Healthcare utilization and costs in diabetes relative to the clinical spectrum of painful diabetic peripheral neuropathy

J Diabetes Complications. 2015 Mar;29(2):212-7. doi: 10.1016/j.jdiacomp.2014.10.013. Epub 2014 Nov 8.


Aims: Diabetic peripheral neuropathy (DPN) accompanied by painful symptoms is known as painful DPN (pDPN). This study characterized healthcare resource utilization and costs in patients with DPN, pDPN, and severe pDPN relative to diabetes only.

Methods: Four adult cohorts were identified from the Humedica database: type 2 diabetes without DPN (n=288,328); DPN (n=35,050); pDPN (DPN subjects with a pain score ≥1 on a 0-10 numeric rating scale; n=3449); and severe pDPN (pain scores 7-10; n=1824). Resource utilization and costs for 12-months post-diagnosis were compared for diabetes relative to the other cohorts.

Results: Demographic characteristics were different across cohorts. Relative to diabetes alone, DPN, pDPN, and severe pDPN were characterized by significantly higher proportions of patients with resource utilization for all resource categories (all P<0.0001); the highest resource use generally observed for severe pDPN. Total annual direct medical costs were $6632 for diabetes only, with costs for DPN ($12,492), pDPN ($27,931), and severe pDPN ($30,755) significantly higher (all P<0.0001); outpatient costs were consistently the primary driver of total costs.

Conclusions: Patients with DPN, pDPN, and severe pDPN had significantly greater healthcare resource utilization and costs than patients with diabetes only, with the highest burden associated with severe pDPN.

Keywords: Costs; Diabetes; Electronic medical records; Healthcare utilization; Pain severity; Painful diabetic peripheral neuropathy.

Publication types

  • Comparative Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Combined Modality Therapy / economics
  • Cost of Illness
  • Costs and Cost Analysis
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / therapy
  • Diabetic Neuropathies / drug therapy
  • Diabetic Neuropathies / economics
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / therapy*
  • Electronic Health Records
  • Female
  • Health Care Costs
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Pain Measurement
  • Patient Acceptance of Health Care*
  • Retrospective Studies
  • Severity of Illness Index
  • United States
  • Young Adult