Table 7 Economic Costs of Diabetes Mellitus Parameter Estimates, analysis of covariance of factors affecting costs. Std. Error P-value Al-Maskari et al. BMC Public Health 2010, 10:679 http://www.biomedcentral.com/1471-2458/10/679 Parameter Intercept History of Heart attack Foot/leg ulcer Age (years) Disease duration (years) Number of annual visits to DM clinic Dyslipidemia Use of insulin DM retinopathy Mode of diagnosis Value None 1-2 3-6 7-11 12+ (ref) Yes No DK (ref) Yes NO DK (ref) Incidental Screening Symptomatic(ref) B 8.089 .720 .388 .012 .024 -1.137 -1.042 -.565 -.137 0(a) .842 .423 0(a) .752 -.494 -.660 0(a) .578 -.151 0(a) .549 .147 .140 .006 .011 .308 .259 .220 .224 . .293 .300 . .155 .349 .353 . .214 .161 . t 14.744 4.905 2.765 2.117 2.174 -3.687 -4.028 -2.572 -.611 . 2.873 1.411 . 4.840 -1.414 -1.871 . 2.700 -.935 . Page 9 of 10 .000 .000 .007 .036 .031 .000 .000 .011 .542 . .005 .161 . .000 .160 .064 . .008 .351 . Dependent Variable: (natural) logarithm of cost. a This parameter is set to zero because it is redundant. together suggest that 80% of the annual intangible losses related to DM and its complications are incurred in developing countries [23]. A major limiting factor of our study is that it did not correct for costs that would have been incurred in the absence of DM. For example, some vascular complica- tions and costs incurred by them may have occurred in the absence of DM. This may have led to some overesti- mation of costs. By contrast, DM may have aggravated conditions not considered in this study (e.g. hospitaliza- tion duration after accidents) which may have led to some underestimation of costs. However, by sampling from patients attending clinics, we may have over- sampled frequent attendees. Although we tried to com- pensate for this using appropriate statistical technique such as re-weighting, we cannot be absolutely sure that this yields exactly the same results as a truly random sample. Thus, our estimates should be treated with caution. Conclusions In view of the present high prevalence of DM in the UAE, and the potential costs associated with its manage- ment, investments in prevention are expected to be profitable and worthy. Likewise, the control of the con- comitant risk factors for vascular complications, such as obesity, dislipidemia, and hypertension are key elements to reduce progression to these complications, and there- fore, reduce the potential management costs associated with them. However, the high prevalence of incidental diagnosis among UAE patients, the primary source for the high DM treatment costs, suggest that diabetes may be under-diagnosed in the UAE population and tend to remain unrecognized until major complications occur. This suggests that the onset of the disease could be sub- stantially reduced, and therefore the potential costs associated with it, if the high risk population is screened for DM on regular basis. However, to offset the poten- tial costs of screening it may be worthy looking for other risk factors as well, such as obesity, hypertension or vascular diseases to help reducing their incidence, and therefore further reducing the overall burden of chronic diseases in the UAE. List of abbreviations ADA: American Diabetes Association; DM: Diabetes Mellitus; ER: Emergency Room; EUR: EURO; GCC: Gulf Countries Citizens; IDF: International Diabetes Federation; PHCC: Primary Health Care Clinic; UAE: United Arab Emirates; $: US dollars Acknowledgements This work was supported financially by the Research Affairs at the United Arab Emirates University under contract number: 01-14-8-11-0. Our special thanks are extended to the staff, doctors and nurses working in Al-Ain and Tawam hospitals where the surveys were conducted, for their invaluable support, effort and contribution in implementing this project. Our special