Type 2 diabetes (T2D) represents a serious public health problem because it is an important cause of severe morbidity and mortality and requires high economic resources. T2D is the main cause of blindness, renal failure with the need for dialysis or transplantation, non-traumatic amputation of a limb, and is a major cause of myocardial infarction and cerebral stroke.
Economic resources used for complications and comorbidities represent 90% of the total cost of the disease, while the management of the metabolic problem costs only 10%. Recent large trials have shown that, in diabetic patients with cardiovascular disease the use of pioglitazone and, above all, of some drugs included in the class of gliflozine or of the receptor agonists of GLP-1, is able to reduce the risk of further cardiovascular events, of death and, in the case of gliflozine, of hospitalization for heart failure. Based on this evidence, the recent Italian and International Guidelines of the main Scientific Societies have indicated the innovative pharmacological treatment of the diabetic disease to be preferred in terms of effectiveness and reduction of complications. Therefore, the use of innovative drugs for diabetes, although more expensive than traditional therapies, is currently considered an indispensable tool both from a clinical point of view and from a pharmacoeconomic point of view.

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Key words: type 2 diabetes, costs of disease, costs of complication, guidelines, GLP-1 RA