Reducing Complications in Patients Living With Type 2 Diabetes by an Optimized Management of Weight and Glycemia and Their Associated Savings

OBJECTIVES: Clinical guidelines recommend a holistic management of type 2 diabetes (T2D) patients, integrating weight and glycaemic management and cardiorenal protection. This approach might potentially lead to reduced incidence of complications and, therefore, healthcare cost savings. Specifically, the objective of this project was to estimate the potential cost savings by reduction of T2D related complications derived from optimizing patient management from a Spanish healthcare system perspective.

METHODS: Two pragmatic literature reviews were carried out to identify common T2D-related complications and gather evidence on the impact of changes in glycated haemoglobin (HbA1c) and weight on these complications. Additionally, evidence of the association between weight and HbA1c levels was searched. With this data, a three-step analysis was conducted for Spanish T2D patients: 1) estimation of the effect of weight and HbA1c reduction on the risk of complications, 2) estimation of healthcare costs derived from T2D complications, and 3) estimation of the potential cost savings derived from weight and HbA1c reduction.

RESULTS: Out of the literature review, 28 articles reported an association of weight and/or HbA1c with T2D complications, categorized as traditional (macrovascular and microvascular) and emergent. A combined reduction of 5% weight and 1% HbA1c was associated with estimated incidence reduction of complications ranging between 3% for heart failure (n=141), 18.9% for retinopathy (n=12,115), up to 30% for stroke (n=789). This translates into total savings of 514,968€; 103,260,073€; and 6,759,382€, respectively.

CONCLUSIONS: These results reveal a potential decrease in the incidence of complications by optimizing glycaemic and weight control, which will likely lead to cost savings in the management of T2D patients in Spain.