Economic Evaluations of Strategies for Preventing Renal Disease in Non-Insulin Dependent Diabetes Mellitus

  • Diane L. Manninen
  • Erik J. Dasbach
  • Frederick B. Dong
  • Ronald E. Aubert
  • Steven M. Teutsch
  • William H. Herman

Abstract

Recent clinical trials such as the Stockholm Diabetes Intervention Study (SDIS) and the Diabetes Control and Complications Trial (DCCT) have demonstrated that intensive glycaemic control can slow the development and delay the progression of renal disease in persons with insulin dependent diabetes mellitus (IDDM) [1–3]. In addition, clinical studies suggest that treatment of patients with microalbuminuria and clinical nephropathy with angiotensin-converting enzyme (ACE) inhibitors and other antihypertensive agents [4–12] or with a low protein diet [13–16] can slow progression to end-stage renal disease. However, the efficacy of such interventions in persons with non-insulin dependent diabetes mellitus (NIDDM) is less clear [17–20].

Keywords

Economic Evaluation Diabetic Nephropathy Health Care Financing NIDDM Patient Urinary Albumin Excretion Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Reichard P, Nilsson BY, Rosenqvist U. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med 1993; 329: 304–309.PubMedCrossRefGoogle Scholar
  2. 2.
    The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications of insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977–986.CrossRefGoogle Scholar
  3. 3.
    The Diabetes Control and Complications Trial Research Group. Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. Kidney Int 1995; 47: 1703–1720.CrossRefGoogle Scholar
  4. 4.
    Breyer FA, Hunsicker LG, Bain RP, Lewis EJ, Collaborative Study Group. Angiotensin converting enzyme inhibition in diabetic nephropathy. Kidney Int 1994; 45: S156–S160.Google Scholar
  5. 5.
    Kasiske BL, Kalil RSN, Ma JZ, Liao M, Keane WF. Effect of antihypertensive therapy on the kidney in patients with diabetes: A meta-regression analysis. Ann Intern Med 1993; 118: 129–138.PubMedCrossRefGoogle Scholar
  6. 6.
    Viberti GC, Mogensen CE, Groop L, Pauls JF for the European Microalbuminuria Captopril Study Group. Effect of captopril on progression to clinical proteinuria in patients with insulin-dependent diabetes mellitus and microalbuminuria. JAMA 1994; 271: 275–279.PubMedCrossRefGoogle Scholar
  7. 7.
    Lewis EJ, Hunsicker LG, Bain RP, Rhode RD. The effect of angiotensin-converting-enzyme inhibition on nephropathy. N Engl J Med 1993; 329: 1456–1462.PubMedCrossRefGoogle Scholar
  8. 8.
    Wiegman TB, Herron KG, Chonko AM, MacDougall ML, Moore WV. Effect of angiotensinconverting enzyme inhibition on renal function and albuminuria in normotensive type I diabetic patients. Diabetes 1992; 41: 62–67.CrossRefGoogle Scholar
  9. 9.
    Björck S, Mulec H, Johnsen SA, Norden G, Aurell M. Renal protective effect of enalapril in diabetic nephropathy. BMJ 1992; 304: 339–343.PubMedCrossRefGoogle Scholar
  10. 10.
    Mathiesen ER, Hommel E, Giese J, Parving HH. Efficacy of captopril in postponing nephropathy in normotensive insulin dependent patients with microalbuminuria. BMJ 1991; 303: 81–87.PubMedCrossRefGoogle Scholar
  11. 11.
    Mogensen CE. Long-term antihypertensive treatment inhibiting progression of diabetic nephropathy. BMJ 1982; 285: 685–688.PubMedCrossRefGoogle Scholar
  12. 12.
    Christensen CK, Mogensen CE. Antihypertensive treatment: long-term reversal of progression of albuminuria in incipient diabetic nephropathy. A longitudinal study of renal function. J Diabetic Compl 1987; 1:45–52.CrossRefGoogle Scholar
  13. 13.
    Zeller K, Whittaker E, Sullivan L, Raskin P, Jacobson HR. Effect of restricting dietary protein on the progression of renal failure in patients with insulin-dependent diabetes mellitus. N Engl J Med 1991; 324: 78–84.PubMedCrossRefGoogle Scholar
