Estimation of mortality savings due to a national program for diabetes care.
BACKGROUND
Diabetes-related complications can be reduced by better control of glycemia, lipid abnormalities and blood pressure. In recent years, efforts at improving diabetes care in Israel have been made. This study aims to estimate mortality savings related to a national program for diabetes care in Israel.


METHODS
Total population data for Israel was projected to 2020. Current diabetes prevalence and disease management data were obtained from a national program of diabetes care. Projections of the program's effect were based on two models: improvement in glycemic control, reflected in Hb A1c levels, and improvement in overall diabetes care, reflected in the percentage with LDL<100 mg/dl, a proxy for multi-factorial control. Potential years of life lost (PYLL) and quality-adjusted life years (QALYs) saved were calculated.


RESULTS
A drop in average Hb A1c values from 8.13% at baseline to 7.36% in 2020 is expected, and as a result 4216 deaths from diabetes will be prevented over the period 2001-2020, saving around 47,773 life years or 34,342 QALYs. Overall diabetes care, reflected in improving the control rate of LDL levels to <100 mg/dl from 36% in 2000 to 58% in 2020, is estimated to prevent around 4803 deaths from diabetes over the period 2001-2020., so the program will save around 47,127 PYLL or 32,862 QALYs.


CONCLUSIONS
A nationwide program of diabetes care is estimated to result in significant reductions of overall, as well as CHD-related, mortality.
Dreiher
Jacob
J
Clalit Health Services, Israel; Division of Health in the Community, Ben Gurion University of the Negev, Beer Sheva, Israel.
Ginsberg
Gary
G
Rabinowitz
Gad
G
Raskin-Segal
Anat
A
Weitzman
Ron
R
Porath
Avi
A
D048909:Diabetes Complications / Q000401:mortality; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality* / Q000628:therapy*; D019317:Evidence-Based Medicine; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008329:Managed Care Programs / Q000592:standards / Q000706:statistics & numerical data; D009313:National Health Programs / Q000592:standards* / Q000706:statistics & numerical data; D015995:Prevalence; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care; D017678:Sex Distribution
D006442:Glycated Hemoglobin