OBJECTIVES: Asians with predisposition for diabetes mellitus (DM) contributed to over 60% of the world’s diabetic population. DM model has been widely applied in assisting healthcare decision. Only few studies comparing validity of DM models developing from different races for Asian DM population. We examined model validity of United Kingdom Prospective Diabetes Study (UKPDS) Outcomes and Taiwan Diabetes Mellitus Hoslistic Care (TwDM) models against major complications of Taiwan type 2 DM population.

METHODS: TwDM model with first-hitting-time approach was developed based on population-based data containing nearly 140 thousand newly-diagnosed type 2 DM patients from 2002 to June of 2016. Multilayer DM complication (ischemic heart disease, chronic heart failure, ischemic stroke, end-stage renal disease, and eye disease) validation simulations were performed. A simulation cohort representing baseline of Taiwan DM population namely age, sex, HbA1C, systolic blood pressure, weight, high, low density lipoprotein, high density lipoprotein, and estimated glomerular filtration rate were generated and applied to both models. We assessed consistent predicted and observed complication number in TwDM mode by correlation coefficient and compared consistent predicted and observed complication probability with those from UKPDS outcomes model.

RESULTS: The simulation cohort whose average age of 55 years was with a median of follow-up time 15 years. There was a significant high correlation (R²= 98.4%) between multilayer predicted and observed complication number in TwDM model. An overestimated probability in chronic heart failure (0.08 vs. 0.002) and stroke (0.006 vs. 0.003) but underestimated probability in end-stage renal disease (0.002 vs. 0.013) was found when applying UKPDS outcomes model in Taiwan type 2 DM population.

CONCLUSIONS: This analysis demonstrated that TwDM model compared to UKPDS outcomes model is more appropriately applied in Asian population. Further studies are necessary to elucidate the validity of TwDM model on different Asian races.