{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:25:58Z","timestamp":1764739558570,"version":"3.46.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:00:00Z","timestamp":1764720000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"\n Background<\/jats:title>\n With the prevalence of Type 2 Diabetes (T2D) projected to increase, understanding its potential consequences on healthcare systems is crucial for adequately preparing society to address this growing challenge. In 2019, Malm\u00f6, Sweden\u2019s third-largest city, joined the Cities for Better Health global initiative to tackle the multifaceted challenges associated with T2D, including its significant economic burden on the healthcare system and the broader community. Understanding the economic burden of T2D on the healthcare system will facilitate optimisation of the initiatives undertaken by the programme. Therefore, this study aimed to estimate the costs associated with primary care, hospital care, and work absenteeism due to diabetes-related complications among people with T2D residing in Malm\u00f6.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In order to estimate the cost for the City of Malm\u00f6, we expanded a model (Andersson et\u00a0al., 2020) developed to estimate the cost of T2D on a national level, using retrospective data from 1997\u20132016. The costs were estimated by using NordDRG weights and national reference prices. Primary care costs for Region Sk\u00e5ne were added to the model. Data on healthcare utilisation, work absence, and socioeconomic factors were collected from Swedish national and regional registers. The method was expanded to include Malm\u00f6-specific adjustments for demographics, employment, and education, as well as regional primary care costs.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The prevalence of T2D in Malm\u00f6 was 5.4%, and diabetes complications were: diabetic retinopathy (49.9%), diabetic kidney disease (19.1%), angina pectoris (13.7%), ischaemic heart disease (10.9%), and myocardial infarction (10.5%). Total excess costs for T2D in primary care were \u20ac12.7 million. The lowest primary care excess costs were in the age group 16\u201334 and the highest in the age group 65\u201374. Estimated overall hospital-based costs for T2D were \u20ac38.8 million, and costs related to macrovascular and microvascular complications were \u20ac18.1 million and \u20ac16.4 million, respectively. Estimated total cost due to absence from work related to T2D complications was \u20ac15.4 million. The complication costs were higher for men, except for neuropathy.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These findings may support city-level healthcare planning and preventive interventions, as Malm\u00f6 is facing substantial costs both in monetary terms and in reduced quality of life. Younger persons increasingly develop diabetes complications, which needs to be considered when allocating resources for primary prevention, treatment of complications, and municipality costs within a near future.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fcdhc.2025.1611426","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:20:51Z","timestamp":1764739251000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the societal cost of type 2 diabetes in Malm\u00f6, Sweden: a register-based cost analysis"],"prefix":"10.3389","volume":"6","author":[{"given":"Magdalena","family":"Annersten Gershater","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Dozet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c5sa","family":"Ericsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Slobodan","family":"Zdravkovic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00618-8","article-title":"Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants","volume":"387","year":"2016","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14667","article-title":"The public economic burden of sub-optimal type-2 diabetes control on tax payors in Sweden: Looking beyond health costs","volume":"24","author":"Kotsopoulos","year":"2022","journal-title":"Diabetes Obes Metab"},{"key":"B3","article-title":"P\u00e5verkbara kostnader f\u00f6r typ 2-diabetes \u00e5r 2020 och \u00e5r 2030 i Sverige. Prognoser med IHE Cohort Model of type 2-diabetes [Modifiable costs of type 2 diabetes in Sweden in 2020 and 2030","volume-title":"Projections using the IHE cohort model of type 2 diabetes","author":"Steen Carlsson","year":"2015"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-020-05277-3","article-title":"Costs of diabetes complications: hospital-based care and absence from work for 392,200 people with T2D and matched control participants in Sweden","volume":"63","author":"Andersson","year":"2020","journal-title":"Diabetologia"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015240","article-title":"Study