A computer simulation model of diabetes progression, quality of life, and cost

Honghong Zhou, Deanna J M Isaman, Shari Messinger, Morton B. Brown, Ronald Klein, Michael Brandle, William H. Herman

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

OBJECTIVE - To develop and validate a comprehensive computer simulation model to assess the impact of screening, prevention, and treatment strategies on type 2 diabetes and its complications, comorbidities, quality of life, and cost. RESEARCH DESIGN AND METHODS- The incidence of type 2 diabetes and its complications and comorbidities were derived from population-based epidemiologic studies and randomized, controlled clinical trials. Health utility scores were derived for patients with type 2 diabetes using the Quality of Well Being-Self-Administered. Direct medical costs were derived for managed care patients with type 2 diabetes using paid insurance claims. Monte Carlo techniques were used to implement a semi-Markov model. Performance of the model was assessed using baseline and 4- and 10-year follow-up data from the older-onset diabetic population studied in the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR). RESULTS - Applying the model to the baseline WESDR population with type 2 diabetes, we predicted mortality to be 51% at 10 years. The prevalences of stroke and myocardial infarction were predicted to be 18 and 19% at 10 years. The prevalences of nonproliferative diabetic retinopathy, proliferative retinopathy, and macular edema were predicted to be 45, 16, and 18%, respectively; the prevalences of microalbuminuria, proteinuria, and end-stage renal disease were predicted to be 19, 39, and 3%, respectively; and the prevalences of clinical neuropathy and amputation were predicted to be 52 and 5%, respectively, at 10 years. Over 10 years, average undiscounted total direct medical costs were estimated to be $53,000 per person. Among survivors, the average utility score was estimated to be 0.56 at 10 years. CONCLUSIONS - Our computer simulation model accurately predicted survival and the cardiovascular, microvascular, and neuropathic complications observed in the WESDR cohort with type 2 diabetes over 10 years. The model can be used to predict the progression of diabetes and its complications, comorbidities, quality of life, and cost and to assess the relative effectiveness, cost-effectiveness, and cost-utility of alternative strategies for the prevention and treatment of type 2 diabetes.

Original languageEnglish
Pages (from-to)2856-2863
Number of pages8
JournalDiabetes Care
Volume28
Issue number12
DOIs
StatePublished - Dec 1 2005
Externally publishedYes

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Computer Simulation
Type 2 Diabetes Mellitus
Quality of Life
Costs and Cost Analysis
Diabetic Retinopathy
Epidemiologic Studies
Diabetes Complications
Comorbidity
Population
Macular Edema
Managed Care Programs
Insurance
Amputation
Proteinuria
Chronic Kidney Failure
Cost-Benefit Analysis
Survivors
Research Design
Randomized Controlled Trials
Stroke

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Zhou, H., Isaman, D. J. M., Messinger, S., Brown, M. B., Klein, R., Brandle, M., & Herman, W. H. (2005). A computer simulation model of diabetes progression, quality of life, and cost. Diabetes Care, 28(12), 2856-2863. https://doi.org/10.2337/diacare.28.12.2856

A computer simulation model of diabetes progression, quality of life, and cost. / Zhou, Honghong; Isaman, Deanna J M; Messinger, Shari; Brown, Morton B.; Klein, Ronald; Brandle, Michael; Herman, William H.

In: Diabetes Care, Vol. 28, No. 12, 01.12.2005, p. 2856-2863.

Research output: Contribution to journalArticle

Zhou, H, Isaman, DJM, Messinger, S, Brown, MB, Klein, R, Brandle, M & Herman, WH 2005, 'A computer simulation model of diabetes progression, quality of life, and cost', Diabetes Care, vol. 28, no. 12, pp. 2856-2863. https://doi.org/10.2337/diacare.28.12.2856
Zhou, Honghong ; Isaman, Deanna J M ; Messinger, Shari ; Brown, Morton B. ; Klein, Ronald ; Brandle, Michael ; Herman, William H. / A computer simulation model of diabetes progression, quality of life, and cost. In: Diabetes Care. 2005 ; Vol. 28, No. 12. pp. 2856-2863.
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