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Nov 25, 2015 (publication date) through Oct 25, 2025
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Publication Name
World Journal of Diabetes
ISSN
1948-9358
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Basic Study
Copyright ©The Author(s) 2015.
World J Diabetes. Nov 25, 2015; 6(16): 1312-1322
Published online Nov 25, 2015. doi: 10.4239/wjd.v6.i16.1312
Table 1 Care parameters for basic treatment of uncomplicated diabetes and for the treatment of chronic and acute complications
Medical conditionsCare componentGuidelines
Uncomplicated diabetes
Consultation of diabetes specialist or a general practitioner4/yr
Fasting glucose test4/yr
Urine glucose test6/yr
Glycated hemoglobin2/yr
Proteinuria test1/yr
Blood lipid test TG, HDL-cholesterol, LDL-cholesterol1/yr
Electrocardiogram1/yr
Chest X-ray1/yr
Ophthalmology consult1/yr
Oral hypoglycemic agents
Glibenclamide 5 mg OR in combination with metformin3 tablets/d
Metformin® 500 mg3 tablets/d
Glucophage® 850 mg OR in combination with Amarel®3 tablets/d
Amarel® 4 mg1 tablet/d
For insulin users
Syringes1/wk (min)-1/d (max)
Insulin30 UI (min) et 60 UI (max)/d
Strips for blood glucose control1 strip/d (min)
3 strips/d (max)
Glucometer1 (Duration: 2 yr)
Chronic complications
Proliferative retinopathy
Consultation in ophthalmology3/yr
Retinography1/yr
Laser photocoagulation1/yr
Overt nephropathy
Consultation in nephrology2/yr
Blood creatinine test2/yr
Serum protein test2/yr
Serum electrolytes test (sodium, potassium)2/yr
Urinary electrolytes test (sodium, potassium)2/yr
Urine creatinine test2/yr
Proteinuria2/yr
Hemogram2/yr
Urine bacteriology4/yr
Urine culture (ECBU)1/yr
Antiplatelet drugs
Aspirin® 100 mg OR1 tablet/d
Plavix® 75 mg1 tablet/d
Antihypertensive (ARA2)
Valsartan® 80 mg1 tablet/d
Diuretics:
Laxilix® 40 mg OR3 tablets/d
Laxilix® special 500 mgHalf tablet/d
Calcium carbonate (added to antiplatelet therapy, maximum cost)2 tablets/d
Statin (added to antiplatelet therapy, maximum cost)1 tablet/d
Renal failure
Dialysis2 session/wk
Potex® 4000 UI (EPO)50 UI/kg weight (max)
2 sessions/wk
Calcium carbonate 500 mg1.5 g or 3 tablets/d (max)
Ischemic heart disease
Consultation in cardiology2/an
Antiplatelet drugsSee under nephropathy
Statins
Simvastatin (Zocor®) OR1 tablet/d
Atorvastatin (Tahor®)1 tablet/d
Exercise electrocardiogram testing1/yr
Echo doppler1/yr
Cardiac ultrasound1/yr
Coronarography1/yr
Hypertension
Consultation in cardiology1/yr
Antihypertensive drugs (ACEI)
Captopril® 25 mg OU3 tablets/d
Ramipril® 5 mg1 tablet/d
DiureticsSee under nephropathy
Aggregation inhibitorsSee under nephropathy
Semi quantitative urine protein test2/yr
Blood creatinine test2/yr
Proteinemia2/yr
Blood electrolytes test (Na, K, Ca)2/an
Stroke (chronic phase)
Consultation in cardiology2/yr
Antiplatelet drugsSee under nephropathy
Diabetic foot
Consultation in podiatry1/yr
Arteriography of the lower limbs1/yr
Physiotherapy sessions10-20 sessions/yr
Echo doppler1/yr
StatinsSee under ischemic heart disease
Antiplatelet drugs1 tablet/d
Orthopedic shoes2 pairs/yr
Acute complications
Ketoacidosis
Hospitalization7 d
Blood glucose testDone once during hospitalization
Glycated hemoglobinDone once during hospitalization
HemogramDone once during hospitalization
Blood lipids testDone once during hospitalization
Blood electrolytes test (Na, K)Done once during hospitalization
Blood creatinine testDone once during hospitalization
Blood urea testDone once during hospitalization
ElectrocardiogramDone once during hospitalization
Chest X- rayDone once during hospitalization
Echo dopplerDone once during hospitalization
