Early Detection and Treatment of Type 2 Diabetes Reduce Cardiovascular Morbidity and Mortality: A Simulation of the Results of the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen-Detected Diabetes in Primary Care (ADDITION-Europe)

Research output: Research - peer-reviewJournal article

DOI

  • William H Herman
    William H HermanUnited States
  • Wen Ye
    Wen YeUnited States
  • Simon J Griffin
    Simon J GriffinUnited Kingdom
  • Rebecca K Simmons
  • Melanie J Davies
    Melanie J DaviesUnited Kingdom
  • Kamlesh Khunti
    Kamlesh KhuntiUnited Kingdom
  • Guy E H M Rutten
    Guy E H M RuttenNetherlands
  • Annelli Sandbaek
  • Torsten Lauritzen
  • Knut Borch-Johnsen
    Knut Borch-JohnsenDenmark
  • Morton B Brown
    Morton B BrownUnited States
  • Nicholas J Wareham
    Nicholas J WarehamUnited Kingdom
OBJECTIVE To estimate the benefits of screening and early treatment of type 2 diabetes compared with no screening and late treatment using a simulation model with data from the ADDITION-Europe study.

RESEARCH DESIGN AND METHODS We used the Michigan Model, a validated computer simulation model, and data from the ADDITION-Europe study to estimate the absolute risk of cardiovascular outcomes and the relative risk reduction associated with screening and intensive treatment, screening and routine treatment, and no screening with a 3- or 6-year delay in the diagnosis and routine treatment of diabetes and cardiovascular risk factors.

RESULTS When the computer simulation model was programmed with the baseline demographic and clinical characteristics of the ADDITION-Europe population, it accurately predicted the empiric results of the trial. The simulated absolute risk reduction and relative risk reduction were substantially greater at 5 years with screening, early diagnosis, and routine treatment compared with scenarios in which there was a 3-year (3.3% absolute risk reduction [ARR], 29% relative risk reduction [RRR]) or a 6-year (4.9% ARR, 38% RRR) delay in diagnosis and routine treatment of diabetes and cardiovascular risk factors.

CONCLUSIONS Major benefits are likely to accrue from the early diagnosis and treatment of glycemia and cardiovascular risk factors in type 2 diabetes. The intensity of glucose, blood pressure, and cholesterol treatment after diagnosis is less important than the time of its initiation. Screening for type 2 diabetes to reduce the lead time between diabetes onset and clinical diagnosis and to allow for prompt multifactorial treatment is warranted.
Original languageEnglish
JournalDiabetes care
Volume38
Issue number8
Pages (from-to)1449-55
Number of pages7
ISSN0149-5992
DOIs
StatePublished - Aug 2015

    Research areas

  • Adult, Aged, Blood Glucose, Blood Pressure, Cholesterol, Computer Simulation, Critical Care, Denmark, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Early Diagnosis, Female, Great Britain, Humans, Mass Screening, Middle Aged, Netherlands, Primary Health Care, Risk Factors

See relations at Aarhus University Citationformats

Projects

ID: 97774002