Abstract Taking into consideration the main evidence available in 2015, Boussageon contest the status of metformin as the first -line treatment for DT2 patients. He contends that as regards macrovascular and microvascular complications, its efficacy has never been proven in a double-blind RCT. This observation leads to a more general interrogation on how anti-diabetes medication is to be assessed. .....
Keywords: type 2 diabetes; UKPDS; metformin

Abstract Diabetes is a highly prevalent chronic disease with a substantial impact on quality of life and societal cost. Depressive disorders have been found to be more prevalent among individuals with diabetes than those without diabetes. Studies reported 4.5-times higher total annual healthcare costs for Medicare patients with comorbid diabetes and depression than for patients with diabetes but no comorbid depression. Data regarding the appropriateness of treatment and treatment outcomes in the real world setting for patients with diabetes and a depressive disorder is lacking. Our aim is to investigate the prevalence of undiagnosed and diagnosed depression and to describe health-related quality of life and health care utilisation and costs in a German sample of individuals with diabetes and comorbid depression. The DiaDec study is based on a random sample of a statutory health insurance (SHI) population with diabetes. In a baseline survey, participants were assessed with respect to subthreshold and major depression and health-related quality of life. Data on diagnosed depression, amount and cost of prescribed medications, and outpatient and inpatient care was extracted from health insurance records for each study participant. By linking the survey data with longitudinal health insurance data the association between depression status, quality of life and health care utilisation/costs in the year before and after the survey will be investigated. We expect that our results will foster discussion on the quality and cost-effectiveness of health care for patients with diabetes and a comorbid depression.
Keywords: diabetes; health insurance data; depression; health-related quality of life; health care costs