Abstract
The objective of this analysis is to project the long-term impacts on life expectancy and occurrence over 5, 10, and 40 years of microvascular and macrovascular complications of diabetes when using different haemoglobin A1c (HbA1c) thresholds for intensifying treatment of type 2 diabetes. A flexible, discrete-event simulation model has been developed to evaluate alternative treatment strategies based on the United Kingdom Prospective Diabetes Study Outcomes Model. In the present analysis, the model is used to investigate the impact of alternative HbA1c thresholds for treatment intensification ranging from 7.0 to 9.0%. For each intensification strategy, the model is run using 80 simulated patients for each of 1224 patient profiles from the Real-Life Effectiveness and Care Patterns of Diabetes Management study (for a total of 97,920 simulated patients) to project the number of patients who will experience diabetes-related complications over time. The use of lower HbA1c thresholds for intensifying treatment is associated with improved long-term outcomes. When the HbA1c threshold for intensifying therapy from oral treatment to basal insulin (T1) is 7.0% and the threshold for intensifying basal insulin to multiple-dose insulin (T2) ...Continue Reading
References
Jan 14, 1995·BMJ : British Medical Journal
Jan 1, 1996·Annals of Internal Medicine·R TurnerR Holman
Nov 25, 2000·Diabetes Care·H P Wetzler, J W Snyder
Nov 6, 2001·Annals of Internal Medicine·L S PhillipsC S Barnes
Dec 28, 2002·Diabetes Care·UNKNOWN American Diabetes Association
Dec 25, 2003·Diabetes Care·Markolf HanefeldUNKNOWN QUARTET Study Group
Jan 22, 2004·JAMA : the Journal of the American Medical Association·Sharon H SaydahCatherine C Cowie
Jun 29, 2004·Diabetes Care·Jonathan B BrownAndrew Perry
Aug 31, 2004·Diabetes Care·UNKNOWN American Diabetes Association Consensus Panel
Nov 2, 2004·Diabetologia·P M ClarkeUNKNOWN UK Prospective Diabetes Study (UKDPS) Group
Jan 29, 2005·Diabetes Care·Hans U JankaHannele Yki-Järvinen
Jan 29, 2005·Diabetes Care·Philip RaskinUNKNOWN INITIATE Study Group
Jan 29, 2005·Diabetes Care·Richard W GrantUNKNOWN University HealthSystem Consortium (UHC) Diabetes Benchmarking Project Team
Mar 1, 2005·Diabetes Care·Baiju R ShahCarl van Walraven
Aug 16, 2005·The Diabetes Educator·David C ZiemerLawrence S Phillips
Nov 25, 2005·Diabetes Care·Honghong ZhouWilliam H Herman
Feb 2, 2006·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·S A Schreiber, A Russmann
Apr 6, 2006·Annals of Internal Medicine·Nicolas RodondiJoe V Selby
Feb 16, 2007·Diabetes, Obesity & Metabolism·M A NauckUNKNOWN Sitagliptin Study 024 Group
May 29, 2007·Diabetes Care·UNKNOWN Mount Hood 4 Modeling Group
Oct 16, 2007·Diabetes & Metabolism·B Bouhanick, B Chamontin
Jan 19, 2008·Diabetes, Obesity & Metabolism·R ScottUNKNOWN Sitagliptin Study 801 Group
Citations
Apr 26, 2008·Diabetes, Obesity & Metabolism·B SchwarzH Sintonen
Sep 20, 2012·Environmental Health : a Global Access Science Source·M Patricia FabianJonathan I Levy
Mar 15, 2014·PharmacoEconomics·Jonathan Karnon, Hossein Haji Ali Afzali
Jul 21, 2010·Current Medical Research and Opinion·Y YiK Burslem
Oct 17, 2015·Current Medical Research and Opinion·M CharokopouBg Verheggen
Mar 24, 2009·Life Sciences·Wen-Ying ChenFrank Chiahung Mao
Feb 11, 2014·Computers in Biology and Medicine·T Eugene DayAnn Brugh
Apr 15, 2014·Risk Analysis : an Official Publication of the Society for Risk Analysis·Jonathan I LevyJunenette L Peters
Feb 28, 2014·Diabetes Care·Yuanhui ZhangBrian T Denton
Aug 26, 2014·Diabetes Care·Yuanhui ZhangBrian T Denton
Dec 23, 2014·Diabetes Technology & Therapeutics·Frances StringerKohei Kaku
Jun 21, 2012·The Diabetes Educator·Anne Peters
Dec 11, 2013·American Journal of Medical Quality : the Official Journal of the American College of Medical Quality·Matthew Harris RutbergTheodore Eugene Day
Aug 23, 2018·Journal of Comparative Effectiveness Research·Bin WuHaixiang Wu
Apr 24, 2015·Diabetology & Metabolic Syndrome·Daniel Dutra Romualdo Silva, Adriana Aparecida Bosco
Mar 2, 2012·The Journal of Endocrinology·A J ConleyA D Nguyen
Nov 5, 2019·Journal of Behavioral Medicine·Molly B RichardsonJulia M Gohlke
Oct 2, 2019·PharmacoEconomics·Daniel M SugrueHeleen G M van Haalen
Jul 6, 2019·Journal of Diabetes and Metabolic Disorders·Vivian Saraiva VerasMaria Lúcia Zanetti
Jan 21, 2017·Health Technology Assessment : HTA·Rhona JohnstonNorman Waugh
Jun 28, 2019·Clinical Drug Investigation·Joe AlexanderBruce Parsons
Feb 16, 2021·Environmental Health : a Global Access Science Source·Koen F TieskensM Patricia Fabian
Dec 8, 2021·BMC Health Services Research·Elton MukondaMaia Lesosky