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Abstract Title
Cost-effectiveness analysis of medical intervention in patients with early detected of Diabetic
nephropathy in a tertiary care hospital in bangladesh
Authors : Samira Humaira Habib
Co Authors : Salima Akter 2 , soma saha 1 , fahmida binte Mesbah 1 , Mosaraf Hossain 2 , Liaquat ali 1
Conference Theme: Diabetic neuropathy in our region
Abstract:
background and aims: the economic burden resulting from Diabetic nephropathy (Dn) consumes
a major portion of resources allocated for health-care services. Cost-effectiveness of various
interventions on Dn & its complications have relatively been well explored in developed countries,
but these are almost absent in developing countries. the present study was undertaken to assess
the cost-effectiveness of medical intervention in patients with Dn.
Materials and Methods: two hundred patients with Dn, with at least 1 yr of follow-up, were
purposively selected from birDeM (tertiary diabetes care hospital) of bangladesh. of them 100
were late in detection (serum Creatinine≥ 4.0 mmom/l, Late detected Dn or Late detected diabetic
nephropathy) and 100 were detected early (serum Creatinine< 4.0 mmom/l, early detected Dn
or early detected diabetic nephropathy). the degree & extent of complications like cardiopathy,
peripheral neuropathy, retinopathy & vasculopathy, treatment outcome, clinical effectiveness of
interventions and direct, indirect & incremental cost of complications were calculated. Comparison
was made between the groups. Cost included drugs, hospitalizations, diagnostics & visits.
results: a total of 200 patients were considered for an average of 365 days, amounting to 651 personyears
of observation in total. the mean±sD fasting serum glucose of the groups was 9.36±0.40
mmol/l & 4.78±0.38 mmol/l, total cholesterol was 206.50±42.60 & 104.20±35.50 mg/dl, hba 1c was
9.80±0.50% & 5.70±0.38%, tG was 163.76±99.46 & 155.67±94.84 mg/dl and serum creatinine was
0.89±0.03 & 4.90±1.17 mmol/l in Late detected diabetic nephropathy & early detected diabetic
nephropathy respectively. about 19% patients in Late detected diabetic nephropathy & 36% in
early detected diabetic nephropathy were free of diabetic complications other than Dn. in Late
detected diabetic nephropathy, 32% had one complication, 29% had two & 20% had more than
two complications. on the other hand, in early detected diabetic nephropathy the corresponding
values were 48%, 10% & 6% respectively. the most frequent complication was cardiopathy, which
affected 33% patients in Late detected diabetic nephropathy & 27% in early detected diabetic
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