Pregestational Diabetes Care Yields Significant Savings

Providing preconception care for pregestational diabetes mellitus in women of reproductive age could potentially save up to $5.5 billion in health expenditures.

Providing preconception care (PCC) for pregestational diabetes mellitus (PGDM) in women of reproductive age could potentially save up to $5.5 billion in health expenditures, according to research findings published in the American Journal of Obstetrics & Gynecology.

Researchers from the US Centers for Disease Control and Prevention (CDC) estimated the health care cost savings that PCC for women aged 15 to 44 years with diagnosed or undiagnosed PGDM could generate by helping to avoid adverse birth outcomes, though they did not estimate maternal outcomes and associated costs.

According to the authors, approximately 2.2% of US births are to women with PGDM, among whom universal PCC might prevent 8397 preterm deliveries, 3725 birth defects, and 1872 perinatal deaths annually. In 2012 dollars, that amounts to about $4.3 billion in lifetime costs averted for the affected children of women with PGDM. Another $1.2 billion could potentially be saved by providing PCC to women with undiagnosed PGDM, which would bring the estimated total health care cost savings to $5.5 billion.

“We estimated thousands of adverse birth outcomes might be prevented each year among US women with PGDM through universal PCC at an estimated lifetime societal cost savings of up to $5.5 billion, including nearly $1 billion in direct medical costs,” said lead investigator Cora Peterson, PhD, of the CDC's National Center for Injury Prevention and Control, in a press release. “Our results suggest a substantial health and cost burden associated with PGDM that could be prevented by universal PCC, which might offset the cost of providing such care.”

However, the researchers’ data did not take into account the cost of obtaining or maintaining affordable PCC.

“Our estimates indicate the potential economic benefit of PCC if it were to be fully utilized by eligible women,” Dr. Peterson continued. “It is possible that lack of insurance coverage might disproportionately affect women with both unintended pregnancies and undiagnosed PGDM, creating a substantial cost barrier to PCC for such women.”

While previous studies have demonstrated a link between PGDM and preterm deliveries, birth defects, and perinatal deaths, the current research suggested that access to PCC could also reduce the frequency of those adverse outcomes by improving glucose levels before and during the early stages of pregnancy.