Estimating the impact of better management of glycaemic control in adults with Type 1 and Type 2 diabetes on the number of clinical complications and the associated financial benefit

Abstract Aim To estimate the potential benefits in terms of avoided complications and cost reduction if the Spanish health system would encourage the intensification of treatment for better glycaemic control in adults with Type 2 diabetes from the current HbA1c target used in clinical practice of 68 mmol/mol to a target of 53 mmol/mol. Methods The IQVIA Core Diabetes Model (version 9.0) was used to model the impact of these changes in respect of micro- and macrovascular complications and the associated costs. The modelling was based on data derived from the SIDIAP-Q population database from Catalonia, taking a random cohort of 10,000 people with type 2 diabetes and dividing it into sub-groups based on their basal HbA1c. Results The CDM modelling showed that the average cost reduction per person varies depending on basal HbA1c. The model estimates that after 25 years, people with a basal HbA1c between 48 and 58 mmol/mol and >75 mmol/mol show an average cost reduction of €6,027 and €11,966, respectively. Applying the per-person cost reduction to the cohorts of the prevalent population in Spain (1,910,374) the overall estimated cost reduction was €14.7 billion over 25 years. The improvements in outcomes resulted in an estimated reduction of more than 1.2 million complications cumulatively over 25 years, of which more than 550,000 relate to diabetic foot and more than 170,000 related to renal disease. Conclusion Over a 25 year period, Spain could considerably reduce costs and avoid major complications if, on a population level, more ambitious glycaemic control, according to Spanish or EU guidelines, could be achieved among people with type 2 diabetes by reducing the HbA1c threshold for treatment intensification. Although there is a slower trajectory for benefits in earlier years, there is a much more rapid benefit gain between years 5 and 15.

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Multicentre, randomised, controlled study of the impact of continuous sub-cutaneous glucose monitoring (GlucoDay®) on glycaemic control in type 1 and type 2 diabetes patients

Diabetes & Metabolism ◽

10.1016/j.diabet.2009.02.006 ◽

2009 ◽

Vol 35 (4) ◽

pp. 312-318 ◽

Cited By ~ 25

Author(s):

E. Cosson ◽

E. Hamo-Tchatchouang ◽

L. Dufaitre-Patouraux ◽

J.-R. Attali ◽

J. Pariès ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Glucose Monitoring ◽

Controlled Study ◽

Randomised Controlled Study ◽

Randomised Controlled ◽

The Impact ◽

Diabetes Patients

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Improving management of glycaemic control in people with T2DM in Primary Care: estimation of the impact on the clinical complications and associated costs

10.21203/rs.2.13173/v1 ◽

2019 ◽

Author(s):

Manel Mata-Cases ◽

James Mahon ◽

Didac Mauricio ◽

Josep Franch-Nadal ◽

Jordi Real ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Average Cost ◽

Cost Reduction ◽

Population Level ◽

Treatment Intensification ◽

Population Database ◽

Clinical Complications ◽

The Impact

Abstract Aim To estimate the potential benefits in terms of avoided complications and cost reduction if the Spanish health system would encourage the intensification of treatment for better glycaemic control in adults with Type 2 diabetes from the current HbA1c target used in clinical practice of 68 mmol/mol to a target of 53 mmol/mol. Methods The IQVIA Core Diabetes Model (version 9.0) was used to model the impact of these changes in respect of micro- and macrovascular complications and the associated costs. The modelling was based on data derived from the SIDIAP-Q population database from Catalonia, taking a random cohort of 10,000 people with type 2 diabetes and dividing it into sub-groups based on their basal HbA1c. Results The CDM modelling showed that the average cost reduction per person varies depending on basal HbA1c. The model estimates that after 25 years, people with a basal HbA1c between 48 and 58 mmol/mol and >75 mmol/mol show an average cost reduction of €6,027 and €11,966, respectively. Applying the per-person cost reduction to the cohorts of the prevalent population in Spain (1,910,374) the overall estimated cost reduction was €14.7 billion over 25 years. The improvements in outcomes resulted in an estimated reduction of more than 1.2 million complications cumulatively over 25 years, of which more than 550,000 relate to diabetic foot and more than 170,000 related to renal disease. Conclusion Over a 25 year period, Spain could considerably reduce costs and avoid major complications if, on a population level, more ambitious glycaemic control, according to Spanish or EU guidelines, could be achieved among people with type 2 diabetes by reducing the HbA1c threshold for treatment intensification. Although there is a slower trajectory for benefits in earlier years, there is a much more rapid benefit gain between years 5 and 15.

