Endocrine Abstracts

Introduction: Type 2 diabetes (T2D) is a globally expanding disease with severe consequences. Cardiovascular and renal complications are concerning, leading to high costs for individuals and healthcare systems. Evaluating these costs is crucial to guide health policies and identify factors influencing these expenditures.

Materials and Methods: A retrospective descriptive study was conducted to collect data on diabetic patients with chronic complications. The study included patients hospitalized in the Endocrinology Department of Hedi Chaker University Hospital in Sfax from January 1 to December 31, 2022. The research focused on the impact of age on the expenses of managing complicated diabetes.

Results: The study involved 114 patients, with a sex ratio of 1.28. The average age of our population of T2D patients with chronic complications was 65 years, ranging from 41 to 87 years. In our study, 67.54% of patients were found to have diabetic nephropathy, while diabetic retinopathy and neuropathy were observed in 33.3% and 52.6% of cases, respectively. Among the 90 patients exhibiting cardiovascular involvement, the prevalent macroangiopathy was coronary insufficiency (59.7%), followed by heart failure, peripheral arterial disease, and stroke (10.5%). The average cost per patient was approximately 2,246.46 TND or 713.16 USD for an average hospitalization duration of 7 days. The difference in the average cost of care between patients under 65 and those 65 or older was statistically significant (2773.50 vs 1804.42 TND, P=0.043). This finding indicates that patients under 65 have higher care costs than those 65 or older. Table IV provides a detailed analysis of the variations in overall cost between the two age groups based on the different components of this cost. Specifically, advancing age correlated with a decrease in expenses related to cardiovascular, radiological, and medical treatment, with significant correlation coefficients of r=-0.208, r=-0.245, r=-0.094, respectively. Interestingly, age showed a positive correlation with expenses for biological explorations, with a correlation coefficient of r=0.273 and a P-value less than 0.001, potentially aiding in alleviating the financial burden and enhancing patient outcomes.

Conclusion: This emphasizes that aging itself, beyond managing classic risk factors, can significantly contribute to the onset of diabetes-related complications. The study’s results highlight the importance of closely monitoring elderly diabetic patients, even if they have adequate control of their cardiovascular risk factors, to prevent and manage these complications.