Purpose: There are 114 million people with diabetes in China and more than 60% of them are undiagnosed. People with undiagnosed diabetes have a high risk of developing complications or death. Early detection of diabetes through screening is thus critical in preventing costly complications. This study aims to compare long-term impact of several diabetes screening strategies on Chinese adults.

Methods: We developed an agent-based model to simulate the development of diabetes and its complications (i.e., neuropathy, nephropathy and cardiovascular diseases). Based on data from the China Health and Nutrition Survey and the published literature, we estimated model parameters and validated the model. We compared a set of screening strategies, including screening for 10%, 20%, and 50%, and screening people who smoke, have unhealthy diet or have limited physical activity. We simulated 10,000 people for 10 years and reported the number of diabetes, myocardial infarction (MI), stroke, neuropathy and nephropathy.

Results:Random screening for 50% of the population performs well in reducing all complications. Screening people with unhealthy diet is more effective in reducing cases of MI and neuropathy, and screening people who smoke is more effective in reducing cases of stroke.

Conclusions:Agent-based modeling is a promising tool to evaluate diabetes screening strategies, which can provide decision support to policymakers.


X. Xie: None. B. Pang: None. Y. Li: None.

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