Abstract
Background: Type 2 diabetes (T2D) is associated with acute and chronic complications, entailing significant use of healthcare resources. Clinical guidelines recommend holistic management and recognize the critical role of obesity and cardio-renal protection in T2D. This study aims to estimate the clinical, quality of life, and economic benefits of optimized weight, metabolic, and cardiovascular management of T2D-related complications in Spain. Methods: An estimation model was built incorporating the risk of complications associated with changes in glycated hemoglobin (HbA1c), weight and high-sensitivity C-reactive protein (hs-CRP), considering incidence of complications and healthcare costs in Spain. A literature review was performed to identify these clinical inputs. The potential reduction in the annual number of complications and their associated disability-adjusted life years (DALYs) and costs were estimated for reductions of 1% HbA1c, 5% weight and 0.5 mg/L hs-CRP in three T2D patient subgroup scenarios. Probabilistic sensitivity analyses were conducted to validate the results and determine their potential range. Results: Combined reduction of HbA1c, weight and hs-CRP was estimated to prevent 19.16-20.80% T2D complications per year. This led to an estimated range of 1317-6568 avoided DALYs, and potential annual savings between €242.77M and €821.68M depending on the T2D patient subgroup. Savings per patient and year ranged from €196.86 to €296.75 for the three scenarios analyzed. Sensitivity analysis validated these results. Conclusions: Integrated management of patients with T2D, controlling HbA1c levels, weight, and cardiovascular benefit, can improve patient outcomes, reduce incidence of complications, prevent quality of life worsening, and result in cost savings for the Spanish national healthcare system.