Institute of Health Economics (Canada) Diabetes Model (IHE-DM)
Information last updated: April 2026
Contact: Megan Wiggins, Institute of Health Economics, Edmonton, Alberta, Canada
Email: mwiggins[@]ihe.ca
Participated in the following Mt Hood Diabetes Challenge Meetings: NA
Purpose of model: Pre-diabetes and Type 2 Diabetes
Publicly accessible?: No. Information about the model code can be made available upon request to info@ihe.ca.
Is the model continuing to be developed?: Yes.
Brief Description:
The IHE-DM is an individual-level discrete-time microsimulation model that
simulates: (i) progression from normal glucose tolerance (NGT) to T2DM, (ii) the
occurrence and timing of T2DM-related comorbidities and mortality, and (iii) time-
varying changes in individual-level T2DM risk factors.
All patients move through two model levels during each 1-year model cycle. This
continues until either a user-defined time horizon (e.g., 25 years) is reached or the
patient dies. The top level of the model determines the patient’s T2DM health state,
where they can be in one of two independent T2DM health states determined by their
HbA1c: (i) NGT/pre-T2DM, with an HbA1c of less than 6.5 percent, or (ii) T2DM,
with an HbA1c of 6.5 percent or higher.
The second level of the model predicts the occurrence and timing of T2DM-related
comorbidities (congestive heart failure [CHF], ischemic heart disease [IHD],
blindness, renal failure, myocardial infarction [MI], stroke, amputation, diabetic ulcer)
and death conditioned on the patient’s T2DM health state and their individual risk
factors (e.g., age, history of comorbidities, BMI). Time-varying risk factors are also
updated based on the patient’s T2DM health state and their individual risk factors in
this section of the model.
The IHE-DM can estimate the cost-effectiveness of T2DM interventions from
prevention to management and can be used to inform future funding decisions and
identify target populations for intervention. Model outputs include cumulative
incidence and rates of T2DM, comorbidities, mortality; life years (LYs) and quality-
adjusted life years (QALYs); biomarker trajectories; as well as cost and cost-
effectiveness estimates.
Funding source for model development:
The model development work was supported by Alberta Health Services (no grant number). Model validation work was supported by Alberta Primary and Preventative Health Services (grant # 019109).
Key Publications:
Wiggins M, Round J, Kirwin E. Development and validation of a type 2 diabetes model to estimate the cost-effectiveness of diabetes interventions across the care continuum. International Journal of Technology Assessment in Health Care 2025;41(1):e36.