BACKGROUND: The benefits of intensive glycemic control in @entity1 with @entity164 2 @entity6 are not well quantified. It is therefore not clear which @entity1 will benefit most from aggressive glycemic control. OBJECTIVE: To evaluate the efficacy of glycemic control in @entity164 2 @entity6 . DESIGN: Markov decision model. @entity1 : @entity6 @entity1 at a health maintenance organization. MAIN OUTCOME MEASURES: Risks for developing @entity1939 and @entity454 ; number of @entity1 and @entity1 -years needed to treat to prevent complications. RESULTS: For a @entity1 in whom @entity6 developed before 50 years of age, reducing hemoglobin A1c levels from 9% to 7% results in an estimated 2.3-percentage point decrease (from 2.6% to 0.3%) in lifetime risk for @entity1939 due to @entity989 . The same change in a @entity1 with @entity6 onset at 65 years of age would be expected to decrease the risk for @entity1939 by 0.5 percentage points (from 0.5% to < 0.1%). However, the Markov model predicts substantially greater benefit when moving from poor to moderate glycemic control than when moving from moderate to almost-normal glycemic control. Targeting less than 20% of the @entity1 at one health maintenance organization for intensified therapy may prevent more than 80% of the preventable @entity1 -time spent blind. The risks for @entity454 and the risk reduction provided by improved glycemic control are lower than those for @entity1939 . CONCLUSIONS: This probability model, based on extrapolation from the experience with @entity164 1 @entity6 , suggests that @entity1 with early onset of @entity164 2 @entity6 will accrue substantial benefit from almost-normal glycemic control. In @entity1 with later onset, moderate glycemic control prevents most end-stage complications caused by @entity66 . These results have important implications for informing @entity1 and allocating health care resources.

Estimated benefits of glycemic control in microvascular complications in XXXX 2 @entity6 .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity66 :: ('MESH:D004194', 'Disease') :: ['microvascular disease'] @entity6 :: ('MESH:D003920', 'Disease') :: ['Diabetic', 'diabetes'] @entity1939 :: ('MESH:D001766', 'Disease') :: ['blindness'] @entity164 :: ('MESH:D017827', 'Disease') :: ['type'] @entity989 :: ('MESH:D012164', 'Disease') :: ['retinopathy'] @entity454 :: ('MESH:D007676', 'Disease') :: ['end-stage renal disease']
@entity164 :: (MESH:D017827,Disease) :: ['type']
