The prevalence of type 2 diabetes mellitus has been increasing with the changes of diet and lifestyle in Asia. Further, diabetes is manifested itself in the form of association between different types of complications. These complications are contributing to huge impact on healthcare utilization, societal productivity, quality of life and survival rate. This requires accurate understanding and description of diabetes progression and its complications. Mathematical models thus offer an opportunity to provide data on long-term health, economic and quality of life outcomes for decision making. In this study, four sub-models will be constructed to simulate major diabetes-related cardiovascular complications and estimate time-to-occurrence and probability of diabetes-related complications. Semi-Markov model serves as the major modeling tool in this study. The prevalence and mortality of diabetic cardiovascular complication were estimated by different status using survival analysis. The interdependence relation between MI and stroke is significant. The mortality rate of patients with MI, CHF and stroke at the same time is highest (93.3%). By contrast, those patient with IHD have the lowest mortality rate-1.71%. This model can let us clearly understand the mortality rate of diabetes patients and the progression of diabetes-related cardiovascular diseases. Furthermore, not only diabetic patients can get more target treatment, but also those medical providers can make management strategies more efficiently based on the results of those estimations. Key words: type 2 diabetes mellitus, cardiovascular complications, transition probability.

隨著飲食以及生活作息逐漸西化，糖尿病在亞洲地區的發病率與盛行率有 也有逐漸攀升的現象。若糖尿病病情沒得到有效控制，容易引發許多併發症發 生，而這些相關併發症不僅直接影響患者的健康與生活品質，耗費大量的醫療 資源以及社會成本，更是造成糖尿病成為高死亡率疾病的原因。若能完整分析 糖尿病以及其相關併發症的整個發展病程，提供臨床醫療工作者制定更有效的 治療方案的決策依據，使病人得到更完善的醫療服務照顧，穩定病情及延緩其 併發症的惡化速度，改善其生活品質，降低糖尿病及相關併發造成的死亡率和 醫療成本。 本研究以建立糖尿病數學模擬模型，來推算糖尿病心血管併發症發生的時 間及機率，同時驗證心血管併發症之間是否有相互影響。先利用半馬可夫模型 建立出心血管疾病的轉移路徑，通過描述性統計得到各階段患者的統計人數以 及每條路徑的所需的平均天數。再將描述性統計之結果經過韋伯分布來推算出 不同路徑之併發症轉移機率。第二型糖尿病男性患者在三年內發生充血性心臟 衰竭的機率是最低的。患者同時擁有心肌梗塞、充血性心臟衰竭和中風時有 93.4%機率在三年內死亡，是所有心血管併發症組合中死亡機率最高；若只有缺 血性心臟病的患者之死亡率為最低，只有 1.71%。 本研究之模擬模型可以清楚相關心血管併發症的發展以及三年內可能死亡 之機率，不僅可以幫助患者在對於自身的血糖以及相關疾病控制，有正向的效 果，也可讓醫療服務提供者提供糖尿病病患更針對性以及有效的治療方式，進 而達到節省醫療資源的使用且患者可以得到更優良的生活品質。 關鍵字：糖尿病、心血管併發症、轉移機率