OBJECTIVES: Exogenous insulin therapy is essential to prevent fatal complications from hyperglycemia. Several interventions can be applied to prevent complications of Type 1 Diabetes Mellitus (T1DM). This model estimates the optimal allocation of resources across available treatments for patients with T1DM in Mexico.

METHODS: This study was a retrospective observational study using data from the National Survey on Health and Nutrition. A multivariate longitudinal regression was used to estimate the risk of microvascular and macrovascular complication events. Second-degree polynomial was applied to identify the optimal goals in their associations with lowest risk of clinical outcomes, controlling for demographic characteristics, medical history, and medications. Information about efficacy and safety was obtained from clinical trials of each regime (Degludec+Aspart, Detemir+Lispro, NNPH+Lispro, Glargina100+Lispro, Glargina 300+Lispro). Costs are expressed in 2022 USD.

RESULTS: For a follow-up of 10 years, to achieve the lowest risk of microvascular and macrovascular complication, the optimal treatment distribution is Degludec+Aspart=36.2%, Detemir+Lispro, NPH+Lispro=16.5%, Glargine300+Lispro=11.5% and Glargine100+LisproI=9.3%. At this level, every 1,000 T1DM patients, cost (treatment and complications) per year is: Degludec+Aspart=$2,801,111,00, Detemir+Lispro=$2,809,875.00, NPH+Lispro=$2,910,435.00, Glargine300+Lispro=$2,801,096.00 and Glargine100+LisproI= $2,805,407.00. Difference of Detemir+Lispro versus Degludec+Aspart is $8,764.00, meanwhile vs NPH+Lispro $43,718.00. Regarding Glargine100+Lispro and Glargine300+Lispro the difference is $43,11.00 and $109,339.00, respectively.

CONCLUSIONS: Available treatment strategies in Mexico targeting hypertension, hyperglycemia, and hyperlipidemia may improve health outcome in patients with T1DM. Using optimally available treatments based on the best outcomes may led to important savings to the Mexican health system.