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Control/Tracking Number: 2012-A-3346-Diabetes
Activity: Abstract
Current Date/Time: 1/30/2012 7:14:44 AM

Validation and Evaluation of the Risk-To-Benefit Ratio of Glucose Lowering Therapies in High Cardiovascular Risk Type 2 Diabetes Patients; Projections using the IMS CORE Diabetes Model.

Author Block: VOLKER FOOS, NICK FREEMANTLE, JAMES PALMER, DAVID GRANT, ADAM LLOYD, MARC EVANS, PHIL MCEWAN, Basel, Switzerland, London, United Kingdom, Cardiff, United Kingdom, Swansea, United Kingdom

Abstract:
Meta-analyses of recent outcomes trials in type 2 diabetes (T2DM) have demonstrated an overall reduction in coronary events without increased risk of mortality. The aim of this study is to demonstrate the predictive validity of a diabetes simulation model to 5-year meta-analyzed trial data and assess the long term expected outcomes of intensive versus conventional glycemic control in high cardiovascular risk T2DM patients.
The IMS CORE Diabetes Model (CDM) is a validated and widely used simulation model designed to predict the healthcare costs and benefits associated with diabetes management. The CDM was initialized to baseline characteristics consistent with ACCORD and predicted 5-year relative risks of cardiovascular morbidity and all cause mortality was compared to random effects meta-analysis of ACCORD, ADVANCE and VADT. Results were extrapolated over a lifetime to obtain life and quality-adjusted life expectancy (QALE). Healthcare benefits were discounted at 3.5%.
Five-year relative risk for non-fatal myocardial infarction (MI), non-fatal stroke, heart failure and all cause mortality were 0.76, 0.83, 0.93 and 0.94 for intensive versus conventional therapy respectively; all within 95% confidence intervals of the meta analysis results. Lifetime relative risks were 0.90 (non-fatal MI), 0.88 (non-fatal stroke), 0.89 (heart failure) and 0.91 (diabetes specific mortality), favoring intensive glycemic control. Life expectancy was 11.49 and 11.13 years, QALE was 7.4 and 7.2 years in the intensive versus conventional arms respectively.
The CDM relative risk reductions associated with intensive glycemic control in high-risk type 2 diabetes patients were consistent with recent meta-analysis results. Long-term projections suggest that intensive therapy contributes to both increased life and quality-adjusted life expectancy in high cardiovascular risk patients
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Category (Complete):  13 Health Care Delivery - Economics
Presentation Preference (Complete):  No Preference
Sponsor (Complete):
* At least one (1) author listed on this abstract is a current member of the ADA and therefore a sponsor is not required.: Yes

Financial Support (Complete):
* ADA Support: No

Keywords (Complete):  Validation ; Meta Analysis ; Diabetes Model
Payment (Complete): Your credit card order has been processed on Thursday 5 January 2012 at 10:28 AM.
Status: Complete

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