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We parameterised the model using the best available data on population characteristics, healthcare costs and health-related quality of life from German studies. The modelled scenarios were: (1) a permanent reduction of HbA<jats:sub>1c<\/jats:sub> by 5.5 mmol\/mol (0.5%), of systolic BP (SBP) by 10 mmHg, or of LDL-cholesterol by 0.26 mmol\/l in all patients, and (2) achievement of guideline care recommendations for HbA<jats:sub>1c<\/jats:sub> (\u226453 mmol\/mol [7%]), SBP (\u2264140 mmHg) or LDL-cholesterol (\u22642.6 mmol\/l) in patients who do not meet the recommendations. We calculated nationwide estimates using age- and sex-specific quality-adjusted life year (QALY) and cost estimates, type\u00a02 diabetes prevalence and population size.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Over 10 years, a permanent reduction of HbA<jats:sub>1c<\/jats:sub> by 5.5 mmol\/mol (0.5%), SBP by 10 mmHg or LDL-cholesterol by 0.26 mmol\/l led to per-person savings in healthcare expenditures of \u20ac121, \u20ac238 and \u20ac34, and 0.01, 0.02 and 0.015 QALYs gained, respectively. Achieving guideline care recommendations for HbA<jats:sub>1c<\/jats:sub>, SBP or LDL-cholesterol could reduce healthcare expenditure by \u20ac451, \u20ac507 and \u20ac327 and gained 0.03, 0.05 and 0.06 additional QALYs in individuals who did not meet the recommendations. Nationally, achieving guideline care recommendations for HbA<jats:sub>1c<\/jats:sub>, SBP and LDL-cholesterol could reduce healthcare costs by over \u20ac1.9 billion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions\/interpretation<\/jats:title>\n                <jats:p>Sustained improvements in HbA<jats:sub>1c<\/jats:sub>, SBP and LDL-cholesterol control among diabetes patients in Germany can lead to substantial health benefits and reduce healthcare expenditures.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00125-023-05950-3","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T21:01:21Z","timestamp":1688158881000},"page":"1693-1704","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Health and economic impact of improved glucose, blood pressure and lipid control among German adults with type 2 diabetes: a modelling study"],"prefix":"10.1007","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1846-1265","authenticated-orcid":false,"given":"Min","family":"Fan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6438-2058","authenticated-orcid":false,"given":"Anna-Janina","family":"Stephan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2330-1079","authenticated-orcid":false,"given":"Karl","family":"Emmert-Fees","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6645-0985","authenticated-orcid":false,"given":"Annette","family":"Peters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-7417","authenticated-orcid":false,"given":"Michael","family":"Laxy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"issue":"11","key":"5950_CR1","doi-asserted-by":"publisher","first-page":"177","DOI":"10.3238\/arztebl.2016.0177","volume":"113","author":"T Tamayo","year":"2016","unstructured":"Tamayo T, Brinks R, Hoyer A, Kuss OS, Rathmann W (2016) The prevalence and incidence of diabetes in Germany. 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PLoS One 9(6):e99773. https:\/\/doi.org\/10.1371\/journal.pone.0099773","journal-title":"PLoS One"}],"container-title":["Diabetologia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-023-05950-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00125-023-05950-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00125-023-05950-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T13:03:37Z","timestamp":1690808617000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00125-023-05950-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,30]]},"references-count":45,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["5950"],"URL":"https:\/\/doi.org\/10.1007\/s00125-023-05950-3","relation":{},"ISSN":["0012-186X","1432-0428"],"issn-type":[{"value":"0012-186X","type":"print"},{"value":"1432-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,30]]},"assertion":[{"value":"6 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 April 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Data collection in the KORA study was performed in cooperation with the University Hospital of Augsburg. An abstract of this paper was submitted to the EUHEA (European Health Economics Association) Conference 2022 \u2018Health Economics for Sustainable Welfare Systems\u2019 (Oslo, Norway), and was presented orally by Min Fan.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Acknowledgements"}},{"value":"The data are subject to national data protection laws, and restrictions were imposed by the Ethics Committee of the Bavarian Medical Association to ensure data privacy of the study participants; therefore, data cannot be made freely available in a public repository. Data are third-party and belong to the KORA research platform, but may be accessed for specific research projects through individual project agreements. Interested researchers can request data from KORA via the online tool (). Interested researchers, who agree to the general terms and conditions of the KORA data user agreement, can therefore access the data of KORA in the same way that we did.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data availability"}},{"value":"Parts of this work were funded by iPDM-GO (Integrated Personalised Diabetes Management), for which we received funding from the European Institute for Innovation and Technology (EIT) through its Knowledge and Innovation Community EIT Health. The EIT is a body of the European Union that receives support from the European Union\u2019s Horizon 2020 research and innovation programme. The KORA study was initiated and financed by the Helmholtz Zentrum M\u00fcnchen\/German Research Center for Environmental Health, which is funded by the German Bundesministerium f\u00fcr Bildung und Forschung and the State of Bavaria. Open\u00a0Access funding enabled and organised by Projekt DEAL. \u00a0","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Authors\u2019 relationships and activities"}},{"value":"MF analysed and interpreted the data and drafted the manuscript. ML conceptualised and designed the study, interpreted the data, and contributed to acquisition of the data and drafting the article. A-JS and KE-F contributed to the drafting of the article and revised it critically for important intellectual content. AP made contributions to the acquisition of the data, and critically reviewed the manuscript. All authors gave final approval of the version to be published. MF and ML are the guarantors of this work and, as such, had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of this data analysis.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Contribution statement"}}]}}