Broader attainment of guideline-based cardiometabolic targets may substantially reduce cardiovascular disease burden in type 2 diabetes mellitus (T2DM). A scenario-based analysis published in Diabetes, Obesity and Metabolism found that multifactorial control was associated with markedly lower projected CVD events and substantial healthcare cost savings across Asia.

The study applied the validated ABC model to data from the Joint Asia Diabetes Evaluation (JADE) Register, including 103,958 patients with T2DM across 11 Asian countries and jurisdictions. Simulations assessed the 3-year impact of reaching glycated hemoglobin (HbA1c) below 7%, blood pressure under 130/80 mmHg, risk-stratified low-density lipoprotein cholesterol (LDL-C) targets, smoking cessation, and weight reduction.

Among participants, 53.4% were men and 12.0% were current smokers. Mean age was 57.6 years, mean HbA1c was 7.96%, mean systolic blood pressure was 132.0 mmHg, mean LDL-C was 2.6 mmol/L, and mean body mass index (BMI) was 26.2 kg/m². Prior CVD was present in 16.5%, while 83.5% had no baseline CVD.

Only 1.5% of those with prior CVD and 5.1% without CVD achieved all three ABC targets at baseline. Estimated CVD incidence rates were 61.60 per 1000 person-years in the prior CVD group and 11.65 per 1000 person-years in the non-CVD group. Simulated attainment of all ABC targets reduced incidence rates by 35.1% to 40.01% in the prior CVD group and by 8.13% to 30.2% in the non-CVD group.

In China alone, the model estimated that 1,177,682 CVD events annually could be averted, with projected savings of US$11,292,823,476. The findings suggest broader multifactorial risk factor control may meaningfully reduce cardiometabolic complications and costs in T2DM.