Costs of Comorbidities and Complications Associated with Type 2 Diabetes: A Retrospective, Cohort Study

Type 2 diabetes (T2D) is often accompanied by complications and comorbidities. This retrospective study used a large medical claims database to examine the annualized, direct costs associated with T2D-related comorbidities and complications among US adults diagnosed with T2D. It also examined excess costs associated with substandard glycemic control (glycated hemoglobin [HbA1c] ≥ 7%).

Optum's de-identified Market Clarity Data (Optum^® Market Clarity) database was used to identify the 2021-2023 health records of a cohort of adults with T2D. Generalized linear models were used to estimate the age- and sex-adjusted additional costs associated with T2D-related comorbidities and complications. Multivariable analyses were used to examine the costs associated with having HbA1c either within (HbA1c < 7%) or above (HbA1c ≥ 7%) the target range.

The study cohort consisted of 108,498 adults, with 50.6% female and average age 66.3 years (standard deviation [SD] = 11.9 years). Results illustrate a substantial burden associated with T2D-related comorbidities. Over half (52.1%) of this cohort of US adults with T2D had three or more comorbidities or complications during the study period, while 22.1% had five or more. The annual, per-person medical costs for these conditions averaged $13,614 and ranged from $5418 (SD = $3598) for knee pain to $23,313 (SD = $11,728) for heart failure. The estimated costs per 100,000 adults with T2D extended from $7.4 million (M) (SD = $8.3M) for severe vision loss/no light perception to $377.4M (SD = $197.9M) for neuropathy. HbA1c above target, compared with HbA1c < 7%, was associated with an additional average annual cost of $5367 per person.

The results of this research illustrate potential economic benefits of improving patient comorbidity and complication profiles and achieving HbA1c < 7%. These findings underscore the importance of effective diabetes management strategies that both reduce the risk of complications and alleviate the economic burden on patients and the healthcare system.