Prevention programs can delay or hinder the development of type 2 diabetes in high-risk adults and lower health care costs, according to results from a randomized controlled clinical trial.
“The adoption of diabetes prevention programs by health plans and society will result in important health benefits over 10 years and represents a good value for the money spent,” researchers wrote in the Diabetes Prevention Program Outcomes Study (DPPOS).
William H. Herman, MD, MPH, of the DPP Research Group and director of the Michigan Center for Diabetes Translational Research, and researchers designed a 10-year trial that examined 3,234 men and women of varying races, with an average age of 51 years. Participants were randomly assigned to one of three intervention categories for the prevention of type 2 diabetes: lifestyle, metformin or placebo.
Members in the lifestyle group were asked to achieve weight loss of at least 7% of their initial body weight through diet and moderate physical activity of at least 150 minutes per week. After 1 month, those in medical intervention groups were switched from 850 mg once-daily metformin or placebo to 850 mg twice-daily metformin. Each participant was given a case manager to emphasize a healthy lifestyle.
After 3 years, 2,766 of the original 3,234 participants (88%) were eligible for a follow-up, including 910 participants from the lifestyle group, 924 from the metformin group and 932 from the placebo group. Interventions were given to participants who developed diabetes.
Over 10 years, researchers found that the cumulative, undiscounted per capita direct medical costs of lifestyle intervention reached $4,601, considerably more than the metformin group ($2,300) or the placebo group ($769).
The researchers said the well-being score was rated best for the lifestyle (6.81) and metformin groups (6.69) vs. placebo (6.67).
They concluded that lifestyle interventions may be too expensive for health plans or to create a national program; however, they demonstrated that lifestyle intervention is cost-effective and metformin intervention is cost-saving when compared with placebo.
Disclosure: Bristol-Myers Squibb and Parke-Davis provided additional funding and material support during the DPP trial. Lipha (Merck-Sante) provided medication, and LifeScan Inc. donated materials during the DPP and the DPPOS. No other relevant financial disclosures were reported.