Model Predicts Pill Combination Could Prevent 4.5 Million Deaths

Giving most people with diabetes an inexpensive combination of medications consisting of an ACE, Aspirin, Metformin and a Statin, could dramatically reduce the number of diabetes-related complications and deaths in America and ultimately save money, according to a highly detailed mathematical model developed to simulate human physiology and health care systems. The Archimedes Model, originally developed by researchers at Kaiser Permanente, was used to make predictions in three areas: What would happen if diabetes were cured, if all people with diabetes reached their treatment goals, or if the disease were treated more aggressively?

Not surprisingly, curing diabetes would dramatically reduce the risk of heart attacks in the United States (by 40 percent) and prevent nearly 4.5 million deaths over a 30-year period. It would also reduce health care costs by a whopping $444 billion over the same period of time.

Absent a cure, providing optimal care – bringing 100 percent of those with diabetes to their treatment goals – would save $325 billion in health costs and add 3.55 million life years to people who have diabetes today. Adding a "polypill" to the usual care given people with diabetes – the most practical scenario analyzed – would cut the number of heart attacks in half, reduce eye complications by a third and result in 10 percent fewer diabetes-related deaths, the model found. Overall, giving an inexpensive drug combination to all people with diabetes would result in 7.3 million fewer serious complications over the next 30 years.

Diabetes continues to increase at an alarming rate in the U.S. and around the world. Currently, about 10 percent of all American adults and 20 percent of adults over the age of 60 have been diagnosed with the disease. In 2007, Americans spent $174 billion on type 1 and type 2 diabetes, including $58 billion in reduced national productivity.

The Archimedes Model was used to see whether and how the human and financial costs of this epidemic could be reduced. The authors concluded that research for a cure should be made a national priority and innovative solutions such as a polypill cocktail should be pursued more aggressively.

"A world without diabetes and its complications is certainly possible and the appropriate care for people with diabetes is within our grasp," the authors wrote. "Both, however, require unrelenting commitment and resolve."

People who have diabetes and don’t know it – and those who have a condition known as pre-diabetes – will soon have access to a free tool to assess their health status online. The Diabetes Risk Test, based on a model developed by researchers at Archimedes, Inc., a company that uses mathematical simulation models to address healthcare problems, accurately assesses a person’s chances of having or developing undiagnosed diabetes or prediabetes, a condition that often leads to diabetes.

The assessment tool, which will soon replace the American Diabetes Association’s existing online risk test, calculates a person’s chances of having diabetes using the answers to a series of questions, such as age, weight, history of gestational diabetes and other variables. The tool is intended to help people determine if they should see a physician for further testing. It can be found at https://www.diabetes.org/risktest.

"We know that the prevalence of diabetes continues to rise, and that at least a quarter of people who have diabetes don’t yet know it," said David Eddy, lead researcher on the study and founder of Archimedes, Inc. "But it’s not cost effective or even efficient to screen every single patient. This no-cost, easy-to-use tool can help identify those people most likely to have diabetes or prediabetes, so that they can receive the appropriate testing and subsequent medical care."

The Diabetes Risk Test is the only currently available noninvasive screening tool designed and scientifically validated to detect both prediabetes and undiagnosed diabetes in the U.S. population.
ADA

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FACT: In the US, nearly one in three children reaches a BMI greater than 35 by adolescence: Dr. Richard Nesto, Chairman of the Department of Cardiovascular Medicine at the Lahey Clinic in Burlington, Massachusetts, explained that in adults, a BMI of 25 or above signals overweight and a BMI of 30 or above signals obesity.