According to a recent study published in the journal Diabetes Care, screening of Type 2 diabetes and early treatment could be beneficial for patients’ health, specifically reduced risk of cardiovascular disease or death. The study conducted by scientists from the University of Michigan and the MRC Epidemiology Unit, University of Cambridge combined innovative computer modeling with large scale clinical observations.
The ADDITION-Europe study included people aged between 40 and 69 years with undiagnosed diabetes from a total of 343 general clinical practices in the UK, the Netherlands and Denmark. The study assessed if routine screening for Type 2 diabetes was viable, and if intensive, early treatment of cardiovascular risk factors would reduce the risk of cardiovascular events. Results from the study showed that the method was viable.
The team used information from the ADDITION-Europe study, which employed a computer simulation model of diabetes progression for diabetes screening and treatment. Findings from the study revealed the method is efficient to reduce cardiovascular disease risk or death within a 5 year follow-up period when compared to patients who do not undergo screening.
“Diabetes can be debilitating for patients and costly for healthcare,” said in a recent news release William Herman, M.D., lead author of the paper and a professor at the University of Michigan Medical School. “This research shows that the early identification of diabetes has major health benefits, and supports the introduction of measures such as screening to reduce the time between development of Type 2 diabetes and its treatment.”
Professor Nick Wareham, senior author of the study and director of the MRC Epidemiology Unit, University of Cambridge, added in the news release: “This work shows the value of public health modelling to assess impacts and interventions for diseases such as Type 2 diabetes that pose an increasing public health challenge”.
At 10 years follow-up, results from the computer simulation showed the method anticipated that assuming a delay of 3 and 6 years in diagnosis and treatment, 22.4% and 25.9% of patients with type 2 Diabetes would have a cardiovascular disease event, respectively.
Upon implementing screening in routine care, the approach predicted 18.4% of patients would experience a cardiovascular disease event at 10 years. The results also showed this method determined an incidence of all-cause mortality of 16.4% and 18.2% with a delay of 3 and 6 years, respectively, in comparison to 14.6% for screening and treatment.
The results demonstrate that over a 10 year period the simulator is able to predict that for individuals with undiagnosed diabetes, screening would reduce by 29% the risk of a cardiovascular disease event, compared to a delay of 6 years in diagnosis and treatment. This translates to a reduction of 7.5% of the risk of cardiovascular events in this particular population, with an all-cause mortality of 20% of relative risk and of 3.6% of absolute risk reduction.
Herman explained, “Comparing the results of our simulations with the real-world data gave us confidence that our model successfully predicts the impact of delaying diagnosis of Type 2 diabetes on future cardiovascular health outcomes.”
“ADDITION-Europe is a large, high quality study, but even so there are limitations in how much direct clinical observation can tell us about the costs and benefits of screening. Computer simulations add an extra dimension which we hope will guide future research as well as the development of public health policy,” added Wareham.
