• Margareta Hellgren, Ann-Marie Svensson, Stefan Franzén, Åsa Ericsson, Soffia Gudbjörnsdottir, Nils Ekström, Rebecka Bertilsson, William Valentine, and Samuel Malkin.
• The Skaraborg Institute, Skövde, Sweden.
• Diabetes Obes Metab. 2021 Jul 1; 23 (7): 1604-1613.

AimTo 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.Materials And MethodsPopulation 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.ResultsImmediate 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.ConclusionsEven 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.© 2021 Ossian Health Economics and Communications GmbH. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

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