The economics of diabetes prevention

Abstract

In the United States, the costs associated with diabetes mellitus are increasing. Although people with diabetes comprise less than 6% of the US population, approximately 1 in 5 health care dollars is spent caring for people with diabetes. Healthy lifestyle interventions for the general population and intensive lifestyle and medication interventions for high-risk individuals present opportunities for diabetes prevention. This article describes the costs associated with glucose intolerance and diabetes, the effect of glucose intolerance and diabetes on the quality of life, and the cost-effectiveness of screening and primary prevention interventions for diabetes prevention.

Figure 1. Annual Direct Medical Costs in a Man Progressing from IGT to Diabetes with Complications

Adapted from Brandle M, Zhou H, Smith BRK, Marriott D, Burke R, Tabaei BP, Brown MB, Herman WH. The direct medical cost of type 2 diabetes mellitus. Diabetes Care 2003;26:2300–2304.

Figure 2. Health Utility Scores in a Man Progressing from IGT to Diabetes with Complications

Adapted from Coffey JT, Brandle M, Zhou H, Marriott D, Burke R, Tabaei BP, Engelgau MM, Kaplan R, Herman WH. Valuing health-related quality of life in diabetes. Diabetes Care 2002;25:2238–2243.

Figure 3. Simulated Cumulative Incidence of Diabetes in the DPP

From Herman WH, Hoerger TJ, Brandle M, Hicks K, Sorensen S, Zhang P, Hamman RF, Ackermann RT, Engelgau MM, Ratner RE. The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Ann Intern Med 2005;142:323–332.