Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa

Table 1 Care parameters for basic treatment of uncomplicated diabetes and for the treatment of chronic and acute complications

Medical conditions	Care component	Guidelines
Uncomplicated diabetes
	Consultation of diabetes specialist or a general practitioner	4/yr
	Fasting glucose test	4/yr
	Urine glucose test	6/yr
	Glycated hemoglobin	2/yr
	Proteinuria test	1/yr
	Blood lipid test TG, HDL-cholesterol, LDL-cholesterol	1/yr
	Electrocardiogram	1/yr
	Chest X-ray	1/yr
	Ophthalmology consult	1/yr
	Oral hypoglycemic agents
	Glibenclamide 5 mg OR in combination with metformin	3 tablets/d
	Metformin® 500 mg	3 tablets/d
	Glucophage® 850 mg OR in combination with Amarel®	3 tablets/d
	Amarel® 4 mg	1 tablet/d
	For insulin users
	Syringes	1/wk (min)-1/d (max)
	Insulin	30 UI (min) et 60 UI (max)/d
	Strips for blood glucose control	1 strip/d (min)
		3 strips/d (max)
	Glucometer	1 (Duration: 2 yr)
Chronic complications
Proliferative retinopathy
	Consultation in ophthalmology	3/yr
	Retinography	1/yr
	Laser photocoagulation	1/yr
Overt nephropathy
	Consultation in nephrology	2/yr
	Blood creatinine test	2/yr
	Serum protein test	2/yr
	Serum electrolytes test (sodium, potassium)	2/yr
	Urinary electrolytes test (sodium, potassium)	2/yr
	Urine creatinine test	2/yr
	Proteinuria	2/yr
	Hemogram	2/yr
	Urine bacteriology	4/yr
	Urine culture (ECBU)	1/yr
	Antiplatelet drugs
	Aspirin® 100 mg OR	1 tablet/d
	Plavix® 75 mg	1 tablet/d
	Antihypertensive (ARA2)
	Valsartan® 80 mg	1 tablet/d
	Diuretics:
	Laxilix® 40 mg OR	3 tablets/d
	Laxilix® special 500 mg	Half tablet/d
	Calcium carbonate (added to antiplatelet therapy, maximum cost)	2 tablets/d
	Statin (added to antiplatelet therapy, maximum cost)	1 tablet/d
Renal failure
	Dialysis	2 session/wk
	Potex® 4000 UI (EPO)	50 UI/kg weight (max)
		2 sessions/wk
	Calcium carbonate 500 mg	1.5 g or 3 tablets/d (max)
Ischemic heart disease
	Consultation in cardiology	2/an
	Antiplatelet drugs	See under nephropathy
	Statins
	Simvastatin (Zocor®) OR	1 tablet/d
	Atorvastatin (Tahor®)	1 tablet/d
	Exercise electrocardiogram testing	1/yr
	Echo doppler	1/yr
	Cardiac ultrasound	1/yr
	Coronarography	1/yr
Hypertension
	Consultation in cardiology	1/yr
	Antihypertensive drugs (ACEI)
	Captopril® 25 mg OU	3 tablets/d
	Ramipril® 5 mg	1 tablet/d
	Diuretics	See under nephropathy
	Aggregation inhibitors	See under nephropathy
	Semi quantitative urine protein test	2/yr
	Blood creatinine test	2/yr
	Proteinemia	2/yr
	Blood electrolytes test (Na, K, Ca)	2/an
	Stroke (chronic phase)
	Consultation in cardiology	2/yr
	Antiplatelet drugs	See under nephropathy
Diabetic foot
	Consultation in podiatry	1/yr
	Arteriography of the lower limbs	1/yr
	Physiotherapy sessions	10-20 sessions/yr
	Echo doppler	1/yr
	Statins	See under ischemic heart disease
	Antiplatelet drugs	1 tablet/d
	Orthopedic shoes	2 pairs/yr
Acute complications
Ketoacidosis
	Hospitalization	7 d
	Blood glucose test	Done once during hospitalization
	Glycated hemoglobin	Done once during hospitalization
	Hemogram	Done once during hospitalization
	Blood lipids test	Done once during hospitalization
	Blood electrolytes test (Na, K)	Done once during hospitalization
	Blood creatinine test	Done once during hospitalization
	Blood urea test	Done once during hospitalization
	Electrocardiogram	Done once during hospitalization
	Chest X- ray	Done once during hospitalization
	Echo doppler	Done once during hospitalization
	Keto-Diastix® box of 50 strips (blood biology)	3 times/d for 3 d
	Perfusion	3 d
Diabetic foot (acute)
	Hospitalization	90 d
	Antibiotics
	Oxaciline® 500 mg	4 tablets/d
		3 wk of treatment without bone involvement (min); 10 wk when bone involved (max)
	Vasodilator: Vastarel® 35 mg	2 tablets/d, 22 wk
	Biopsy	Done once during hospitalization
	Antibiogram	Done once during hospitalization
	Bone radiography	Done once during hospitalization
	Vascular ultrasound	Done once during hospitalization
	Dressings	1/wk, 22 wk
Foot surgery
	Minor surgery (56%)
	Major surgery, amputation (44%)
	Prosthesis
End stage renal disease
	Hospitalization	30 d
	Ultrasound	Done once during hospitalization
	Electrolytes blood test (Na, K)	Done once during hospitalization
	Creatinine blood test	Done once during hospitalization
	Proteinemia	Done once during hospitalization
Stroke
	Hospitalization	18 d
	Vasodilatator: Vastarel® 35 mg	2 tablets/d, 18 d
	Anticoagulants	1 tablet/d, 18 d
	Rehabilitation/physical therapy	18 d

TG: Triglycerides; HDL-cholesterol: High density lipoprotein cholesterol; LDL-cholesterol: Low density lipoprotein cholesterol; ARA2: Angiotensin receptor blocker; ACEI: Angiotensin converting enzyme inhibitors; EPO: Erythropoietin.