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Am J Prev Med. 2015 Mar;48(3):271-80. doi: 10.1016/j.amepre.2014.10.003. Epub 2014 Dec 10.

Value of lifestyle intervention to prevent diabetes and sequelae.

Author information

1
IHS Life Sciences, Washington, District of Columbia. Electronic address: tim.dall@ihs.com.
2
IHS Life Sciences, Washington, District of Columbia.
3
Novo Nordisk Inc. Plainsboro, New Jersey.
4
NORC at the University of Chicago, Illinois.
5
Rollins School of Public Health, Emory University, Atlanta, Georgia.

Abstract

BACKGROUND:

The Community Preventive Services Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes, as evidence continues to show that intensive lifestyle interventions are effective for overweight individuals with prediabetes.

PURPOSE:

To illustrate the potential clinical and economic benefits of treating prediabetes with lifestyle intervention to prevent or delay onset of type 2 diabetes and sequelae.

METHODS:

This 2014 analysis used a Markov model to simulate disease onset, medical expenditures, economic outcomes, mortality, and quality of life for a nationally representative sample with prediabetes from the 2003-2010 National Health and Nutrition Examination Survey. Modeled scenarios used 10-year follow-up results from the lifestyle arm of the Diabetes Prevention Program and Outcomes Study versus simulated natural history of disease.

RESULTS:

Over 10 years, estimated average cumulative gross economic benefits of treating patients who met diabetes screening criteria recommended by the ADA ($26,800) or USPSTF ($24,700) exceeded average benefits from treating the entire prediabetes population ($17,800). Estimated cumulative, gross medical savings for these three populations averaged $10,400, $11,200, and $6,300, respectively. Published estimates suggest that opportunistic screening for prediabetes is inexpensive, and lifestyle intervention similar to the Diabetes Prevention Program can be achieved for ≤$2,300 over 10 years.

CONCLUSIONS:

Lifestyle intervention among people with prediabetes produces long-term societal benefits that exceed anticipated intervention costs, especially among prediabetes patients that meet the ADA and USPSTF screening guidelines.

PMID:
25498548
DOI:
10.1016/j.amepre.2014.10.003
[Indexed for MEDLINE]
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