6,778 3,995 8,055 3,538 5,213 5,144 4,319 4,077 6,117 16,923 3,576 7,139 3,004 4,598 6,191 9,783 Page 5 of 10 6,651 4,941 7,276 3,811 6,021 6,015 5,978 5,007 6,315 0 5,382 6,059 3,946 5,231 6,605 6,573 Al-Maskari et al. BMC Public Health 2010, 10:679 http://www.biomedcentral.com/1471-2458/10/679 Patient Clinical Characteristics Type of DM Mode of Diagnosis Family History of DM Current health care provider Duration of DM insulin treated non insulin treated Incidental Screening Symptomatic Present Absent Primary Health Clinic Hospital Diabetes specialist Hospital ER Private clinic Other health care provider <=5 yrs 6 - 10 yrs 11 - 20 yrs >=21 yrs N 55 94 36 26 88 97 52 43 70 1 34 2 40 40 60 9 % (95% C.I) 43% (35.1-50.9) 57% (49.1-64.9) 13% (7.6-18.4) 23% (16.3-29.7) 63% (55.3-70.7) 65.1% (57.4-72.8) 34.8% (27.2-42.4) 28.6% (21.3-35.9) 46.6% (38.6-54.6) 0.6% (-0.6-1.8) 22.6% (15.9-29.3) 1(-0.5-2.5) 26% (19.2-33.2) 26% (19.2-33.2) 40% (31.8-47.4) 8% (3.7-12.5) Table 2 Average Annual DM Treatment Costs in US $ by Patient Clinical Characteristics and Health Care Provider in the UAE during 2004 (N = 150) Mean $ Annual Cost Std Deviation and 40% had retinal imaging during the preceding year. Of the total sample 17% had a history of laser treatment for retinopathy and 21% had (ever) undergone cataract extraction. Thirty-four percent had diabetic nephropa- thy, out of which 14% experienced chronic renal failure. Of those who had renal failure, 71% were on haemodia- lysis and 29% had undergone kidney transplantation (Table 4). The assessment of the overall health status showed that 61% reported to have suffered poor health during the past month (before the survey) while 39% reported to have good health status (Table 4). 4. Direct Treatment Costs of Diabetes Mellitus Table (1) shows the unit management costs of diabetes by various patient characteristics; male treatment costs were higher, compared to females (mean $5,470 vs. $4,646) and treatment costs were also higher among patients from neighbouring Gulf Council countries (GCC) (Table 1). The annual mean treatment cost of a GCC patient amounted to $7,025 compared to $5,645 per UAE patient or $4,304 per Asian patient. DM treat- ment costs among patients also increased with increas- ing age (Table 1). Young patients, aged 20-39 years, had the lowest annual mean treatment cost viz. $2,610 com- pared to $6,175 for those aged 61 years and above (Table 1). Likewise, DM management costs increased with duration of disease. Those who had the disease for less than 5 years had a mean unit treatment cost of $3,004, compared to $9,783 for those who had DM for more than 20 years (Table 2). Management costs of DM also varied with the mode of diagnosis. Patients diagnosed incidentally had the highest annual mean cost amounting to$8,055 compared to only $3,585 for those diagnosed by screening, perhaps due to the medical conditions that prompted the inci- dental diagnosis (Table 2). The annual mean treatments cost for patients on diet control and without complications was US$ 1,605 (SD = ±$1,206) (Table 5). However, the presence of DM com- plications substantially increased the average patient treatment costs (Table 5). For example, the annual mean treatment cost of patients on insulin is US$ 7,086 (SD ± $ 6425) and for those with hypertension the annual mean cost was 6,210 (SD ± $6,132) (Table 5). Annual treatment costs of patients with microvascular complications were 2.2 times higher than the costs of those without complications (Table 6 & Figure 1). DM treatment costs of patients with macrovascular compli- cations were 6.4 times higher than those without com- plications and the costs of those with both micro and macrovascular complications were 9.4 times higher. Hospital costs constituted a large proportion of overall treatment costs (Table 6 & Figure 2). Estimates and associations were not substantially affected by weighting cases (inversely) by frequency of clinic attendance, suggesting that our sampling method did not introduce substantial bias. As many of the factors