A systematic review of the cost-effectiveness of lifestyle modification as primary prevention intervention for type 2 diabetes mellitus
Open accessAbstract
Background: diabetes is one of the leading causes of death, and has a huge economic impact on the burden of society. Lifestyle interventions such as diet, physical activity and weight reducing are proven to be effective in the prevention of diabetes. To encourage policy actions, data on the costeffectiveness of such strategies of prevention programmes are needed. Methods: a systematic review of the literature on the cost-effectiveness of prevention strategies focusing on lifestyle interventions for diabetes type 2 patients. A weighted version of Drummond checklist was used to further assess the quality of the included studies. Results: six studies met the inclusion criteria and were therefore considered in this paper. Intensive lifestyle intervention to prevent diabetes type 2 is cost-effective in comparison to other interventions. All studies were judged of medium-to-high quality. Conclusions: policy makers should consider the adoption of a prevention strategy focusing on intensive lifestyle changes because they are proven to be either cost-saving or cost-effective.
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Lifestyle interventions, including dietary modifications and physical activity programs, are clinically effective and cost-effective in preventing and managing T2D.
“Recent systematic reviews and meta-analyses have demonstrated that lifestyle interventions, including dietary modifications and physical activity programs, are clinically effective and cost-effective in preventing and managing T2D [8,9].”
From Economic evaluation of wearable fitness trackers versus metformin for preventing type 2 diabetes in the UK population (2025) · cites this paper as [8]
The Abstract and Discussion (p. 6) describe lifestyle changes as clinically effective and cost-effective for preventing type 2 diabetes. The review addresses primary prevention, however, not management of established T2D; its inclusion criteria exclude interventions combined with therapy. The management portion of the citing sentence is therefore unsupported by this source. (LLM, conf=0.90)
Experimental — accuracy not yet measuredStructured lifestyle programs involving dietary counselling, exercise prescriptions, and behavioural coaching have shown promising results in reducing diabetes risk.
“Among the preventive interventions studied, structured lifestyle programs involving dietary counselling, exercise prescriptions, and behavioural coaching have shown promising results in reducing diabetes risk [8].”
From Economic evaluation of wearable fitness trackers versus metformin for preventing type 2 diabetes in the UK population (2025) · cites this paper as [8]
The Introduction (p. 1) reports that changing diet and physical activity had a clinically significant impact on reducing diabetes, and the Discussion (p. 6) describes lifestyle modification as an effective prevention strategy. The paper does not establish that the programs included exercise prescriptions and behavioural coaching specifically; it mentions group or one-to-one delivery of lifestyle information instead. (LLM, conf=0.84)
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Xu, Y., & García-Lorenzo, B. (2025) · BMC Digital Health · doi:10.1186/s44247-025-00194-0
- Authors
- Radl, K., Ianuale, C., & Boccia, S.
- Affiliations
- Bocconi University (IT)
- Università Cattolica del Sacro Cuore (IT)
- ORCID
- Boccia, Stefania
- Venue
- Epidemiology, Biostatistics, and Public Health
- Publisher
- Milano University Press
- Published
- 2022-07-07
- Volume
- 10
- Issue
- 2
- ISSN
- 2282-0930 (ISSN-L)
- DOI
- 10.2427/8846
- OpenAlex
- W988219964
- Cited by
- 13
- References
- 28
- Citations by year
- 2025: 1 · 2021: 1 · 2020: 2 · 2018: 2 · 2017: 1 · 2016: 1 · 2015: 4 · 2014: 1
- FWCI
- 0.05
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Epidemiology Biostatistics and Public Health (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Bollettino del CILEA (CILEA) (submittedVersion)
- di/segni (Università degli Studi di Milano) (submittedVersion, cc-by-sa)
- PubliCatt (Università Cattolica del Sacro Cuore) (submittedVersion, other-oa)
- 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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 2 diabetes, primary prevention, lifestyle modification, cost-effectiveness, intensive lifestyle intervention, diet, physical activity, weight loss, prevention programmes, health policy
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