OBJECTIVES: To evaluate the effect of symptoms of diabetic peripheral neuropathy (SDPN), diabetic retinopathy (DR) and co-morbid SDPN & DR (COMORB) among US adults ≥40 years old with diagnosed diabetes on several burden of illness (BOI) measures, including indirect costs and health care utilization, using the combined 1999–2000 and 2001–2002 National Health and Nutrition Examination Surveys (NHANES).
METHODS: Included in the analysis were 850 NHANES respondents ≥40 years old classified as having diagnosed diabetes. Logistic regression models were used to assess the effect of SDPN, DR and COMORB on BOI. Model covariates included age, gender, race, education, insurance status, current smoking status, currently asthmatic, and history of cardiovascular disease, cancer, arthritis, COPD, hypertension and stroke. The conditions of interest were assessed based upon respondent self-report.
RESULTS: Using the combined 1999–2000 and 2001–2002 NHANES, it was estimated that, among US adults ≥40 years old with diagnosed diabetes, those with SDPN (OR = 2.27; 95% CI = 1.34, 3.85), DR (1.67; 1.08, 2.59) and COMORB (2.88; 1.28, 6.48) were each more likely to have four or more health care visits in the past year than those without the corresponding condition. Those with DR (1.81; 1.31, 2.50) and COMORB (2.07; 1.13, 3.77) were both more likely to have had at least one overnight hospital stay in the past year. Finally, those of working age (40–65) with SDPN (3.39; 1.66, 6.89), DR (3.08; 1.55, 6.11) and COMORB (4.51; 2.27, 8.96) were each more likely to be unable to work due to physical limitations.
CONCLUSION: Among US adults ≥40 years old with diagnosed diabetes, SDPN, DR, and COMORB all appear to significantly increased BOI. Future therapies that offer relief of both of these conditions may have significant benefits on indirect costs (such as lost work time) and direct measures of health care resource utilization.
