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In a remarkable achievement, Denmark has significantly improved diabetes-related health outcomes over the past two decades, despite an aging population and an increase in comorbidities. A new study, published in Diabetes Care, reveals that Denmark’s type 2 diabetes population has grown substantially, yet the country has managed to reduce complications and treatment-related harms without a corresponding increase in medication costs.
The comprehensive study analyzed data from 461,805 individuals diagnosed with type 2 diabetes between 2002 and 2020. During this period, the diabetic population more than tripled, increasing from 113,105 to 306,962. Over the same timeframe, the median age of affected individuals also rose from 66 to 68 years, and the Charlson Comorbidity Index, which measures the burden of concurrent diseases, showed a notable increase, highlighting a population that is living longer with more health conditions.
Despite these demographic shifts, the study found promising results: mortality rates per 1000 person-years dropped by 28%, and there was a substantial 63% reduction in the risk of acute myocardial infarction, a common and severe complication of diabetes. These findings underscore the effectiveness of Denmark’s diabetes management strategies in improving patient outcomes despite a more complex health landscape.
While the number of medications redeemed per person slightly increased—particularly for statins and antihypertensives—the study pointed to a shift in treatment patterns. There was a notable move from older medications like sulfonylureas to newer and more effective glucose-lowering options, such as metformin. Additionally, improvements were observed in reducing adverse events like hypoglycemia, falls, and gastric bleeding.
However, the study also revealed an increase in hospitalizations for conditions related to volume depletion, ketoacidosis, infections, and electrolyte imbalances, reflecting the growing complexity of managing diabetes in an older, multi-comorbidity population.
Perhaps most notably, the report showed that, despite an overall rise in medication costs, the average cost per individual fell by 8%. This was due in part to the declining costs of certain diabetes drugs, highlighting a cost-effective approach to diabetes management.
The findings underscore Denmark’s success in improving diabetes outcomes and managing costs, even as its population ages and faces more health challenges. The study serves as a model for other nations looking to enhance diabetes care and outcomes, particularly in the face of an increasingly older and more complex patient base.
