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. 2012 Sep 10;20(1):32.
doi: 10.1186/2008-2231-20-32.

Structured self monitoring of blood glucose in Iranian people with type 2 diabetes; A cost consequence analysis

Rokhsareh Aghili  1 , Mohammad E Khamseh, Mojtaba Malek, Shahin Yarahmadi, Amir Farshchi
Affiliations

Structured self monitoring of blood glucose in Iranian people with type 2 diabetes; A cost consequence analysis

Rokhsareh Aghili et al. Daru. .

Abstract

Background: Self-Monitoring of Blood Glucose (SMBG) is considered as a key factor in management of people with diabetes which is a growing and cost demanding health problem. The purpose of this study was to investigate the effect of comprehensive patient management using structured SMBG on metabolic control as well as its cost consequence analysis.

Methods: Sixty subjects were recruited in an observational study for a period of 6 months. They were provided with the ACCU-CHEK 360° View tool to fill in the values of the 7-point blood glucose profiles in three consecutive days during the study on a monthly basis. Changes in metabolic control were assessed by HbA1c and lipid profile measurement at the beginning and at the end of the study. In addition, cost consequence analysis was done considering different level of health care professionals with or without insurance coverage. The Average Cost Effectiveness Ratio (ACER) as well as Cost saving analysis were calculated and compared.

Results: The analysis showed significant reduction in HbA1c during the 6-month period in all subjects (P = 0.000). Furthermore, a positive effect was observed on lipid profile. The cost of endocrinologist's visit in private sector was estimated to be 265.76 USD while this figure was149.15 USD for general practitioner in public sector with insurance coverage. Total complications and mortality cost saving was 154.8 USD. The lowest ACER was calculated for intervention with general practitioner in public sector with insurance coverage.

Conclusion: Structured SMBG results in significant improvement of glycemic status. Moreover, it is more cost saving in public sector with insurance coverage. It seems that general practitioner visits with insurance coverage is the most affordable option for people with type 2 diabetes.

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Figures

Figure 1
Figure 1
Sensitivity analysis of effects of costs considering the level of health care professionals in public and private sectors. ACER; Average Cost Effectiveness Ratio.
See this image and copyright information in PMC

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