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Cited by 491Health Systems, Economic Evaluations, Quality of LifeDiabetes Management and EducationDiabetes Treatment and Management

The DOI matches its Crossref record; 84 of the 87 references it cites were found in a registry or an index.

Cost-Effectiveness of Interventions to Prevent and Control Diabetes Mellitus: A Systematic Review

Open access
Li, Rui, Zhang, Ping, Barker, Lawrence E., Chowdhury, Farah M., Zhang, Xuanping·2010·Diabetes Care
DOI 10.2337/dc10-0843PMC PMC2909081
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Abstract

OBJECTIVE: To synthesize the cost-effectiveness (CE) of interventions to prevent and control diabetes, its complications, and comorbidities. RESEARCH DESIGN AND METHODS: We conducted a systematic review of literature on the CE of diabetes interventions recommended by the American Diabetes Association (ADA) and published between January 1985 and May 2008. We categorized the strength of evidence about the CE of an intervention as strong, supportive, or uncertain. CEs were classified as cost saving (more health benefit at a lower cost), very cost-effective (≤$25,000 per life year gained [LYG] or quality-adjusted life year [QALY]), cost-effective ($25,001 to $50,000 per LYG or QALY), marginally cost-effective ($50,001 to $100,000 per LYG or QALY), or not cost-effective (>$100,000 per LYG or QALY). The CE classification of an intervention was reported separately by country setting (U.S. or other developed countries) if CE varied by where the intervention was implemented. Costs were measured in 2007 U.S. dollars. RESULTS: Fifty-six studies from 20 countries met the inclusion criteria. A large majority of the ADA recommended interventions are cost-effective. We found strong evidence to classify the following interventions as cost saving or very cost-effective: (I) Cost saving— 1) ACE inhibitor (ACEI) therapy for intensive hypertension control compared with standard hypertension control; 2) ACEI or angiotensin receptor blocker (ARB) therapy to prevent end-stage renal disease (ESRD) compared with no ACEI or ARB treatment; 3) early irbesartan therapy (at the microalbuminuria stage) to prevent ESRD compared with later treatment (at the macroalbuminuria stage); 4) comprehensive foot care to prevent ulcers compared with usual care; 5) multi-component interventions for diabetic risk factor control and early detection of complications compared with conventional insulin therapy for persons with type 1 diabetes; and 6) multi-component interventions for diabetic risk factor control and early detection of complications compared with standard glycemic control for persons with type 2 diabetes. (II) Very cost-effective— 1) intensive lifestyle interventions to prevent type 2 diabetes among persons with impaired glucose tolerance compared with standard lifestyle recommendations; 2) universal opportunistic screening for undiagnosed type 2 diabetes in African Americans between 45 and 54 years old; 3) intensive glycemic control as implemented in the UK Prospective Diabetes Study in persons with newly diagnosed type 2 diabetes compared with conventional glycemic control; 4) statin therapy for secondary prevention of cardiovascular disease compared with no statin therapy; 5) counseling and treatment for smoking cessation compared with no counseling and treatment; 6) annual screening for diabetic retinopathy and ensuing treatment in persons with type 1 diabetes compared with no screening; 7) annual screening for diabetic retinopathy and ensuing treatment in persons with type 2 diabetes compared with no screening; and 8) immediate vitrectomy to treat diabetic retinopathy compared with deferred vitrectomy. CONCLUSIONS: Many interventions intended to prevent/control diabetes are cost saving or very cost-effective and supported by strong evidence. Policy makers should consider giving these interventions a higher priority.

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Figure 1 Selection of cost-effectiveness studies for systematic review of interventions to prevent and control diabetes.
Figure 1 Selection of cost-effectiveness studies for systematic review of interventions to prevent and control diabetes.CC BY-NC-ND · PubMed Central

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Metadata

Authors
Li, R., Zhang, P., Barker, L. E., Chowdhury, F. M., & Zhang, X.
Affiliations
Centers for Disease Control and Prevention (US)
Corresponding author
Li, Rui
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2010-08-01
Volume
33
Issue
8
Pages
1872-1894
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc10-0843
PMC
PMC2909081
OpenAlex
W2101430875
Cited by
491
References
87
Citations by year
2026: 11 · 2025: 25 · 2024: 22 · 2023: 13 · 2022: 24 · 2021: 35 · 2020: 36 · 2019: 24 · 2018: 33 · 2017: 33 · 2016: 40 · 2015: 37 · 2014: 41 · 2013: 50 · 2012: 42
FWCI
9.76
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
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 Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
Keywords
cost-effectiveness, diabetes prevention, diabetes complications, diabetes comorbidity, ACE inhibitors, angiotensin receptor blockers, end-stage renal disease prevention, irbesartan, microalbuminuria, diabetic foot ulcer prevention, type 1 diabetes, type 2 diabetes, tight glycemic control, lifestyle intervention, impaired glucose tolerance, diabetes screening, statin therapy, smoking cessation
MeSH terms
Cost-Benefit Analysis, Diabetes Mellitus, Humans, Quality-Adjusted Life Years

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