Cost of illness of adult diabetes mellitus underestimated if comorbidity is not considered

Objective. To determine costs of illness for adult diabetes mellitus (DM), including complications caused by DM. Design. A population-based multicentre cross-sectional study including an i nterview and a physical examination of patients identified as having DM. Th e patients' medical records were analysed regarding diagnoses and complicat ions attributable to DM. Setting. Eight health care centres of six primary care districts in Souther n Sweden. Subjects, 1677 adults aged 25+, cared for at the health care centres, enter ed the study. Main outcome measures. Utilization of health care and care from relatives a nd the municipality, absence of short- and long-term sickness, cost of illn ess. Results. The average annual direct and indirect costs for an adult with DM were calculated to be 61 700 Swedish Kronor (SEK) or 2.5 times higher than earlier estimates. The incremental cost of DM was 34 100 SEK. The cost dist ribution was 28%, for health care, 31%, for the municipality and relatives and 41%, lost productivity. Conclusions. Calculations for the cost of illness of DM are underestimated if comorbidity caused by DM is not considered. When DM-related complication s are included to identify the actual burden of disease to society, the cos t of illness as a result of DM in Sweden is substantially higher than previ ously estimated.