Impact of Obesity on Annual Medical Expenditures and Diabetes Care in Japanese Patients with Type 2 Diabetes Mellitus

Overview

Journal J Diabetes Investig

Specialty Endocrinology

Date 2017 Oct 26

PMID 29068148

Citations 8

Authors

Chisato Kusunoki-Tsuji

Shin-Ichi Araki

Shinji Kume

Masami Chin-Kanasaki

Norihisa Osawa

Katsutaro Morino

Osamu Sekine

Satoshi Ugi

Atsunori Kashiwagi

Hiroshi Maegawa

Affiliations

Soon will be listed here.

Abstract

Aims/introduction: Diabetes and obesity are important health and economic concerns. We investigated the influence of obesity on diabetes control, the annual medical expenditures and medications in Japanese patients with type 2 diabetes who were relatively lean in comparison with those in Western countries.

Materials And Methods: A total of 402 Japanese patients with type 2 diabetes were enrolled and their annual medical expenditures investigated. Obesity was defined as body mass index ≥25 kg/m , according to the obesity classifications from the Japan Society for the Study of Obesity.

Results: A total of 165 patients (41.0%) were classified as obese. The obese group was younger, had poor glycemic control and higher frequency of hypertension than the non-obese group. The median total annual medical expenditures for all participants was ¥269,333 (interquartile range ¥169,664-437,437), which was equivalent to approximately $US2,450. The annual medical expenditure was significantly higher in patients with obesity than in non-obese patients (P < 0.001). This difference was mainly attributed to the annual expenditures for medication and hospitalization. In particular, the medication expenditures and the average number of drug classes for hyperglycemia and hypertension were significantly higher in the obese group.

Conclusions: Japanese patients with type 2 diabetes and obesity had higher annual medical expenditures and a larger number of medications, but their diabetes control care was insufficient in comparison with those without obesity. Further studies are required to assess the effect of reducing bodyweight on diabetes control and costs.

Citing Articles

Assessing the health and economic burden of obesity-related complications in East-Asian populations: implementation of risk equations in the Core Obesity Model for Japan and model validation.

Tatsuno I, Gerlier L, Olivieri A, Baker-Knight J, Lamotte M BMJ Public Health. 2025; 2(1):e000302.

PMID: 40018224 PMC: 11812756. DOI: 10.1136/bmjph-2023-000302.

Cost-Effectiveness Analysis of Finerenone for Treatment of Chronic Kidney Disease in Patients with Type 2 Diabetes from Japanese Payer Perspective.

Igarashi A, Ohara K, Matsuda H, Morii J, Jagannathan S, Filomeno R Adv Ther. 2024; 42(2):995-1008.

PMID: 39688813 PMC: 11787189. DOI: 10.1007/s12325-024-03084-5.

Cost-effectiveness of behavioural counselling intervention compared with non-intervention for adult patients with metabolic syndrome to prevent cardiovascular diseases and type 2 diabetes in Japan: a microsimulation modelling study.

Akune Y, Anezaki H, Nakao Y, Goto R BMJ Open. 2024; 14(4):e072688.

PMID: 38580368 PMC: 11002415. DOI: 10.1136/bmjopen-2023-072688.

Efficacy and safety of once-weekly semaglutide in Japanese individuals with type 2 diabetes in the SUSTAIN 1, 2, 5 and 9 trials: Post-hoc analysis.

Araki E, Harashima S, Nishida T, Nakamura J J Diabetes Investig. 2022; 13(12):1971-1980.

PMID: 36222597 PMC: 9720207. DOI: 10.1111/jdi.13905.

Efficacy and safety of once-weekly semaglutide in Japanese individuals with type 2 diabetes by baseline age and body mass index.

Yabe D, Yamada Y, Kaku K, Nishida T, Sato T, Seino Y J Diabetes Investig. 2022; 13(7):1161-1174.

PMID: 35174649 PMC: 9248424. DOI: 10.1111/jdi.13773.

References

Araki S, Haneda M, Koya D, Sugaya T, Isshiki K, Kume S . Predictive effects of urinary liver-type fatty acid-binding protein for deteriorating renal function and incidence of cardiovascular disease in type 2 diabetic patients without advanced nephropathy. Diabetes Care. 2012; 36(5):1248-53. PMC: 3631864. DOI: 10.2337/dc12-1298. View

Espeland M, Glick H, Bertoni A, Brancati F, Bray G, Clark J . Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes. Diabetes Care. 2014; 37(9):2548-56. PMC: 4140155. DOI: 10.2337/dc14-0093. View