  14. 14.
    Jibani MM, Bloodworth LL, Foden E, Griffiths KD, Galpin OP. Predominantly vegetarian diet in patients with incipient and early clinical diabetic nephropathy: Effects on albumin excretion rate and nutritional status. Diabetic Med 1991; 8: 949–953.PubMedCrossRefGoogle Scholar
  15. 15.
    Evanoff GV, Thompson CS, Brown J, Weinman EJ. The effect of dietary protein restriction on the progression of diabetic nephropathy. Arch Intern Med 1987; 147: 492–495.PubMedCrossRefGoogle Scholar
  16. 16.
    Wiseman MJ, Bognetti E, Dodds R, Keen H, Viberti GC. Changes in renal function in response to protein restricted diet in type 1 (insulin-dependent) diabetic patients. Diabetologia 1987; 30: 154–159.PubMedCrossRefGoogle Scholar
  17. 17.
    Abraira C, Colwell JA, Nuttall FQ, Sawin CT, Nagel JN, Comstock JP, Emanuele NV, Levin SR, Henderson W, Lee HS, VA CSDM Group. Veterans Affairs Cooperative Study on glycemic control and complications in type II diabetes (VA CSDM). Diabetes Care 1995; 18: 1113–1123.PubMedCrossRefGoogle Scholar
  18. 18.
    Ohkubo Y, Kishikawa H, Araki E, Miyata T, Isami S, Motoyoshi S, Kojima Y, Furuyoshi N, Shichiri M. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract 1995; 28: 103–117.PubMedCrossRefGoogle Scholar
  19. 19.
    Nathan DM. Inferences and implications: Do results from the Diabetes Control and Complications Trial apply in NIDDM? Diabetes Care 1995; 18: 251–257.PubMedGoogle Scholar
  20. 20.
    Harris MI, Eastman RC, Siebert C. The DCCT and medical care for diabetes in the U.S. Diabetes Care 1994; 17: 761–764.PubMedGoogle Scholar
  21. 21.
    Drummond MF, Davies LM, Ferris FL III. Assessing the costs and benefits of medical research: the Diabetic Retinopathy Study. Soc Sci Med 1992; 34: 973–981.PubMedCrossRefGoogle Scholar
  22. 22.
    Detsky AS. Using economic analysis to determine the resource consequences of choices made in planning clinical trials. J Chron Dis 1985; 38: 733–765.CrossRefGoogle Scholar
  23. 23.
    Detsky AS. Are clinical trials a cost-effective investment? JAMA 1989; 262: 1795–1800.PubMedCrossRefGoogle Scholar
  24. 24.
    Weinstein MC. Cost-effective priorities for cancer prevention. Science 1983; 221: 17–23.PubMedCrossRefGoogle Scholar
  25. 25.
    Siegel JE, Krolewski AS, Warram JH, Weinstein MC. Cost-effectiveness of screening and early treatment of nephropathy in patients with insulin-dependent diabetes mellitus. J Am Soc Nephrol 1992; 3: S111–S119.PubMedGoogle Scholar
  26. 26.
    Borch-Johnsen K, Wenzel H, Viberti GC, Mogensen CE. Is screening and intervention for microalbuminuria worthwhile in patients with insulin-dependent diabetes? BMJ 1993; 306: 1722–1725.PubMedCrossRefGoogle Scholar
  27. 27.
    Tull ES, Roseman JM. »Diabetes in African Americans.« In Diabetes in America. National Diabetes Data Group, ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive Kidney Diseases, 1995; pp 613–630.Google Scholar
  28. 28.
    Stern MP, Mitchell BD. »Diabetes in Hispanic Americans.« In Diabetes in America. National Diabetes Data Group, ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive Kidney Diseases, 1995; pp 631–659.Google Scholar
  29. 29.
    Gohdes D. »Diabetes in North American Indians and Alaska Natives.« In Diabetes in America. National Diabetes Data Group, ed. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive Kidney Diseases, 1995; pp 683–701.Google Scholar
  30. 30.
    Cowie CC, Port FK, Wolfe RA, Savage PJ, Moll PP, Hawthorne VM. Disparities in incidence of diabetic end-stage renal disease according to race and type of diabetes. N Engl J Med 1989; 321: 1074–1079.PubMedCrossRefGoogle Scholar
  31. 31.
