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. 2006 Mar;96(3):488-94.
doi: 10.2105/AJPH.2005.063529. Epub 2006 Jan 31.

Understanding diabetes population dynamics through simulation modeling and experimentation

Andrew P Jones  1 , Jack B Homer, Dara L Murphy, Joyce D K Essien, Bobby Milstein, Donald A Seville
Affiliations

Understanding diabetes population dynamics through simulation modeling and experimentation

Andrew P Jones et al. Am J Public Health. 2006 Mar.

Abstract

Health planners in the Division of Diabetes Translation and others from the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention used system dynamics simulation modeling to gain a better understanding of diabetes population dynamics and to explore implications for public health strategy. A model was developed to explain the growth of diabetes since 1980 and portray possible futures through 2050. The model simulations suggest characteristic dynamics of the diabetes population, including unintended increases in diabetes prevalence due to diabetes control, the inability of diabetes control efforts alone to reduce diabetes-related deaths in the long term, and significant delays between primary prevention efforts and downstream improvements in diabetes outcomes.

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Figures

FIGURE 1—
FIGURE 1—
Overview of model structure, showing primary population stocks (boxes) and flows (arrows with valve symbols and cloud symbols for deaths), modifiable factors affecting flows (roman), and inputs amenable to policy intervention (italics).
FIGURE 2—
FIGURE 2—
Selected baseline model output, 1980–2050, and comparison to historical data for obesity prevalence (a), diabetes prevalence (b), complication-related deaths per complicated cases (c), and complication-related deaths (d). Note. Reported obesity prevalence based on National Health and Nutrition Examination Survey, and reported diabetes prevalence based on National Health Interview Survey. Baseline projection assumes that obesity prevalence rises to 37% in 2006 and remains fixed thereafter, and that disease detection and control efforts all remain fixed after 2004.
FIGURE 2—
FIGURE 2—
Selected baseline model output, 1980–2050, and comparison to historical data for obesity prevalence (a), diabetes prevalence (b), complication-related deaths per complicated cases (c), and complication-related deaths (d). Note. Reported obesity prevalence based on National Health and Nutrition Examination Survey, and reported diabetes prevalence based on National Health Interview Survey. Baseline projection assumes that obesity prevalence rises to 37% in 2006 and remains fixed thereafter, and that disease detection and control efforts all remain fixed after 2004.
FIGURE 3—
FIGURE 3—
Model output for 3 intervention scenarios compared with the baseline scenario for diabetes prevalence (a) and complication-related deaths (b).
FIGURE 3—
FIGURE 3—
Model output for 3 intervention scenarios compared with the baseline scenario for diabetes prevalence (a) and complication-related deaths (b).
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References

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