Health and economic impact of improved glucose, blood pressure and lipid control among German adults with type 2 diabetes: a modelling study

Fan, Min, Stephan, Anna-Janina, Emmert-Fees, Karl ORCID: 0000-0003-2330-1079, Peters, Annette and Laxy, Michael (2023) Health and economic impact of improved glucose, blood pressure and lipid control among German adults with type 2 diabetes: a modelling study. DIABETOLOGIA, 66 (9). pp. 1693-1704.

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Official URL: http://dx.doi.org/10.1007/s00125-023-05950-3

Abstract

<h4>Aims/hypothesis</h4>The aim of this study was to estimate the long-term health and economic consequences of improved risk factor control in German adults with type 2 diabetes.<h4>Methods</h4>We used the UK Prospective Diabetes Study Outcomes Model 2 to project the patient-level health outcomes and healthcare costs of people with type 2 diabetes in Germany over 5, 10 and 30 years. We parameterised the model using the best available data on population characteristics, healthcare costs and health-related quality of life from German studies. The modelled scenarios were: (1) a permanent reduction of HbA<sub>1c</sub> by 5.5 mmol/mol (0.5%), of systolic BP (SBP) by 10 mmHg, or of LDL-cholesterol by 0.26 mmol/l in all patients, and (2) achievement of guideline care recommendations for HbA<sub>1c</sub> (≤53 mmol/mol [7%]), SBP (≤140 mmHg) or LDL-cholesterol (≤2.6 mmol/l) in patients who do not meet the recommendations. We calculated nationwide estimates using age- and sex-specific quality-adjusted life year (QALY) and cost estimates, type 2 diabetes prevalence and population size.<h4>Results</h4>Over 10 years, a permanent reduction of HbA<sub>1c</sub> by 5.5 mmol/mol (0.5%), SBP by 10 mmHg or LDL-cholesterol by 0.26 mmol/l led to per-person savings in healthcare expenditures of €121, €238 and €34, and 0.01, 0.02 and 0.015 QALYs gained, respectively. Achieving guideline care recommendations for HbA<sub>1c</sub>, SBP or LDL-cholesterol could reduce healthcare expenditure by €451, €507 and €327 and gained 0.03, 0.05 and 0.06 additional QALYs in individuals who did not meet the recommendations. Nationally, achieving guideline care recommendations for HbA<sub>1c</sub>, SBP and LDL-cholesterol could reduce healthcare costs by over €1.9 billion.<h4>Conclusions/interpretation</h4>Sustained improvements in HbA<sub>1c</sub>, SBP and LDL-cholesterol control among diabetes patients in Germany can lead to substantial health benefits and reduce healthcare expenditures.

Item Type:	Article
Uncontrolled Keywords:	Diabetes, Long-term consequences, Risk factor control, Simulation modelling
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health
Depositing User:	Symplectic Admin
Date Deposited:	31 Jan 2024 10:44
Last Modified:	31 Jan 2024 10:45
DOI:	10.1007/s00125-023-05950-3
Open Access URL:	https://doi.org/10.1007/s00125-023-05950-3
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3178184