Validation of economic and health outcomes simulation model of type 2 diabetes mellitus (ECHO-T2DM)

Abstract Type 2 diabetes mellitus (T2D) is often accompanied by chronic diseases, including mental health problems. We aimed at studying mental health comorbidity prevalence in T2D patients and its association with T2D outcomes through a retrospective, observational study of individuals of the EpiChron Cohort (Aragón, Spain) with prevalent T2D in 2011 (n = 63,365). Participants were categorized as having or not mental health comorbidity (i.e., depression, anxiety, schizophrenia, and/or substance use disorder). We performed logistic regression models, controlled for age, sex and comorbidities, to analyse the likelihood of 4-year mortality, 1-year all-cause hospitalization, T2D-hospitalization, and emergency room visit. Mental health comorbidity was observed in 19% of patients. Depression was the most frequent condition, especially in women (20.7% vs. 7.57%). Mortality risk was higher in patients with mental health comorbidity (odds ratio 1.24; 95% confidence interval 1.16–1.31), especially in those with substance use disorder (2.18; 1.84–2.57) and schizophrenia (1.82; 1.50–2.21). Mental health comorbidity also increased the likelihood of all-cause hospitalization (1.16; 1.10–1.23), T2D-hospitalization (1.51; 1.18–1.93) and emergency room visit (1.26; 1.21–1.32). These results suggest that T2D healthcare management should include specific strategies for the early detection and treatment of mental health problems to reduce its impact on health outcomes.

Download Full-text

First Russian Type 2 Diabetes Mellitus Simulation Model with Discrete Events Modeling. Health-Economic Analysis

Value in Health ◽

10.1016/j.jval.2013.08.659 ◽

2013 ◽

Vol 16 (7) ◽

pp. A437-A438

Author(s):

A. Kolbin ◽

A. Kurylev ◽

Y. Balykina ◽

M. Proskurin

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Health Economic ◽

Type 2 Diabetes Mellitus ◽

Economic Analysis ◽

Simulation Model ◽

Discrete Events ◽

Health Economic Analysis

Download Full-text

How Consistent is the Relationship between Improved Glucose Control and Modelled Health Outcomes for People with Type 2 Diabetes Mellitus? a Systematic Review

PharmacoEconomics ◽

10.1007/s40273-016-0466-0 ◽

2016 ◽

Vol 35 (3) ◽

pp. 319-329 ◽

Cited By ~ 4

Author(s):

Xinyang Hua ◽

Thomas Wai-Chun Lung ◽

Andrew Palmer ◽

Lei Si ◽

William H. Herman ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Outcomes ◽

Glucose Control ◽

The Relationship

Download Full-text

Optimizing treatment goals for long-term health outcomes among patients with type 2 diabetes mellitus

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2021-002396 ◽

2021 ◽

Vol 9 (1) ◽

pp. e002396

Author(s):

Qian Shi ◽

Yilu Lin ◽

Vivian A Fonseca ◽

Lizheng Shi

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Health Outcomes ◽

Treatment Strategies ◽

Optimal Treatment ◽

Treatment Goals ◽

Macrovascular Complication

IntroductionConsiderable confusions on treatment target have resulted from recent changes in guidelines. Evidence in medical guidelines came from clinical trials with highly selected patients, whereas treatment goals may differ in some subgroups. This study aimed to assess optimal treatment goals (A1C, blood pressure, low-density lipoprotein cholesterol (LDL-C)) for patients with type 2 diabetes mellitus (T2DM), which lead to optimal health outcomes by different treatment strategies.Research design and methodsA retrospective longitudinal study was conducted for veterans with T2DM by using US Veterans Affairs Administrative Database (2005−2015). Medical records were prepared for repeated evaluation performed at 6-month intervals and multivariate longitudinal regression was used to estimate the risk of microvascular and macrovascular complication events. Second-degree polynomial and splines were applied to identify the optimal goals in their associations with lowest risk of clinical outcomes, controlling for demographic characteristics, medical history, and medications.ResultsA total of 124 651 patients with T2DM were selected, with mean of 6.72 follow-up years. In the general population, to achieve the lowest risk of microvascular and macrovascular complication, the optimal goals were A1C=6.81%, LDL-C=109.10 mg/dL; and A1C=6.76%, LDL-C=111.65 mg/dL, systolic blood pressure (SBP)=130.60 mmHg, respectively. The optimal goals differed between age and racial subgroups. Lower SBP for younger patients and lower LDL-C for black patients were associated with better health outcomes.ConclusionsOptimal treatment goals were identified and multi-faceted treatment strategies targeting hyperglycemia and hyperlipidemia and hypertension may improve health outcome in veterans with T2DM. In addition to guidelines’ recommended goals, health systems may examine their own large diverse patients with T2DM for better quality of care.

Download Full-text