2005 Volume 48 Issue 12 Pages 841-847
We studied resources and candidates for the primary prevention of type 2 diabetes based on medical expenditure calculated by health insurance medical care claims and annual health-checkup results among employee at an electronics company. Men aged 40-60 years-old with fasting plasma glucose levels (FPG) exceeding 100 mg/dl in 1992 were more prone to be diabetic within 8 years of observation than subjects with FPG less than 90 mg/dl, and these subjects had higher medical expenditures in fiscal 1999 and 2000 (April 1999 to March 2001). Of 1242 subjects with FPG between 100 and 125 mg/dl in 1992, 21% showed a diabetic range of FPG, exceeding 126 mg/dl in 1996 or 1997. Medical expenditures calculated from claims in these subjects in 1999 and 2000 fiscal years was 410±58 (mean±SE, x 1,000 Japanese yen in two years), which was 100,000 JPY higher than those in subjects with FPG remaining similar or improved. When 25% effective intervention for the primary prevention of diabetes is supposed to be introduced to these high-risk subjects, medical expenditures in the group may decrease for 3,000 JPY per person per year if the medical expenditures in subjects who are prevented from becoming diabetic are similar to those in subjects with FPG remaining unchanged. In low-risk subjects with FPG less than 100 mg/dl, the expected reduction is 440 JPY. Primary prevention should be cost-effective in reducing short-term direct medical expenditures in newly diagnosed type 2 diabetic subjects detected in annual health checkups.
