Lifetime economic burden of type 2 diabetes mellitus: A longitudinal analysis of adults in the Wasatch Front Region of Utah, United States.

Abstract

To generate precise estimates of excess lifetime medical expenditures attributable to type 2 diabetes mellitus (T2DM) by leveraging statewide administrative, health, and insurance records. Data were drawn from the Utah Population Database and included administrative and health records prior to 2015 and insurance records in 2014. Study population consisted of individuals born in 1970-1990 and their parents, who resided in four urban counties in Utah, United States, and had health insurance in 2014. Logistic and generalized linear regression models were used to estimate annual T2DM-attributable medical expenditures. Lifetime T2DM-attributable medical expenditures overall and by sex were calculated using population-specific age- and sex-adjusted survival probabilities. Our study cohort comprised 430,171 individuals, of whom 11% had a T2DM diagnosis. Expenditures declined with later age at T2DM diagnosis, with especially sharp reductions during early adulthood. Women incurred higher healthcare costs when diagnosed prior to age 40 compared with men, but lower costs when diagnosed between ages 40-59. Lifetime T2DM-attributable medical expenditures declined rapidly with later diagnosis age, with patterns varying by sex. Our study demonstrates the value of using administrative and insurance claims data to improve precision in assessing the economic burden associated with T2DM across the life course.