Pdb3 Intensive Lifestyle Changes or Metformin in Overweight, Glucose Intolerant Patients: Modeling the Long-Term Health Economics Implications of the Diabetes Prevention Program in the French, German, and Uk Settings

Palmer, AJ; Roze, S; Comte, S; Cabrières, L

doi:10.1016/s1098-3015(10)61440-4

Cited by 3 publications

(3 citation statements)

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“…A cost-benefit analysis of the DPP in the French, German and United Kingdom settings recently found that, despite the greater efficacy of lifesyle intervention, the cost per case of diabetes prevented was higher than that for metformin [44]. The study concluded that, while both intensive lifestyle and metformin were highly cost-effective when judged by current international health economic standards, metformin was possibly the more cost-effective of the two strategies.…”

Section: Primary Prevention Of Type 2 Diabetes In the Real Worldmentioning

confidence: 99%

Preventing Type 2 diabetes and the dysmetabolic syndrome in the real world: a realistic view

2003

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The last two decades have seen an explosive increase in the number of people with diabetes globally. There is now an urgent need for strategies to prevent the emerging global epidemic. Several recent successful intervention studies, both lifestyle and pharmacological, targeting subjects with impaired glucose tolerance (IGT) have stimulated enthusiasm for prevention of Type 2 diabetes. Lifestyle interventions reduced the incidence of diabetes by over 50% in the Finnish Diabetes Prevention Study and the Diabetes Prevention Program. Can the findings of these two studies be applied globally? Underpinning the enthusiasm, there needs to be a realistic approach to interventions in both developed and developing nations, and in ethnic groups where a better understanding of the socio-economic, cultural and demographic issues and perceptions surrounding chronic diseases such as diabetes is required. Whether the strategies used in these two studies can be translated into a 'real world' scenario is doubtful. In practice, it is more than likely that a number of strategies will be needed to compliment the lifestyle approach. These will include pharmacological approaches with metformin, acarbose and other agents used to treat diabetes and its complications, currently under investigation. Longer-term follow-up studies will also clarify whether both lifestyle and pharmacological interventions actually prevent Type 2 diabetes, or merely delay its onset.

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Section: Primary Prevention Of Type 2 Diabetes In the Real Worldmentioning

confidence: 99%

Preventing Type 2 diabetes and the dysmetabolic syndrome in the real world: a realistic view

2003

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“…A recent analysis of the cost-effectiveness of the interventions used in the DPP according to usual clinical practice in a European setting suggested that both intensive lifestyle intervention and pharmacotherapy were cost-effective according to the usual standards employed for such analyses. 25 The costs per life-year gained, relative to placebo, for metformin and for intensive lifestyle intervention were €7,950 and €15,568, respectively, for France, €4,675 and €7,184, respectively, for Germany, and €3,950 and €8,984, respectively, for the UK.…”

Section: Impact Of Diabetes Prevention Studiesmentioning

confidence: 99%

Preventing type 2 diabetes: what have we learned?

Nathan

2003

Diabetes & Vascular Disease

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The substantial burden of morbidity and mortality associated with type 2 diabetes and the high costs associated with the management of diabetic complications highlight the need for the development of strategies for the prevention of diabetes. Impaired glucose tolerance is a pre-diabetic state which may present an opportunity for intervention to prevent the onset of clinical diabetes. Four recent clinical trials, the DPP, the FDPS, the STOP-NIDDM and the Da Qing study, have evaluated interventions based on diet and exercise and/or pharmacotherapy in pre-diabetic subjects. In all these trials the intervention strategies significantly reduced the incidence of diabetes. A worldwide epidemic of type 2 diabetes will occur over the coming decades and translating the results of these studies into practical and effective initiatives for diabetes prevention is an urgent clinical priority.Br J Diabetes Vasc Dis 2003;3(suppl 1):S6—S11

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“…The Diabetes Prevention Program has shown us that preventing type 2 diabetes with lifestyle interventions or with pharmacologic therapy is cost-effective in either the European or American settings [79,80]. However, extending these benefits beyond the tightly-controlled structure of a randomised clinical trial will require an unprecedented degree of public health intervention.…”

Section: Are We Doing Enough?mentioning

confidence: 99%

The burden of type 2 diabetes: are we doing enough?

Zimmet

2003

Diabetes & Metabolism

220

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Increasing levels of obesity, arising from energy-rich diets and sedentary lifestyles, are driving a global pandemic of type 2 diabetes. The prevalence of type 2 diabetes worldwide is set to increase from its present level of 150 million, to 225 million by the end of the decade and to as many as 300 million by 2025. Shocking as they are, these figures represent only clinically diagnosed diabetes, and many more cases of diabetes remain undiagnosed and untreated. In addition, up to one-quarter of western populations have impaired glucose tolerance or the dysmetabolic syndrome, which are considered to represent pre-diabetic states. Type 2 diabetes is appearing increasingly in children and adolescents, and the frequency of diagnosis of paediatric type 2 diabetes is outstripping that of type 1 diabetes in some areas. The long-term complications associated with type 2 diabetes carries a crushing burden of morbidity and mortality, and most type 2 diabetic patients die prematurely from a cardiovascular event. Diabetic patients are more than twice as costly to manage as non-diabetic patients, due mainly to the high costs associated with management of diabetic complications. Indeed, diabetes care already accounts for about 2-7% of the total national health care budgets of western European countries. Controlling the type 2 diabetes epidemic will require changes to the structure of healthcare delivery. Well-resourced interventions will be required, with effective co-ordination between all levels of government, health care agencies, multidisciplinary health care teams, professional organisations, and patient advocacy groups. Above all, intervention is needed today.

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Pdb3 Intensive Lifestyle Changes or Metformin in Overweight, Glucose Intolerant Patients: Modeling the Long-Term Health Economics Implications of the Diabetes Prevention Program in the French, German, and Uk Settings

Cited by 3 publications

References 0 publications

Preventing Type 2 diabetes and the dysmetabolic syndrome in the real world: a realistic view

Preventing Type 2 diabetes and the dysmetabolic syndrome in the real world: a realistic view

Preventing type 2 diabetes: what have we learned?

The burden of type 2 diabetes: are we doing enough?

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