Abs, R

Bengtsson, B-Å

Feldt-Rasmussen, U

Hernberg-Ståhl, E

Monson, JP

Wilton, P

Wüster, C

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370 Abstracts
ED3
DEALING WITH CO-MORBIDITY AND RARE 
COMPLICATIONS IN A DIABETES TYPE 2 COST 
OF ILLNESS STUDY
Spannheimer A1, Goertz A2, Reitberger U1, Neiss A3, Liebl A4
1Kendle GmbH & Co. GMI KG, Munich, Germany; 2SmithKline 
Beecham Pharma, Munich, Germany; 3Institute for Medical 
Statistics and Epidemiology at the Technical University, Munich, 
Germany; 4Diabetes Center Bogenhausen, Munich, Germany
OBJECTIVES: There is a general lack of data on the prev-
alence of diabetic complications, especially on co-mor-
bidity. As part of a pan-European cost of illness study
(CODE-2: Cost of Diabetes in Europe, Type 2) an epide-
miological cross-sectional study has been conducted with
practitioners in Germany prior to the main study in order
to investigate the frequency of major complications (car-
diovascular, cerebrovascular, nephrological, neuropathy,
ophthalmological).
METHODS: A representative random sample of 138 phy-
sicians (GPs and specialists) documented the age and com-
plications of 2701 randomly selected type II2 diabetic pa-
tients on the basis of medical files. Different complication
schemes were grouped in five strata out of which 809 pa-
tients were randomly selected for a more detailed evalua-
tion. Rare complications were over-represented and for es-
timation of event rates weighted by the prevalence data
derived from the pre-study.
RESULTS: Absence of complications was found in 48.5%
of the patients. Co-morbidity appeared in the majority of
patients with complications (44%–89%, depending on the
main complication). Overall incidence in the diabetes popu-
lation was estimated to be 0.78% for myocardial infarction,
1.28% for stroke and 0.80% for amputations. Prevalence
of blindness accounted for 1.34%. Due to the sampling
strategy even rare complications like dialysis were suffi-
ciently reported (three times the number expected in an un-
stratified random sample) to estimate an overall prevalence
of 0.62%.
CONCLUSIONS: The study provides for the first time
precise data on co-morbidity. The extrapolated event rates
in diabetic patients showed a strong correspondence with
published data where available. This method proved to be
very effective for the extrapolation of epidemiological data
by avoiding double counting. The method is also useful for
improving quality of estimations in rare subgroups. In ad-
dition, it builds a reliable and precise basis for the estima-
tion of cost on a population level.
ED4
QUALITY OF LIFE AND USE OF HEALTHCARE 
RESOURCES IN GROWTH HORMONE-
DEFICIENT ADULTS AFTER GROWTH 
HORMONE REPLACEMENT THERAPY
Hernberg-Ståhl E1, Abs R2, Bengtsson B-Å3,
Feldt-Rasmussen U4, Monson JP5, Wilton P1, Wüster C6
1Pharmacia & Upjohn, Stockholm, Sweden; 2University Hospital 
Antwerp, Egedem, Belgium; 3Sahlgrenska University Hospital, 
Göteborg, Sweden; 4Rigshospitalet, Copenhagen, Denmark; 
5St. Bartholomew’s Hospital, London, UK; 6University Hospital, 
Heidelberg, Germany
OBJECTIVES: Healthcare and indirect costs have been
shown to be higher in hypopituitary adults with untreated
growth hormone deficiency (GHD) than in the general pop-
ulation. The present study assessed the effect of growth hor-
mone (GH) replacement therapy, in terms of quality of life
(QoL) and use of healthcare resources, in GH-deficient pa-
tients included in KIMS (Pharmacia & Upjohn Interna-
tional Metabolic Database), which is a pharmacoepidemio-
logical survey of adult patients with GHD.
METHODS: The number of visits to the doctor, number
of days in hospital, amount of sick-leave, physical activ-
ity during leisure time and assistance required with nor-
mal daily activities were recorded at entry into KIMS and
after 12 months of GH replacement.
RESULTS: Data were available from 2260 patients at
baseline and from 1019 patients at 12 months. For the
total group, there were significant (p  0.001) decreases
over 12 months in mean number of visits to the doctor
(from 2.7 to 1.6) and mean number of days of sick-leave
(from 6.5 to 3.5) The mean number of hospital days de-
creased from 0.92 to 0.59 (p  0.12). Patients also re-
ported significantly (p  0.001) increased leisure-time
physical activity. Naïve patients (not previously treated
with GH) reported significantly (p  0.001) greater im-
provements in physical activity over 12 months than non-
naïve patients. Naïve patients needed significantly more
assistance with normal daily activities than non-naïve pa-
tients at baseline (22% vs 15%; p  0.001), but not after
12 months (16% vs 14%). Significantly (p  0.001)
more women required assistance in daily activities than
men, both at baseline (28% vs 10%) and after 12 months
(23% vs 7%).
CONCLUSIONS: GH replacement significantly reduces
the use of healthcare resources and improves QoL in
adults with GHD.


ED4: QUALITY OF LIFE AND USE OF HEALTHCARE RESOURCES IN GROWTH HORMONE-DEFICIENT ADULTS AFTER GROWTH HORMONE REPLACEMENT THERAPY 

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ED4: QUALITY OF LIFE AND USE OF HEALTHCARE RESOURCES IN GROWTH HORMONE-DEFICIENT ADULTS AFTER GROWTH HORMONE REPLACEMENT THERAPY

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