OBJECTIVES: Optimal glycemic control is a key goal in patients with type 2 diabetes and is pivotal in reducing the risk of diabetes-related complications.  The aim of the present study was to investigate long-term clinical and economic benefits of a 1% reduction in HbA1c versus baseline levels in patients enrolled in the A1chieve study (an international, prospective, observational study of insulin use within routine clinical practice) in the Indonesian setting. METHODS: The analysis was performed using the published and validated CORE Diabetes Model over a time horizon of 35 years with future costs and clinical benefits were discounted at a rate of 3% per annum.  At baseline patients had a mean HbA1c of 9.8%, the analysis compared patients outcomes in which HbA1c remained at 9.8% in comparison with reducing mean HbA1c by 1%; mean HbA1c was assumed to remain unchanged throughout the simulation.  Direct costs are presented in IDR (converted to EUR at a rate of 1 EUR=11,831 IDR). RESULTS: A 1% reduction in HbA1c from baseline led to improvements in life expectancy and quality-adjusted life expectancy.  Reducing HbA1c from 9.8% to 8.8% improved life expectancy from 10.07 years to 10.69 years (difference 0.61 years) and quality-adjusted life expectancy from 6.56 quality-adjusted life years (QALYs) to 7.04 QALYs (difference 0.48 QALYs).  Mean direct costs were also IDR 6,403,196 (EUR 541) lower in the reduced HbA1c group (IDR 242,721,221 [EUR 20,551] versus IDR 236,318,025 [EUR 20,026]), with the biggest driver of cost savings being the reduced incidence of renal complications in the reduced HbA1c group. CONCLUSIONS: Baseline glycemic control in patients with diabetes in the Indonesian setting was sub-optimal; however, a 1% reduction in HbA1c from baseline was associated with improved life expectancy and quality-adjusted life expectancy as well as being cost-saving over a 35-year time horizon.