OBJECTIVES: Recent population studies and meta-analyses indicate that increased post-prandial blood glucose (PPG) level is an independent risk factor for coronary heart disease (CHD), stroke, and cardiovascular disease (CVD) death. A modeling study was performed to combine best available data with costs of complications to project possible long-term clinical and cost outcomes for patients with different baseline PPG levels. METHODS: Risks of CHD, stroke, and CVD death derived from Framingham formulae were combined with PPG-dependent hazard ratios for incident CHD, stroke, and CVD death to calculate life expectancy dependent on baseline PPG. Direct costs of cardiovascular complications were projected over patients' lifetime using a Markov simulation model. Costs of treating cardiovascular complications were retrieved from published sources. A French, third-party-payer cost perspective was taken, and only direct costs were included in the analysis. Costs were discounted at an annual rate of 5%. RESULTS: A typical population of type 2 diabetes patients aged 60.1 years with PPG levels of 15.3, 14.7, or 13.8 mmol/l at baseline was calculated to have life expectancies of 18.9, 19.4, and 19.9 years respectively. Lifetime costs per patient (discounted at 5% per annum) due to CVD complications were calculated to be FF 58,793, FF 57,912, and FF 56,565 respectively. CONCLUSIONS: Patients with lower PPG levels are likely to have improved life expectancy and reduced costs due to cardiovascular complications. It is possible that newer interventions that improve PPG levels will be cost-effective, as the costs of interventions will be offset by reduced costs due to cardiovascular complications.