Evaluation of the Long-Term Impact of Improving Care for People with Type 2 Diabetes in China

Abstract

BackgroundThe member states of the United Nations launched 17 sustainable development goals (SDGs) as part of the 2030 Sustainable Development Agenda. SDG target 3.4 focused on reducing premature mortality from noncommunicable diseases by one-third by 2030 through prevention and treatment and promoting mental health and well-being. Diabetes is associated with significant clinical and economic burden in China. ObjectivesTo examine the impact of improving care for people with diabetes in China, and how this relates to achieving SDG target 3.4. MethodsLong-term outcomes were projected for people with type 2 diabetes meeting treatment targets recommended by the Chinese Diabetes Society versus remaining at current care. Baseline characteristics were taken from the China Noncommunicable Disease Surveillance Study. Costs of treating diabetes-related complications were accounted in 2015 Chinese yuan (CNY). Outcomes were discounted at 3% annually when appropriate. ResultsBringing people with diabetes to treatment targets was associated with improved mean undiscounted life expectancy compared with current care (by 0.42 years). Nationally, discounted cost savings of up to CNY540 billion could be generated as a result of reduced onset of diabetes-related complications if all people with diabetes achieved treatment targets. Bringing people to treatment targets reduced premature mortality from diabetes by 6% compared with current care. ConclusionsLong-term projections suggested that bringing people with diabetes to treatment targets resulted in improved life expectancy and significant cost savings. However, this was not sufficient to meet SDG target 3.4, indicating that diabetes prevention should form a key objective in China.