    Feldman HI, Klag MJ, Chiapella AP, Whelton PK. End-stage renal disease in US minority groups. Am J Kidney Dis 1992; 19: 397–410.PubMedGoogle Scholar
  32. 32.
    Brancati FL, Whittle JC, Whelton PK, Seidler AJ, Klag MJ. The excess incidence of diabetic end-stage renal disease among blacks. JAMA 1992; 268: 3079–3084.PubMedCrossRefGoogle Scholar
  33. 33.
    Newman JM, Marfin AA, Eggers PW, Helgerson SD. End state renal disease among Native Americans, 1983–1986. Am J Public Health 1990; 80: 318–319.PubMedCrossRefGoogle Scholar
  34. 34.
    Nelson RG, Newman JM, Knowler WC, Sievers ML, Kunzelman CL, Pettitt DJ, Moffett CD, Teutsch SM, Bennett PH. Incidence of end-stage renal disease in Type 2 (non-insulin-dependent) diabetes mellitus in Pima Indians. Diabetologia 1988; 31: 730–736.PubMedCrossRefGoogle Scholar
  35. 35.
    Haffner SM, Mitchell BD, Pugh JA, Stern MP, Kozlowski MK, Hazuda HP, Patterson JK, Klein R. Proteinuria in Mexican Americans and non-Hispanic whites with NIDDM. Diabetes Care 1989; 12: 530–536.PubMedCrossRefGoogle Scholar
  36. 36.
    Pugh JA, Stern MP, Haffner SM, Eifler CW, Zapata M. Excess incidence of treatment of end-stage renal disease in Mexican Americans. Am J Epidemiol 1988; 127: 135–144.PubMedGoogle Scholar
  37. 37.
    Harris MI, Klein R, Welborn TA, Knuiman MW. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care 1992; 15: 815–819.PubMedCrossRefGoogle Scholar
  38. 38.
    Ballard DJ, Humphrey LL, Melton LJ III, Frohnert PP, Chu CP, O’Fallon WM, Palumbo PJ. Epidemiology of persistent proteinuria in type II diabetes mellitus. Diabetes 1988; 37: 405–412.PubMedCrossRefGoogle Scholar
  39. 39.
    United States Renal Data System. USRDS 1995 Annual Data Report. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995.Google Scholar
  40. 40.
    Lawrence WF, Grist TM, Brazy PC, Fryback DG. Magnetic resonance angiopathy in progressive renal failure: a technology assessment. Am J Kidney Dis 1995; 25: 701–709.PubMedCrossRefGoogle Scholar
  41. 41.
    Health Care Financing Administration. Research Report: End Stage Renal Disease, 1992. HCFA Publ. No. 03359. Baltimore, MD: Health Care Financing Administration, 1994.Google Scholar
  42. 42.
    Health Care Financing Administration. List of Top 200 Procedure Codes Ranked by Allowed Charges from the Completed Year 1990. Baltimore, MD: Health Care Financing Administration, 1992.Google Scholar
  43. 43.
    Medicare Fee Schedule. Federal Register, November 25, 1992; 57: 55896-56230.Google Scholar
  44. 44.
    Loomes G, McKenzie L. The use of QALYs in health care decision making. Soc Sci Med 1989; 28: 299–308.PubMedCrossRefGoogle Scholar
  45. 45.
    Mehrez A, Gafni A. Quality adjusted life years utility theory and healthy years equivalent. Med Decis Making 1989; 9: 142–149.PubMedCrossRefGoogle Scholar
  46. 46.
    Sackett DL, Torrance GW. The utility of different health states as perceived by the general public. J Chron Dis 1978; 31: 697–704.PubMedCrossRefGoogle Scholar
  47. 47.
    Churchill DN, Torrance GW, Taylor W, Barnes CC, Ludwin D, Shimizu A, Smith EKM. Measurement of quality of life in end-stage renal disease: the time trade-off approach. Clin Invest Med 1987; 10: 14–20.PubMedGoogle Scholar
  48. 48.
    Canadian Erythropoietin Study Group. Association between recombinant human erythropoietin and quality of life and exercise capacity of patients receiving haemodialysis. BMJ 1990; 300: 573–578.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1996

Authors and Affiliations

  • Diane L. Manninen
    • 1
  • Erik J. Dasbach
    • 1
  • Frederick B. Dong
    • 1
  • Ronald E. Aubert
    • 1
  • Steven M. Teutsch
    • 1
  • William H. Herman
    • 1
  1. 1.Battelle, Centers for Public Health, Research and EvaluationSeattleUSA

Personalised recommendations