The Skaraborg Institute, Skövde, Sweden.
Department of Public Health and Community Medicine/Primary Health Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Diabetes Obes Metab. 2021 Jul;23(7):1604-1613. doi: 10.1111/dom.14376. Epub 2021 Apr 6.
To evaluate the economic and clinical burden associated with poor glycaemic control in Sweden, in people with type 2 diabetes (T2D) initiating first-line glucose-lowering therapy.
Population data were obtained from Swedish national registers. Immediate glycaemic control was compared with delays in achieving control of 1 and 3 years, with outcomes projected over 3, 10 and 50 years in the validated IQVIA CORE Diabetes Model. Glycaemic control was defined as glycated haemoglobin (HbA1c) targets of 52, 48 and 42 mmol/mol, as recommended in Swedish guidelines, according to age and disease duration. Costs (expressed in 2019 Swedish krona [SEK]) were accounted from a Swedish societal perspective.
Immediate glycaemic control was associated with population-level cost savings of up to SEK 279 million and SEK 673 million versus delays of 1 and 3 years, respectively, as well as small population-level life expectancy benefits of up to 1305 and 2590 life years gained. Reduced levels of burden were a result of lower incidence and delayed time to onset of diabetes-related complications.
Even in people with T2D initiating first-line glucose-lowering therapy, the economic burden of poor glycaemic control in Sweden is substantial, but could be reduced by early and effective treatment to achieve glycaemic targets.
评估瑞典 2 型糖尿病（T2D）患者起始一线降糖治疗时血糖控制不佳所带来的经济和临床负担。
人群数据来自瑞典国家登记处。将即时血糖控制与延迟 1 年和 3 年达标进行比较，使用经过验证的 IQVIA CORE Diabetes Model 在 3 年、10 年和 50 年内预测结果。血糖控制定义为糖化血红蛋白（HbA1c）达到瑞典指南推荐的年龄和病程相应目标值，即 52、48 和 42mmol/mol。成本（以 2019 年瑞典克朗[SEK]表示）从瑞典社会角度进行核算。
即时血糖控制可使人群层面成本节省高达 2.79 亿瑞典克朗和 6.73 亿瑞典克朗，分别延迟 1 年和 3 年达标，同时人群层面预期寿命也有 1305 年和 2590 年的小幅度获益。负担水平降低是由于糖尿病相关并发症的发生率降低和发病时间延迟。
即使在起始一线降糖治疗的 T2D 患者中，瑞典血糖控制不佳的经济负担也很沉重，但通过早期和有效的治疗以达到血糖目标值，可减轻这一负担。