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Improving management of glycaemic control in people with T2DM in Primary Care: estimation of the impact on the clinical complications and associated costs

10.21203/rs.2.13173/v2 ◽

2019 ◽

Author(s):

Manel Mata-Cases ◽

James Mahon ◽

Didac Mauricio ◽

Josep Franch-Nadal ◽

Jordi Real ◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Average Cost ◽

Cost Reduction ◽

Population Level ◽

Treatment Intensification ◽

Population Database ◽

Clinical Complications ◽

The Impact

Abstract Aim To estimate the potential benefits in terms of avoided complications and cost reduction if the Spanish health system would encourage the intensification of treatment for better glycaemic control in adults with Type 2 diabetes from the current HbA1c target used in clinical practice of 68 mmol/mol to a target of 53 mmol/mol. Methods The IQVIA Core Diabetes Model (version 9.0) was used to model the impact of these changes in respect of micro- and macrovascular complications and the associated costs. The modelling was based on data derived from the SIDIAP-Q population database from Catalonia, taking a random cohort of 10,000 people with type 2 diabetes and dividing it into sub-groups based on their basal HbA1c. Results The CDM modelling showed that the average cost reduction per person varies depending on basal HbA1c. The model estimates that after 25 years, people with a basal HbA1c between 48 and 58 mmol/mol and >75 mmol/mol show an average cost reduction of €6,027 and €11,966, respectively. Applying the per-person cost reduction to the cohorts of the prevalent population in Spain (1,910,374) the overall estimated cost reduction was €14.7 billion over 25 years. The improvements in outcomes resulted in an estimated reduction of more than 1.2 million complications cumulatively over 25 years, of which more than 550,000 relate to diabetic foot and more than 170,000 related to renal disease. Conclusion Over a 25 year period, Spain could considerably reduce costs and avoid major complications if, on a population level, more ambitious glycaemic control, according to Spanish or EU guidelines, could be achieved among people with type 2 diabetes by reducing the HbA1c threshold for treatment intensification. Although there is a slower trajectory for benefits in earlier years, there is a much more rapid benefit gain between years 5 and 15.

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797-P: Impact of Carbohydrate Counting on Glycaemic Control in People with Type 1 and Type 2 Diabetes on Intensified Insulin Therapy

Diabetes ◽

10.2337/db20-797-p ◽

2020 ◽

Vol 69 (Supplement 1) ◽

pp. 797-P

Author(s):

NORBERT HERMANNS ◽

DOMINIC EHRMANN ◽

BERNHARD KULZER

Keyword(s):

Type 2 Diabetes ◽

Glycaemic Control ◽

Insulin Therapy ◽

Carbohydrate Counting ◽

Intensified Insulin Therapy

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Model estimates of the results of diabetes patients using modern glucometers with tri-color technology for displaying test results

Medical Technologies Assessment and Choice (Медицинские технологии Оценка и выбор) ◽

10.31556/2219-0678.2019.37.3.081-089 ◽

2019 ◽

pp. 81-89

Author(s):

Larisa Dmitrievna Popovich ◽

Svetlana Valentinovna Svetlichnaya ◽

Aleksandr Alekseevich Moiseev

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 1 Diabetes ◽

Economic Benefits ◽

Test Results ◽

Self Monitoring ◽

Patients With Diabetes ◽

The Impact

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.

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