Economic evaluation of physical activity interventions for type 2 diabetes management: a systematic review
Open accessAbstract
Background: Economic evaluation of physical activity interventions has become an important area for policymaking considering the high costs attributable to physical inactivity. However, the evidence for such interventions targeting type 2 diabetes control is scarce. Therefore, the present study aimed to synthesize economic evaluation studies of physical activity interventions for type 2 diabetes management. Methods: A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement (PROSPERO reference number CRD42021231021). An electronic search was performed in PubMed, Web of Science, Cochrane Library and NHS Economic Evaluation Database. Studies were eligible if they included: adults with type 2 diabetes; any physical activity intervention in the community settings; an experimental or quasi-experimental design; and a parameter of economic evaluation [cost analysis of interventions, cost-effectiveness analysis (including cost-utility analysis) and cost-benefit analysis] as an outcome. Results: Ten studies were included in this review: seven were randomized controlled trials and three were quasi-experimental studies. All studies included direct costs, and four also included indirect costs. Four studies demonstrated that physical activity interventions were cost-saving, six studies showed cost-effectiveness, and two studies reported cost-utility. The estimates varied considerably across the studies with different analytical and methodological approaches. Conclusion: Overall, this systematic review found that physical activity interventions are a worth investment for type 2 diabetes management. However, comparability across interventions was limited due to heterogeneity in interventions type, design and delivery, which may explain the differences in the economic measures.
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Most evaluations of digital interventions focus on management rather than preventing T2D.
“Most evaluations of digital interventions focus on management by supporting medication adherence, dietary tracking, and remote coaching for individuals already diagnosed with T2D, rather than preventing it [13].”
From Economic evaluation of wearable fitness trackers versus metformin for preventing type 2 diabetes in the UK population (2025) · cites this paper as [13]
The Results (Study characteristics; page unavailable) say that all included studies involved people with T2D, and some interventions used phone calls, pedometers, or a heart-rate monitor. But this is a review of physical-activity interventions, not digital interventions generally. It does not establish that most digital-intervention evaluations favor management over prevention or that they focus on medication adherence, dietary tracking, and remote coaching. (LLM, conf=0.85)
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Xu, Y., & García-Lorenzo, B. (2025) · BMC Digital Health · doi:10.1186/s44247-025-00194-0
- Authors
- Barbosa, A., Whiting, S., Ding, D., Brito, J., & Mendes, R.
- Affiliations
- Universidade do Porto (PT)
- The University of Sydney (AU)
- Federação Portuguesa de Futebol (PT)
- Corresponding author
- Mendes, Romeu
- Venue
- European Journal of Public Health
- Publisher
- Oxford University Press (OUP)
- Published
- 2022-08-26
- Volume
- 32
- Issue
- Supplement_1
- Pages
- i56-i66
- ISSN
- 1101-1262 (ISSN-L)
- 1464-360X
- PMC
- PMC9421413
- OpenAlex
- W4293426067
- Cited by
- 23
- References
- 35
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 9 · 2023: 5
- FWCI
- 0.88
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- European Journal of Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by)
- Funders
- Portuguese Foundation for Science and Technology (UIDB/04750/2020 and LA/P/0064/2020)
- Foundation for Science and Technology (SFRH/BD/136702/2018)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- physical activity interventions, type 2 diabetes, economic evaluation, cost-effectiveness, cost-utility analysis, cost-benefit analysis, diabetes management, community-based intervention
- MeSH terms
- Adult, Cost-Benefit Analysis, Diabetes Mellitus, Type 2, Humans, Exercise, Sedentary Behavior
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