OBJECTIVES: Based on the type 2 diabetes cohort of the DETECT study (Curr Med Res and Opinion; 2005; 21/4: 619-29) simulations with the EAGLE Diabetes Model (Diab Technology & Therapeutics; 2006; 8/2: 219-36) were conducted. Development of long-term complications was compared with respect to different treatment targets for HbA1c. Additionally, the outcome for a mixed patient population typically for a general practice was assessed. METHODS: The Economic Assessment of Glycemic Control and Longterm Effects (EAGLE) model simulates long-term effects of diabetes treatment and related costs. Baseline characteristics of the simulation cohorts corresponded to type 2 patients of the DETECT study with HbA1c >9%: age 63±11 years, diabetes duration 9±7 years, 49% male, hypertension prevalence 71%, mean HbA1c 10,1±1,3%. Three cohorts with different HbA1c targets were defined: a) no change; b) 8%; and c) 6.4%. A fourth cohort was composed of 25% patients with target a) 60% target; b) and 15%; and target c). All cohorts achieve respective targets within one year followed by a yearly increase of 0.2%. Simulations were run with 1000 patients over 10 years. RESULTS: The relative risk reduction comparing cohort b versus no change was 19% (MI); 17% (stroke); 12% (PAD); 7% (prolif. retinopathy); and 4% (ESRD). A treatment target according to the German diabetes guideline (c versus a) resulted in reductions of 30%, 27%, 20%, 11%, and 6%, respectively. Analysing the mixed cohort demonstrated that treatment effects were similar to the results of cohort b. CONCLUSIONS: The simulations based on a German diabetes population demonstrate the long-term effects of various treatment targets for HbA1c. Although a steady re-increase of HbA1c values was assumed a significant reduction in micro- and macrovascular events can be achieved. Simulations of a mixed cohort correlate to real world patient groups and could be used for cost estimations in practice settings.