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Impaired Fasting Glucose Linked to Higher Medical Costs

Researchers from Kaiser Permanente Northwest wanted to determine whether medical costs differed for patients who met the impaired fasting glucose cutoff point of 100 mg/dl that the American Diabetes Association (ADA) designated in 2003, versus the higher cutoff of 110 mg/dl used by ADA since 1997.

Analysis of records revealed 28,335 patients with two or more fasting plasma glucose (FPG) tests of at least 100 mg/dl during the 1994–2003 study period. Patients with evidence of diabetes were excluded from the study. Patients were categorized into two stages of abnormal glucose: stage 1 (100–109 mg/dl) and stage 2 (110–125 mg/dl). Each person was matched with a control subject—in terms of sex and age—with normal FPG results. All participants were followed until they either left the health plan or had an FPG result that bumped up the diagnosis, or until the study period ended December 31, 2003.

Patients with a normal FPG averaged $4,357 in medical costs per year, compared with $4,580 for those in stage 1 and $4,960 for those in stage 2. After researchers removed data for people who started out with a normal FPG and progressed to impaired glucose levels, average annual costs dropped to $3,799.

The results show that abnormal glucose metabolism is linked to higher medical costs, which researchers attribute to cardiovascular disease. The more stringent 2003 cutoff level for FPG identifies a group of patients with greater costs and comorbidities than people with normal FPG, but with lower costs and comorbidities than those who met the older definition of impaired glucose metabolism.

Nichols GA, Brown JB: Higher medical care costs accompany impaired fasting glucose. Diabetes Care 28: 2223–2229, 2005[Abstract/Free Full Text].

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