Treating mild gestational diabetes mellitus: a cost-effectiveness analysis
Open accessAbstract
Objective This study investigated the cost-effectiveness of treating mild gestational diabetes mellitus (GDM).Study design A decision analytic model was built to compare treating vs not treating mild GDM. The primary outcome was the incremental cost per quality-adjusted life year (QALY). All probabilities, costs, and benefits were derived from the literature. Base case, sensitivity analyses, and a Monte Carlo simulation were performed.Results Treating mild GDM was more expensive, more effective, and cost-effective at $20,412 per QALY. Treatment remained cost-effective when the incremental cost to treat GDM was less than $3555 or if treatment met at least 49% of its reported efficacy at the baseline cost to treat of $1786.Conclusion Treating mild GDM is cost-effective in terms of improving maternal and neonatal outcomes including decreased rates of preeclampsia, cesarean sections, macrosomia, shoulder dystocia, permanent and transient brachial plexus injury, neonatal hypoglycemia, neonatal hyperbilirubinemia, and neonatal intensive care unit admissions.
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Many researchers consider gestational diabetes mellitus treatment highly cost-effective when benefits of future maternal type 2 diabetes mellitus and childhood obesity risk reduction are considered.
“However, many researchers consider GDM treatment highly cost-effective when the benefits of future maternal T2DM and childhood obesity risk reduction are taken into account32,42–45.”
From A global view of hypertensive disorders and diabetes mellitus during pregnancy (2022) · cites this paper as [43]
The Results report that treating mild GDM was cost-effective at $20,412 per QALY. But the Comment says the model could not include long-term effects on offspring, including possible obesity, and it does not report a reduction in future maternal type 2 diabetes. Its cost-effectiveness finding therefore was not based on taking those future benefits into account. (LLM, conf=0.88)
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Lenoir-Wijnkoop, P. I. (2022) · doi:10.33540/1456
Management of Hyperglycemia during Pregnancy in Primary Care Settings, Review Article
Alsudairy, N. M., shwaiheen, R. A., albalawi, W. A., Darraj, A. A., Alotaibi, K. M., ALSHAMMARI, S. K., Mulaysi, D. A., Alanazi, H. O. H., Alotaibi, A. S., Alyousef, S. Z. H., et al. (2022) · Saudi Medical Horizons Journal · doi:10.54293/smhj.v3i1.55
“Therefore, it is crucial to concentrate on GDM prevention, screening, early diagnosis, and management [7, 8].”
BackgroundEl-Samie, A. E.-S. A., Elbaradie, S. M. Y., Wahab, A. A. E., Elrasol, H. A., & Bakry, M. S. (2024) · Evidence Based Women s Health Journal · doi:10.21608/ebwhj.2024.81715.1143
“While some studies have shown that nutritional counseling and home blood glucose monitoring minimize the prevalence of macrosomia [8] , others have shown that stringent glucose management has little efficacy in preventing rapid development and may even result in growth restriction [9] .”
MethodJustman, N., Loberman, N., David, C. B., Wolfovitz, A., & Solt, I. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-13265-0.00026-4
- Authors
- Ohno, M. S., Sparks, T. N., Cheng, Y. W., & Caughey, A. B.
- Affiliations
- University of California, San Francisco (US)
- Brigham and Women's Hospital (US)
- Oregon Health & Science University (US)
- Venue
- American Journal of Obstetrics and Gynecology
- Publisher
- Elsevier BV
- Published
- 2011-09
- Volume
- 205
- Issue
- 3
- Pages
- 282.e1-282.e7
- ISSN
- 0002-9378 (ISSN-L)
- PMC
- PMC3443977
- OpenAlex
- W1983757912
- Cited by
- 67
- References
- 29
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 6 · 2023: 1 · 2022: 9 · 2021: 3 · 2020: 7 · 2019: 6 · 2018: 3 · 2017: 5 · 2016: 3 · 2015: 8 · 2014: 6 · 2013: 1 · 2012: 6
- FWCI
- 5.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Obstetrics and Gynecology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of California
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K12 HD001262)
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- gestational diabetes mellitus, cost-effectiveness, quality-adjusted life years, preeclampsia, cesarean section, macrosomia, neonatal outcomes, maternal outcomes, brachial plexus injury, neonatal hypoglycemia, neonatal intensive care admission
- MeSH terms
- Adult, Cesarean Section, Cost-Benefit Analysis, Decision Support Techniques, Dystocia, Female, Humans, Pregnancy, Severity of Illness Index, Diabetes, Gestational, Health Care Costs, Quality-Adjusted Life Years
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