Simulation of Clinical Trials with Mathematical Models ... - CBI
Simulation of Clinical Trials with Mathematical Models ... - CBI
Simulation of Clinical Trials with Mathematical Models ... - CBI
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In the DPP simulation, populations and interventions<br />
were matched, and identical outcomes were set up<br />
45<br />
• The people: “high risk <strong>of</strong> diabetes”<br />
– BMI >24<br />
– FPG 5.3 – 6.9 mmol/L = 95 – 125 mg/dL<br />
– OGTT 7.8 – 11 mmol/L = 140 – 199 mg/dL<br />
• The interventions<br />
– Metformin (originally $742/year, now $260/year)<br />
• Reduces FPG<br />
• Reduces LDL and TG<br />
• Retards weight gain<br />
– DPP Lifestyle ($1356 in 1 st year, then $672/year thereafter)<br />
• Reduces weight<br />
• Reduces FPG, BP, LDL, Total Cholesterol<br />
• Raises HDL<br />
– Add Lifestyle after diagnosis <strong>of</strong> diabetes<br />
• Outcomes<br />
– Progression to diabetes<br />
• FPG > 7 mmol/L (125 mg/dl) or OGTT > 11 mmol/L (199 mg/dl)<br />
– Myocardial infarction and stroke<br />
– End stage renal disease, retinopathy<br />
– Quality <strong>of</strong> life<br />
– Costs<br />
45
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