Keto-Diastix® box of 50 strips (blood biology)3 times/d for 3 d
Perfusion3 d
Diabetic foot (acute)
Hospitalization90 d
Antibiotics
Oxaciline® 500 mg4 tablets/d
3 wk of treatment without bone involvement (min); 10 wk when bone involved (max)
Vasodilator: Vastarel® 35 mg2 tablets/d, 22 wk
BiopsyDone once during hospitalization
AntibiogramDone once during hospitalization
Bone radiographyDone once during hospitalization
Vascular ultrasoundDone once during hospitalization
Dressings1/wk, 22 wk
Foot surgery
Minor surgery (56%)
Major surgery, amputation (44%)
Prosthesis
End stage renal disease
Hospitalization30 d
UltrasoundDone once during hospitalization
Electrolytes blood test (Na, K)Done once during hospitalization
Creatinine blood testDone once during hospitalization
ProteinemiaDone once during hospitalization
Stroke
Hospitalization18 d
Vasodilatator: Vastarel® 35 mg2 tablets/d, 18 d
Anticoagulants1 tablet/d, 18 d
Rehabilitation/physical therapy18 d
TG: Triglycerides; HDL-cholesterol: High density lipoprotein cholesterol; LDL-cholesterol: Low density lipoprotein cholesterol; ARA2: Angiotensin receptor blocker; ACEI: Angiotensin converting enzyme inhibitors; EPO: Erythropoietin.
Full Size Table
Table 2 Medical costs per individual per year for uncomplicated diabetes and for complications (in United States dollars) in the four countries
Medical conditionBénin
Burkina Faso
Guinea
Mali
Public sector
Private sector
Public sector
Private sector
Public sector
Private sector
Public sector
Private sector
MinMaxMinMaxMinMaxMinMaxMinMaxMinMaxMinMaxMinMax
Uncomplicated diabetes2125423108282244513638591264224371093137335390869
Chronic complications - Basic medical cost for uncomplicated diabetes plus additional annual cost for single complication
Retinopathy32068642198730653246598418748851112431773745241002
Stroke233576672136024146916442155135432126719371473456871850
Nephropathy850192016143198783129925783412808157823664256491180815164069
Hypertension34575112562065377605207425903676671784265529355612122408
Ischemic heart disease5351297105021884967851943257731361214842553441132410022881
Diabetic foot69415331103238692313372447429452787717173393484142410433172
Acute complications - Basic annual medical cost for uncomplicated diabetes plus additional cost per episode of acute complication
Keto acidosis40680257612973876651036193622253172617582434636061391
Infected diabetic foot requiring hospitalization7281539102038607291702688612043667112928976679698134017095802
Stroke (acute phase)637111783419355761064231641475109331427331545570510032266
Full Size Table
Table 3 Diabetes medical costs and national income in the study countries (United States dollars)
CountriesMaliBeninBurkina FasoGuinea
GNI per capita (2013)670790670460
% of population with < $2/d (= $730/yr)78.774.372.672.7
Uncomplicated diabetes
Minimum cost137.21211.63224.42125.58
Maximum cost868.60827.91859.301093.02
% of GNI (% of poverty threshold1)
Minimum20.5 (18.7)26.8 (28.9)33.5 (30.7)27.3 (17.2)
Maximum129.6 (118.9)104.8 (113.4)128.3 (117.6)237.6 (149.7)
Diabetes + retinopathy
Minimum cost176.74320.93305.81187.21
Maximum cost1002.33987.21983.841243.02
% of GNI (% of poverty threshold)
Minimum26.4 (24.2)40.6 (43.9)45.6 (41.9)46.8 (25.6)
Maximum149.6 (137.3)125.0 (135.2)141.6 (134.7)270.2 (170.3)
Diabetes + nephropathy
Minimum cost490.70850.00782.56808.14
Maximum cost4068.603197.673411.634256.98
% of GNI (% of poverty threshold)
Minimum73.2 (67.2)107.6 (116.4)116.8 (107.2)175.7 (110.7)
Maximum607.3 (557.3)404.8 (438.0)509.2 (467.3)925.4 (583.1)
1Threshold of 2 dollars/d ($ 730/year) as set by the World Bank. GNI: Gross national income.
Full Size Table
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