New RTI simulation model predicts long-term health and cost outcomes for type 1 diabetes interventions

First U.S.-specific type 1 diabetes model estimates complications, life years, quality of life and costs

RESEARCH TRIANGLE PARK, N.C. — Researchers at RTI International, an independent scientific research institute, have developed the first simulation model calibrated specifically for people with type 1 diabetes in the U.S., enabling policymakers and health systems to better assess the long-term costs and clinical outcomes of diabetes interventions. 

“Until now, models used to evaluate type 1 diabetes treatments were based on data from other countries or from people with type 2 diabetes,” said Carolina Barbosa, Ph.D., health economist at RTI and lead author of the study. “Our model uses U.S.-based data to predict the risks of complications, changes in life expectancy, quality of life and healthcare costs for people with type 1 diabetes, which is essential for making informed decisions about care.”

The microsimulation model developed by Barbosa and her colleagues combines data from two long-term studies: the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) and the Epidemiology of Diabetes Complications (EDC) study. It creates risk equations for 14 diabetes-related complications, as well as equations predicting changes in blood glucose levels, blood pressure, cholesterol and other factors over time.

The model showed good accuracy in internal validation, predicting complication rates within an average deviation of less than 10% from observed data. External validation against international datasets showed mixed results, suggesting the model should be calibrated before use outside the U.S.

In a case study, the model estimated that expanding insulin pump therapy with continuous glucose monitoring to all people with type 1 diabetes would reduce most complications and add 4.5 years to life expectancy on average, including approximately one quality-adjusted life year (QALY), a measurement of years spent in good health.

The model is publicly available and can be used by researchers and decision-makers to evaluate a wide range of treatments and policy changes for type 1 diabetes in the U.S.

The study was published in Diabetes Care and funded by the Centers for Disease Control and Prevention, with additional support from a National Institutes of Health grant.

Read the full study (via Diabetes Care)

Access the model’s code (via GitHub)

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