Effective diabetes complication management is a step toward a carbon-efficient planet: an economic modeling study.

BACKGROUND

The management of diabetes-related complications accounts for a large share of total carbon dioxide equivalent (COe) emissions. We assessed whether improving diabetes control in people with type 2 diabetes reduces COe emissions, compared with those with unchanging glycemic control.

METHODS

Using the IQVIA Core Diabetes Model, we estimated the impact of maintaining glycated hemoglobin (HbA) at 7% (53 mmol/mol) or reducing it by 1% (11 mmol/mol) on total COe/patient and COe/life-year (LY). Two different cohorts were investigated: those on first-line medical therapy (cohort 1) and those on third-line therapy (cohort 2). COe was estimated using cost inputs converted to carbon inputs using the UK National Health Service's carbon intensity factor. The model was run over a 50-year time horizon, discounting total costs and quality adjusted life years (QALYs) up to 5% and COe at 0%.

RESULTS

Maintaining HbA at 7% (53 mmol/mol) reduced total COe/patient by 18% (1546 kgCOe/patient) vs 13% (937 kgCOe/patient) in cohorts 1 and 2, respectively, and led to a reduction in COe/LY gain of 15%-20%. Reducing HbA by 1% (11 mmol/mol) caused a 12% (cohort 1) and 9% (cohort 2) reduction in COe/patient with a COe/LY gain reduction of 11%-14%.

CONCLUSIONS

When comparing people with untreated diabetes, maintaining glycemic control at 7% (53 mmol/mol) on a single agent or improving HbA by 1% (11 mmol/mol) by the addition of more glucose-lowering treatment was associated with a reduction in carbon emissions.