Anxiety is independently associated with high-cost resource use among individuals with type 2 diabetes, according to a study published online June 18 in Diabetes Care.

Esti Iturralde, Ph.D., from Kaiser Permanente Northern California in Oakland, and colleagues used electronic health record data to assess past anxiety diagnosis, health care use and costs, demographics, comorbidities, and diabetes control status and complications from 2008 to 2012 for 143,573 adults who are members of an integrated health care system and have type 2 diabetes.

The researchers found that 12.9 percent of participants received a diagnosis of anxiety; of these, 52.9 percent also had received a depression diagnosis. Anxiety was positively related to the number of emergency department visits in 2012 (incidence rate ratio, 1.27; 95 percent confidence interval, 1.21 to 1.34); the likelihood of visiting the emergency department on a chronic, frequent basis during 2010 to 2012 (odds ratio, 2.55; 95 percent confidence interval, 1.90 to 3.44); and high-cost status in 2012 (odds ratio, 1.29; 95 percent confidence interval, 1.23 to 1.36) after adjusting for covariates, including depression. However, anxiety was not related to total hospitalization costs in 2012 (relative cost ratio, 1.06; 95 percent confidence interval, 0.94 to 1.21; P = 0.33).

"Strategies to improve anxiety management among people with diabetes hold the potential to also reduce health care costs," the authors write.

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