of good glycemic control and cost of diabetes care: Experience from a tertiary care hospital in Bangladesh

Aim: The present study was undertaken to assess the cost-effectiveness of good glycemic control in a population of Bangladeshi people with type 2 diabetes mellitus (T2DM). Methods: A cross-sectional study was conducted among 496 registered patients with >1 year duration of diabetes. Glycated hemoglobin A1c level <7% was judged as the cut-off value for good glycemic control. All treatment-related records from the last year were collected from patients' guide books and all cost components were calculated. Results: Among patients, 31% had good glycemic control. The average annual cost was US$ 314 per patient. Patients with poor glycemic control were significantly more likely to have complications [(p = 0.049) OR 1.5] and comorbidities [(p = 0.02) OR 1.5]. The annual cost increased rapidly with complications/comorbidities. In multivariable logistic regression analysis, gender (p = 0.003) and cost of care (p = 0.006) were significantly associated with glycemic control, and the presence of any comorbidities/complications was associated with 1.8-fold higher odds of poor glycemic control (p = 0.013 95% CI: 1.131-2.786). Conclusion: Good glycemic control can lead to substantial cost saving through prevention and control of complications. (C) 2016 Elsevier Ireland Ltd. All rights reserved.