{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T08:35:26Z","timestamp":1782894926210,"version":"3.54.5"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes mellitus imposes a substantial economic burden on patients and healthcare systems, particularly in low- and middle-income countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate longitudinal changes in direct and indirect costs of diabetes care and identify predictors of cost reduction following an educational and empowerment-based intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective longitudinal controlled interventional study (quasi-experimental) was conducted over 24 months among adults with type 2 diabetes mellitus at a tertiary care hospital. Patient-level data on direct medical expenses, ancillary costs, and clinical parameters were analyzed using mixed-effects and regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A significant reduction in direct cost and ancillary fees, such as travel and parking, was observed from baseline to 24 months (p&amp;lt;0.001). Mixed-effects modeling confirmed significant temporal reductions in costs at each follow-up (\u03b2 = -3,117.05 at 24 months; 95% CI: -3,224.01 to \u22123,010.09). Furthermore, clusters of moderate, gradual, and high responders were identified. Multivariable regression showed that baseline cost (\u03b2 = 0.582, p&amp;lt;0.001) and HbA1c (\u03b2 = \u2212611.53, p &amp;lt; 0.001) as independent predictors of cost reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Education and empowerment lead to reductions in direct and indirect costs over two years, suggesting improved cost efficiency in diabetes mellitus management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcdhc.2026.1825788","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T06:45:55Z","timestamp":1782888355000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Economic impact of education and empowerment interventions in diabetes care: a two-year prospective longitudinal analysis in a tertiary care population"],"prefix":"10.3389","volume":"7","author":[{"given":"Supriya","family":"Raghav","sequence":"first","affiliation":[{"name":"Department of Public Health, School of Public Health, Poornima University","place":["Jaipur, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Public Health, Poornima University","place":["Jaipur, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Ashraf","sequence":"additional","affiliation":[{"name":"Rajiv Gandhi Center for Diabetes and Endocrinology, J.N. 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