Abstract
The number of individuals suffering from type 2 diabetes is dramatically increasing worldwide, resulting in an increasing burden on society and rising healthcare costs. With increasing evidence supporting lifestyle intervention programs to reduce type 2 diabetes, and the use of scenario simulations for policy support, there is an opportunity to improve population interventions based upon cost–benefit analysis of especially complex lifestyle intervention programs through dynamic simulations. In this article, we used the System Dynamics (SD) modeling methodology aiming to develop a simulation model for policy makers and health professionals to gain a clear understanding of the patient journey of type 2 diabetes mellitus and to assess the impact of lifestyle intervention programs on total cost for society associated with prevention and lifestyle treatment of pre-diabetes and type 2 diabetes in The Netherlands. System dynamics describes underlying structure in the form of causal relationships, stocks, flows, and delays to explore behavior and simulate scenarios, in order to prescribe intervention programs. The methodology has the opportunity to estimate and simulate the consequences of unforeseen interactions in order to prescribe intervention programs based on scenarios tested through “what-if” experiments. First, the extensive knowledge of diabetes, current available data on the type 2 diabetes population, lifestyle intervention programs, and associated cost in The Netherlands were captured in one simulation model. Next, the relationships between leverage points on the growth of type 2 diabetes population were based upon available data. Subsequently, the cost and benefits of future lifestyle intervention programs on reducing diabetes were simulated, identifying the need for an integrated adaptive design of lifestyle programs while collecting the appropriate data over time. The strengths and limitations of scenario simulations of complex lifestyle intervention programs to improve the (cost)effectiveness of these programs to reduce diabetes in a more sustainable way compared to usual care are discussed.
Highlights
Diabetes mellitus (DM) is a complex disorder [1,2,3], and the number of individuals suffering from DM is dramatically increasing worldwide from over 360 million individuals in 2015, expected to be 500 million individuals in 2030 [3,4,5]
The T2DM patient journey model displays the journey of individuals developing T2DM and the possibilities to reduce T2DM via interventions programs, coupled to the costs associated with T2DM and these subsequent programs in The Netherlands (Figure 3)
Individuals are recruited to this population because of being born, migration, and passing away
Summary
Diabetes mellitus (DM) is a complex disorder [1,2,3], and the number of individuals suffering from DM is dramatically increasing worldwide from over 360 million individuals in 2015, expected to be 500 million individuals in 2030 [3,4,5]. The non-heritable risk factors indicate the possibility of T2DM patients, and diagnosed pre-diabetes patients could be reversed to healthy individuals In line with this interaction, Loos and Janssens [29] argued that most individuals develop T2DM as a consequence of suffering from a metabolic syndrome or obesity, which predominantly occurs due the combination of an unhealthy lifestyle and a genetic susceptibility for gaining weight. 51% of the Dutch population above 20 years old are overweight, of which 15% are obese Both populations have increased over the past 5 years [31], and with the knowledge that one of three obese people develops T2DM, these numbers indicate that combined (cost)effective lifestyle programs may have extensive positive implications for society
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
