Early Detection and Treatment of Type 2 Diabetes Reduce Cardiovascular Morbidity and Mortality: A Simulation of the Results of the Anglo-Danish-Dutch Study of Intensive Treatment in People With Screen-Detected Diabetes in Primary Care (ADDITION-Europe) Diabetes Care 2015;38:1449–1455 | DOI: 10.2337/dc14-2459 OBJECTIVE To estimate the benefits of screening and early treatment of type 2 diabetes compared with no screening and late treatment using a simulation model with data from the ADDITION-Europe study. RESEARCH DESIGN AND METHODS We used the Michigan Model, a validated computer simulation model, and data from the ADDITION-Europe study to estimate the absolute risk of cardiovascular outcomes and the relative risk reduction associated with screening and intensive treatment, screening and routine treatment, and no screening with a 3- or 6-year delay in the diagnosis and routine treatment of diabetes and cardiovascular risk factors. RESULTS When the computer simulation model was programmed with the baseline de- mographic and clinical characteristics of the ADDITION-Europe population, it accurately predicted the empiric results of the trial. The simulated absolute risk reduction and relative risk reduction were substantially greater at 5 years with screening, early diagnosis, and routine treatment compared with scenarios in which there was a 3-year (3.3% absolute risk reduction [ARR], 29% relative risk reduction [RRR]) or a 6-year (4.9% ARR, 38% RRR) delay in diagnosis and routine treatment of diabetes and cardiovascular risk factors. CONCLUSIONS Major benefits are likely to accrue from the early diagnosis and treatment of glycemia and cardiovascular risk factors in type 2 diabetes. The intensity of glu- cose, blood pressure, and cholesterol treatment after diagnosis is less important than the time of its initiation. Screening for type 2 diabetes to reduce the lead time between diabetes onset and clinical diagnosis and to allow for prompt multifac- torial treatment is warranted. 1 Departments of Internal Medicine and Epide- miology, University of Michigan, Ann Arbor, MI 2 School of Public Health, University of Michigan, Ann Arbor, MI 3 Medical Research Council Epidemiology Unit, Uni- versity of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, U.K. 4 Leicester Diabetes Centre, University of Leices- ter, Leicester General Hospital, Leicester, U.K. 5 Department of Primary Care, Julius Center, Uni- versity Medical Center, Utrecht, the Netherlands 6 Institute of Public Health, Section of General Practice, Aarhus University, Aarhus, Denmark 7 Holbaek Hospital, Holbæk Sygehus, Holbaek, Denmark Corresponding author: William H. Herman, wherman@umich.edu. Received 16 October 2014 and accepted 23 March 2015. This article contains Supplementary Data online at http://care.diabetesjournals.org/lookup/ suppl/doi:10.2337/dc14-2459/-/DC1. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See accompanying article, p. 1399. William H. Herman, 1 Wen Ye, 2 Simon J. Griffin, 3 Rebecca K. Simmons, 3 Melanie J. Davies, 4 Kamlesh Khunti, 4 Guy E.H.M. Rutten, 5 Annelli Sandbaek, 6 Torsten Lauritzen, 6 Knut Borch-Johnsen, 7 Morton B. Brown, 2 and Nicholas J. Wareham 3 Diabetes Care Volume 38, August 2015 1449 EPIDEMIOLOGY/HEALTH SERVICES RESEARCH