Differential healthcare costs in individuals with type 2 diabetes and incident chronic kidney disease in Hong Kong: a latent class trajectory analysis

Du, Y; Zhang, M; Li, AQY; Lau, ESH; Wu, H; Kong, APS; Luk, AOY; Ma, RCW; O, CK; Lim, LL; Zhang, JYZ; Ming, WK; Ke, W; Li, Y; Chan, JCN; Lui, JNM

doi:10.1007/s00125-026-06698-2

Type 2 & other diabetes

Differential healthcare costs in individuals with type 2 diabetes and incident chronic kidney disease in Hong Kong: a latent class trajectory analysis

DiabetologiaPublished 18 Mar 2026Prospective cohort study

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Authors' conclusion

Those with young-onset type 2 diabetes incurred the highest cost during the year of CKD onset. Individuals with middle-aged onset type 2 diabetes with fewer comorbidities and less intensified treatment at baseline also had subsequent increased healthcare costs.

Study context

Population: Chinese individuals with T2D and incident chronic kidney disease (CKD) with complete data for 42 attributes, prospective Hong Kong Diabetes Register cohort (2007–2019)
Participants: 2,886 individuals

Exposure: Latent classes of individuals with T2D and incident CKD, by longitudinal healthcare costs
Outcome: Longitudinal healthcare costs (per-patient-per-year cost) among class memberships

Methodological detailslatent class analysis, hierarchical generalised linear mixed model

Latent class analysis
Hierarchical generalised linear mixed model

Main finding

As reported in the abstract

Per-patient-per-year (PPPY) healthcare cost

Class 16087mean · SD 15,519 · US$

Class 23822mean · SD 9816 · US$

Class 34260mean · SD 11,725 · US$

Class 43923mean · SD 10,957 · US$

Observational data: associations, not effects.

Further findings

Incidence of CKD and overall per-patient-per-year (PPPY) cost · 109,784 person-years of follow-up

Incidence of CKD: 26.29 per 1000 person-years
Overall PPPY cost, mean ± SD: US$4395 ± 11,947

Reference

Authors: Du Y, Zhang M, Li AQY, Lau ESH, Wu H, Kong APS, et al.
All 16 authors
Du Y, Zhang M, Li AQY, Lau ESH, Wu H, Kong APS, Luk AOY, Ma RCW, O CK, Lim LL, Zhang JYZ, Ming WK, Ke W, Li Y, Chan JCN, Lui JNM
Journal: Diabetologia
Published: 18 Mar 2026
DOI: 10.1007/s00125-026-06698-2
PubMed: 41848900

Topic: Type 2 & other diabetes

Exposure definitions

Class 1: young onset (44.4 ± 10.3 years), moderate comorbidities, multiple medications; 18.3%
Class 2: old-age onset (66.9 ± 6.9 years), moderate comorbidities, multiple medications; 21.2%
Class 3: middle-aged onset (54.2 ± 10.0 years), few comorbidities, few medications; 33.9%
Class 4: middle-aged onset (54.1 ± 7.6 years), moderate comorbidities, multiple medications; 26.5%

Key notes

Class 1 (young onset) and Class 3 (middle-aged onset) incurred the highest cost during the year of CKD onset
Multiple healthcare services contributed to high costs in Class 1; costs in Class 3 mainly post-CKD outpatient and psychiatric care

Original publication

Differential healthcare costs in individuals with type 2 diabetes and incident chronic kidney disease in Hong Kong: a latent class trajectory analysis. Diabetologia. Published 18 March 2026. doi:10.1007/s00125-026-06698-2

Read the original article ↗

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