We conducted the analysis by using the Archimedes model, which has been described elsewhere (7–9). Briefly, it is a simulation model written at a relatively high level of anatomic, physiologic, clinical, and administrative detail. It uses object-oriented programming to create in the model objects that correspond to objects in reality, one-to-one. Among the hundreds of objects are people, pancreases, β cells, plasma glucose levels, coronary arteries, plaque, chest pain, emergency departments, electrocardiograms, aspirin, and angioplasties. Helpful analogies might be a flight simulator (in which the objects include the plane and its wings, airports, runways, buildings, and the wind), or the SimCity computer game. In the Archimedes model, each individual is simulated down to the level of hepatic glucose production, insulin resistance, β-cell fatigue, and similar biological variables. The core of the model is a set of differential equations that represent the anatomy and physiology pertinent to diseases and their complications. Currently, the model includes diabetes, congestive heart failure, coronary artery disease, stroke, hypertension, and asthma in a single integrated model. The structure and equations of the model pertinent to diabetes and its complications are described elsewhere (8–9). The Appendix and a technical report available through our Web site (10) describe additional aspects of the model and its validations that are pertinent to this analysis. Calculations are performed by using a distributed computing network.