Cawley J, Meyerhoefer C, Biener A, Hammer M, Wintfeld N . Savings in Medical Expenditures Associated with Reductions in Body Mass Index Among US Adults with Obesity, by Diabetes Status. Pharmacoeconomics. 2014; 33(7):707-22. PMC: 4486410. DOI: 10.1007/s40273-014-0230-2. View

von Lengerke T, Hagenmeyer E, Gothe H, Schiffhorst G, Happich M, Haussler B . Excess health care costs of obesity in adults with diabetes mellitus: a claims data analysis. Exp Clin Endocrinol Diabetes. 2010; 118(8):496-504. DOI: 10.1055/s-0030-1253400. View

Zhuo X, Zhang P, Kahn H, Bardenheier B, Li R, Gregg E . Change in medical spending attributable to diabetes: national data from 1987 to 2011. Diabetes Care. 2015; 38(4):581-7. DOI: 10.2337/dc14-1687. View

. Economic costs of diabetes in the U.S. in 2012. Diabetes Care. 2013; 36(4):1033-46. PMC: 3609540. DOI: 10.2337/dc12-2625. View

Ide R, Hoshuyama T, Wilson D, Takahashi K, Higashi T . Relationships between diabetes and medical and dental care costs: findings from a worksite cohort study in Japan. Ind Health. 2010; 48(6):857-63. DOI: 10.2486/indhealth.ms1158. View

. New criteria for 'obesity disease' in Japan. Circ J. 2002; 66(11):987-92. DOI: 10.1253/circj.66.987. View

Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K . Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009; 53(6):982-92. DOI: 10.1053/j.ajkd.2008.12.034. View

10.

Charvat H, Goto A, Goto M, Inoue M, Heianza Y, Arase Y . Impact of population aging on trends in diabetes prevalence: A meta-regression analysis of 160,000 Japanese adults. J Diabetes Investig. 2015; 6(5):533-42. PMC: 4578492. DOI: 10.1111/jdi.12333. View

11.

Yokoyama H, Araki S, Kawai K, Hirao K, Oishi M, Sugimoto K . Pioglitazone treatment and cardiovascular event and death in subjects with type 2 diabetes without established cardiovascular disease (JDDM 36). Diabetes Res Clin Pract. 2015; 109(3):485-92. DOI: 10.1016/j.diabres.2015.06.005. View

12.

Ozieh M, Bishu K, Dismuke C, Egede L . Trends in health care expenditure in U.S. adults with diabetes: 2002-2011. Diabetes Care. 2015; 38(10):1844-51. PMC: 4580605. DOI: 10.2337/dc15-0369. View

13.

Yokoyama H, Oishi M, Takamura H, Yamasaki K, Shirabe S, Uchida D . Large-scale survey of rates of achieving targets for blood glucose, blood pressure, and lipids and prevalence of complications in type 2 diabetes (JDDM 40). BMJ Open Diabetes Res Care. 2016; 4(1):e000294. PMC: 5051339. DOI: 10.1136/bmjdrc-2016-000294. View

14.

Kusunoki-Tsuji C, Araki S, Kume S, Chin-Kanasaki M, Osawa N, Morino K . Impact of obesity on annual medical expenditures and diabetes care in Japanese patients with type 2 diabetes mellitus. J Diabetes Investig. 2017; 9(4):776-781. PMC: 6031508. DOI: 10.1111/jdi.12766. View

15.

Nakamura K, Okamura T, Kanda H, Hayakawa T, Murakami Y, Okayama A . Medical expenditure for diabetic patients: a 10-year follow-up study of National Health Insurance in Shiga, Japan. Public Health. 2008; 122(11):1226-8. DOI: 10.1016/j.puhe.2007.12.004. View

16.

Nakamura K, Okamura T, Kanda H, Hayakawa T, Okayama A, Ueshima H . Medical costs of obese Japanese: a 10-year follow-up study of National Health Insurance in Shiga, Japan. Eur J Public Health. 2007; 17(5):424-9. DOI: 10.1093/eurpub/ckl271. View

17.

Wang Y, McPherson K, Marsh T, Gortmaker S, Brown M . Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011; 378(9793):815-25. DOI: 10.1016/S0140-6736(11)60814-3. View

18.

Araki S, Haneda M, Koya D, Kondo K, Tanaka S, Arima H . Urinary Potassium Excretion and Renal and Cardiovascular Complications in Patients with Type 2 Diabetes and Normal Renal Function. Clin J Am Soc Nephrol. 2015; 10(12):2152-8. PMC: 4670758. DOI: 10.2215/CJN.00980115. View

19.

Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, Araki E . Report of the committee on the classification and diagnostic criteria of diabetes mellitus. J Diabetes Investig. 2014; 1(5):212-28. PMC: 4020724. DOI: 10.1111/j.2040-1124.2010.00074.x. View

20.

Zhang P, Zhang X, Brown J, Vistisen D, Sicree R, Shaw J . Global healthcare expenditure on diabetes for 2010 and 2030. Diabetes Res Clin Pract. 2010; 87(3):293-301. DOI: 10.1016/j.diabres.2010.01.026. View