ArticlePloS one2017
Direct medical cost associated with diabetic retinopathy severity in type 2 diabetes in Singapore.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Fenofibrate for diabetic retinopathy.The Cochrane database of systematic reviews · 2023Pooled it
- Cost of Myopia Correction: A Systematic Review.Frontiers in medicine · 2021Pooled it
- Racial and microvascular determinants of progression to treatment-warranted diabetic eye disease.Eye (London, England) · 2026Article
- Quantifying the direct costs of diabetic retinopathy in a mixed healthcare system: a hospital-based study from governmental and patient perspectives.Cost effectiveness and resource allocation : C/E · 2026Article
- Association between endothelial activation and stress index and diabetic retinopathy in patients with diabetic kidney disease: a cross-sectional study based on NHANES database.BMC endocrine disorders · 2025Article
- Cost of diabetes mellitus and associated factors - an institutional cross-sectional study in Ghana.BMC health services research · 2025Article
- Albumin-to-neutrophil-lymphocyte ratio: a novel dual-pathway biomarker for diabetic retinopathy risk assessment.Frontiers in endocrinology · 2025Article
- Patient-Centered Economic Burden of Diabetic Macular Edema: Retrospective Cohort Study.JMIR public health and surveillance · 2024Article
- Real-World Research on Retinal Diseases Using Health Claims Database: A Narrative Review.Diagnostics (Basel, Switzerland) · 2024Review
- Impact of diabetes on healthcare utilization and expenditure among older adults in India.Journal of diabetes and metabolic disorders · 2024Article
- The Economic Burden of Diabetic Retinopathy in Jordan: Cost Analysis and Associated Factors.ClinicoEconomics and outcomes research : CEOR · 2024Article
- Estimating the costs of blindness and moderate to severe visual impairment among people with diabetes in India.BMJ open · 2023Article
- Factors protecting against diabetic retinopathy in a geriatric Indian cohort.Indian journal of ophthalmology · 2021Observational
- Updates on the Current Treatments for Diabetic Retinopathy and Possibility of Future Oral Therapy.Journal of clinical medicine · 2021Review
- The economic burden of diabetic retinopathy care at a tertiary eye care center in South India.Indian journal of ophthalmology · 2021Observational
- Direct Medical Expenditures Associated with Eye Complications among Adults with Diabetes in the United States.Journal of diabetes research · 2020Article
- Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients.Frontiers in pharmacology · 2020Article
- Article
- Neurodegeneration in diabetic retinopathy: does it really matter?Diabetologia · 2018Review
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Diabetic retinopathy (DR) is a leading cause of vision-loss globally among type 2 diabetes (T2DM) patients. Information on the economic burden of DR in Singapore is limited. We aim to identify the total annual direct medical costs of DR at different stages, and to examine factors influencing the costs. Four hundreds and seventy T2DM patients who attended the Diabetes Centre in a secondary hospital in Singapore in 2011-2014 were included. Digital color fundus photographs were assessed for DR in a masked fashion. Retinopathy severity was further categorized into non-proliferative DR (NPDR), including mild, moderate and severe NPDR, and proliferative DR (PDR). Medical costs were assessed using hospital administrative data. DR was diagnosed in 172 (39.5%) patients, including 51 mild, 62 moderate and 18 severe NPDR, and 41 PDR. The median cost in DR [2012.0 (1111.2-4192.3)] was significantly higher than that in non-DR patients [1158.1 (724.1-1838.9)] (p<0.001). The corresponding costs for mild, moderate, severe NPDR and PDR were [1167.1 (895.4-2012.0)], [2212.0 (1215.5-3825.5)], [2717.5 (1444.0-6310.7)], and [3594.8.1 (1978.4-8427.7)], respectively. After adjustment, the corresponding cost ratios for mild, moderate, severe NPDR, and PDR relative to non-DR were 1.1 (p = 0.827), 1.8 (p = 0.003), 2.0 (p = 0.031) and 2.3 (p<0.001), respectively. The other factors affecting the total cost include smoking (ratio = 1.7, p = 0.019), neuropathy (ratio = 1.9, p = 0.001) and chronic kidney disease (CKD) (ratio = 1.4, p = 0.019). The presence and severity of DR was associated with increased direct medical costs in T2DM. Our results suggest that preventing progression of DR may reduce the economic burden of DR.
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