EARNSHAW ET AL.OPTIMAL RESOURCE ALLOCATION ACROSS DIABETES INTERVENTIONSRIGINAL RESE H Optimal Allocation of Resources across Four Interventions for Type 2 Diabetes

Background.Several interventions can be applied to prevent complications of type 2 diabetes. This article examines the optimal allocation of resources across 4 interventions to treat patients newly diagnosed with type 2 diabetes. The interven-tions are intensive glycemic control, intensified hypertension control, cholesterol reduction, and smoking cessation. Methods. A linear programming model was designed to se-lect sets of interventions to maximize quality-adjusted life years (QALYs), subject to varied budget and equity con-straints. Results. For no additional cost, approximately 211,000QALYs canbe gainedover the lifetimes of all persons newly diagnosed with diabetes by implementing interven-tions rather than standardcare.With increasedavailability of funds, additional health benefits can be gained but with di-minishingmarginal returns. The impact of equity constraint