protocol for the Cities Changing Diabetes programme: a global mixed methods approach","volume":"7","author":"Napier","year":"2017","journal-title":"BMJ Open"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2024.06.005","article-title":"Diabetes type 2 prevalence is rising among young residents in Malm\u00f6, Sweden","volume":"18","author":"Gershater","year":"2024","journal-title":"Prim Care Diabetes"},{"key":"B7","unstructured":"The National Patient Register\n \n \n \n 2019"},{"key":"B8","volume-title":"The Health and Medical Services Act","year":"2017"},{"key":"B9","volume-title":"Statistics Metropolitan Malm\u00f6","year":"2021"},{"key":"B10","unstructured":"L\u00e4kemedelsregistret\n \n \n Swedish\n National Prescribed Drugs Register\n \n 2019"},{"key":"B11","doi-asserted-by":"publisher","first-page":"ckaf114","DOI":"10.1093\/eurpub\/ckaf114","article-title":"Increasing incidence of early-onset type 2 diabetes in Sweden 2006\u20132021","author":"Carlsson","year":"2025","journal-title":"Eur J Public Health"},{"key":"B12","article-title":"National guidelines in diabetes care","volume-title":"Support for governance and management","year":"2017"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2337\/dc09-1128","article-title":"Health care and productivity costs associated with diabetic patients with macrovascular comorbid conditions","volume":"32","author":"Fu","year":"2009","journal-title":"Diabetes Care"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-S002","article-title":"Standards of medical care in diabetes\u20142022","volume":"45","year":"2022","journal-title":"Diabetes Care"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2010.01200.x","article-title":"Impact of concurrent macrovascular co-morbidities on healthcare utilization in patients with type 2 diabetes in Europe: a matched study","volume":"12","author":"Fu","year":"2010","journal-title":"Diabetes Obes Metab"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.18553\/jmcp.2005.11.7.559","article-title":"Relationship of glycemic control to total diabetes-related costs for managed care health plan members with type 2 diabetes","volume":"11","author":"Shetty","year":"2005","journal-title":"J Manag Care Pharm"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.321.7258.405","article-title":"Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study","volume":"321","author":"Stratton","year":"2000","journal-title":"BMJ"},{"key":"B18","unstructured":"Region Sk\u00e5ne Certifiering av diabetesmottagning"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14376","article-title":"The burden of poor glycemic control in people with newly diagnosed type 2 diabetes in Sweden: A health economic modeling analysis based on nationwide data","volume":"23","author":"Hellgren","year":"2021","journal-title":"Diabetes Obes Metab"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fragi.2021.727380","article-title":"Estrogen receptor and vascular aging","volume":"2","author":"Davezac","year":"2021","journal-title":"Front Aging"},{"key":"B21","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1111\/j.1365-2648.2004.03348.x","article-title":"Beliefs about health and illness in men with diabetes mellitus of different origin living in Sweden","volume":"1","author":"Hjelm","year":"2005","journal-title":"J Advanced Nursing"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2022.04.007","article-title":"Sex and gender related differences in diabetic kidney disease","volume":"42","author":"Sridhar","year":"2022","journal-title":"Semin Nephrol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1007\/s00125-008-1226-2","article-title":"Complexity of factors related to outcome of neuropathic and neuroischaemic\/ischaemic diabetic foot ulcers: a cohort study","volume":"52","author":"Gershater","year":"2009","journal-title":"Diabetologia"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-6712.2010.00812.x","article-title":"Documentation of diabetes in home nursing service in a Swedish municipality","volume":"25","author":"Gershater","year":"2011","journal-title":"Scandinavian J Caring Sci"}],"container-title":["Frontiers in Clinical Diabetes and Healthcare"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2025.1611426\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T05:20:52Z","timestamp":1764739252000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2025.1611426\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,3]]},"references-count":24,"alternative-id":["10.3389\/fcdhc.2025.1611426"],"URL":"https:\/\/doi.org\/10.3389\/fcdhc.2025.1611426","relation":{},"ISSN":["2673-6616"],"issn-type":[{"value":"2673-6616","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,3]]},"article-number":"1611426"}}