OBJECTIVES: Diabetic patients often have other complications whose impacts on health care costs are not always fully realized. The objective of this study was to quantify these additional costs. METHODS: A 1:1 matched case-control 2-year follow-up analysis was conducted using the IMS LifeLink™ Health Plan Claims Database. Six cohorts were analysed: renal disorders (RD), heart disorders (HD), lower limb disorders (LD), eye disorders (ED), hypoglycemia (HY) and neuropathy (NE). Inclusion criteria included adult patients, a diabetes diagnosis in 2008, continuous enrolment, no complication of interest (COI) during the pre-index period (all patients) and the post-index period (control patients). Patients were matched by age, gender, type of diabetes, comorbidities, pre-index complications, payer and index date. Results reported were demographics, other complications and healthcare costs. A Gamma multiple regression model with a log-link determined the impact of the COI on total annual healthcare costs, adjusted for other relevant co-factors. RESULTS: The demographics across all cohorts were consistent with a mean age of 52-55 years old, 53% of males, more than 99% of patients with type II diabetes and more than 93% patients with commercial insurance. Total first year health care costs in the HD, NE, RD, LD, and HY cohorts were statistically higher in cases with a total cost increase varying from 20% (HY) to 152% (HD). Second year total health care costs were statistically higher for cases in the HD and NE cohorts only with an increase of 36% and 20% respectively compared to controls. The ED cohort did not show any significant difference in health care costs between cases and controls. CONCLUSIONS: Most diabetes COI were associated with significantly higher total health care costs in the first year following the COI, with the exception of ED. This association only remained significant during the second year for HD and NE.