Value of Lifestyle Intervention to Prevent Diabetes and Sequelae
Open accessAbstract
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.
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Previous work has found that IBC intervention, including NDPP, among overweight and obese adults with prediabetes and CVD risk factors can improve clinical measures, prevent or delay disease onset, reduce medical expenditures, and increase productivity.
“Previous work has found that IBC intervention, including NDPP, among overweight and obese adults with prediabetes and CVD risk factors can improve clinical measures, prevent or delay disease onset, reduce medical expenditures, and increase productivity (in the form of higher labor force participation and lower work absenteeism) [1–6,13–15,19].”
In this study we used a previously published and validated microsimulation model to estimate reduced CVD events onset and health expenditure by senior participants of a digital intensive behavioral counseling program.
“In this study we used a previously published and validated microsimulation model to estimate reduced CVD events onset and health expenditure by senior participants of a digital intensive behavioral counseling program.”
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Self-citation
- Authors
- Dall, T. M., Storm, M. V., Semilla, A. P., Wintfeld, N., O’Grady, M., & Venkat Narayan, K. M.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Dall, Timothy M.
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 48
- Issue
- 3
- Pages
- 271-280
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W2045693023
- Cited by
- 53
- References
- 64
- Citations by year
- 2026: 5 · 2025: 1 · 2024: 12 · 2022: 6 · 2021: 3 · 2020: 6 · 2019: 3 · 2018: 3 · 2017: 3 · 2016: 9 · 2015: 1 · 2014: 1
- FWCI
- 11.60
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- American Journal of Preventive Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Novo Nordisk
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- prediabetes, lifestyle intervention, type 2 diabetes prevention, economic benefits, diabetes screening, Diabetes Prevention Program, Markov model, health care costs, quality of life, mortality
- MeSH terms
- Blood Pressure, Cholesterol, Diabetes Mellitus, Type 2, Diet, Health Expenditures, Female, Glycated Hemoglobin, Humans, Life Style, Male, Markov Chains, Mass Screening, Middle Aged, Nutrition Surveys, Prediabetic State, Quality of Life, Risk Factors, Health Behavior, Exercise, Comorbidity, Body Mass Index
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