{"doi":"10.2337/dc25-0124","title":"A New Simulation Model to Estimate the Long-term Health and Cost Outcomes of Interventions for People With Type 1 Diabetes","abstract":"OBJECTIVE: To develop a U.S.-based microsimulation model for assessing the cost-effectiveness of interventions to manage type 1 diabetes. RESEARCH DESIGN AND METHODS: We developed risk equations for 14 diabetes-related complications and mortality, 12 risk factor progression equations, and one equation for utilities associated with 14 complications using data from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) studies and the Epidemiology of Diabetes Complications (EDC) study. We integrated all equations into a simulation model. We conducted internal and external validation and demonstrated the utility of the model using a real-world example. Main model-generated outcomes included cumulative incidence of diabetes-related complications, life years, quality-adjusted life years, medical costs, and incremental cost-effectiveness ratios. RESULTS: The model generates long-term clinical and economic outcomes from changes in risk factors of type 1 diabetes complications. Internal validation comparing modeled outcomes to observed data used to develop the model yielded good prediction accuracy, with mean absolute percentage error across all complications of 9% and correlation of cumulative failure rates above 0.9. External validation results were mixed, with occurrence of slight under- or overprediction across complications and studies. We illustrated the model with a case study estimating the effects of expanding the use of an insulin pump with continuous glucose monitoring to all people with type 1 diabetes. CONCLUSIONS: Our new comprehensive type 1 diabetes simulation model can generate valid and accurate results for assessing the long-term cost-effectiveness of interventions to manage type 1 diabetes in the U.S.","journal":"Diabetes Care","year":2025,"id":528435,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8809,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":817009,"name":"Thomas J. Hoerger","orcid":"0000-0003-4154-7806","position":1,"is_corresponding":false},{"id":420524,"name":"Nicole Mack","orcid":"0000-0002-3801-6310","position":2,"is_corresponding":false},{"id":590154,"name":"Georgiy Bobashev","orcid":"0000-0003-2346-1400","position":3,"is_corresponding":false},{"id":1115335,"name":"Simon Neuwahl","orcid":"0000-0003-3512-7397","position":4,"is_corresponding":false},{"id":397765,"name":"Rainer Hilscher","orcid":"0000-0002-5004-4584","position":5,"is_corresponding":false},{"id":309261,"name":"Trevor J. Orchard","orcid":"0000-0001-9552-3215","position":6,"is_corresponding":false},{"id":439760,"name":"Tina Costacou","orcid":"0000-0001-9303-3810","position":7,"is_corresponding":false},{"id":382894,"name":"Rachel G. Miller","orcid":"0000-0003-1845-8477","position":8,"is_corresponding":false},{"id":43418,"name":"Ralph B. D’Agostino","orcid":"0000-0002-3550-8395","position":9,"is_corresponding":false},{"id":52428,"name":"Ping Zhang","orcid":"0000-0001-9163-6191","position":10,"is_corresponding":false},{"id":428471,"name":"Carolina Barbosa","orcid":"0000-0002-7535-9443","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T02:50:48.492873Z","pmid":"40608287","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}