TUESDAY, June 28 (HealthDay News) -- Preventing type 2 diabetes
not only improves an individual's quality of life, it also saves
quite a bit of money.
By treating people who were at high risk for developing type 2
diabetes, researchers reduced medical costs by $2,600 for each
person enrolled in a lifestyle changes group, and by $1,500 for
each of those taking the diabetes drug metformin over the course of
10 years.
But when the savings in medical care were balanced against the
costs of the interventions, metformin saved $30 over 10 years,
while the lifestyle intervention cost $1,700 over the same time
span.
"Compared to doing nothing to prevent type 2 diabetes, metformin is cost-saving as an intervention. Lifestyle intervention, though not cost-saving, is cost-effective," Dr. William Herman, a study author and professor of medicine and epidemiology at the University of Michigan, told an American Diabetes Association (ADA) press conference.
Herman noted that during the 10-year study follow-up, lifestyle
intervention reduced the rate of diabetes by 34 percent, while
metformin reduced the rate of type 2 diabetes by 18 percent.
Herman was scheduled to present the study's findings on Tuesday
at the ADA's Scientific Sessions in San Diego.
The data for this study came from the Diabetes Prevention
Program, which included more than 3,000 people who were at high
risk of developing type 2 diabetes. They were all overweight and
were considered to have pre-diabetes. They also had additional risk
factors for developing type 2 diabetes.
The participants were randomly placed into one of three groups:
lifestyle intervention, metformin treatment or placebo pills.
The lifestyle intervention group received one-on-one training in
diet, exercise and behavioral modification. The goal was to lose 7
percent of body weight and to exercise at least 150 minutes a week.
The metformin group was given 850 milligrams of the drug twice
daily, and the placebo group received inactive placebo pills to
take twice a day.
The initial phase of the study lasted three years, and found
that lifestyle interventions reduced the rate of diabetes by 58
percent, while metformin dropped the incidence of diabetes by 31
percent, according to Herman.
The researchers continued to follow the study participants for
the next seven years so they could assess economic costs. Herman
said the current study doesn't take into account whether or not
people continued on their prescribed regimens, just at the groups
they had initially been in.
When the researchers reviewed the data to assess what the cost
was per quality of life-adjusted year, they found that metformin
was still cost saving, while lifestyle interventions required an
investment.
Herman said the costs put metformin in the same category of
interventions that you "broadly apply without question," such as
prenatal care, childhood immunizations and flu shots for people
over 65 years old. Lifestyle interventions, on the other hand, were
in the same cost category per quality of life-adjusted year as high
blood pressure medications for those with high diastolic (the
bottom number) blood pressure, cholesterol-lowering medications for
people who've already had a heart attack, and the use of heart
medications known as beta blockers.
"Both of these are effective interventions, and both should be made available to at-risk individuals," said Herman.
"With pre-diabetes, the sooner we intervene, the better," said Dr. Joel Zonszein, director of the clinical diabetes program at Montefiore Medical Center in New York City. "If we wait until someone has type 2, it may be too long. In general, it's cost effective. Treating complications is more costly."
Because one-on-one lifestyle intervention training can be quite
costly, and may not be paid for by insurance companies, Zonszein's
center developed group classes for people with type 2 diabetes that
met for several hours every quarter. They compared this group to
people receiving one-on-one training. The researchers found that
both groups were able to reduce their long-term blood sugar
control. Zonszein's findings were presented in a poster at the ADA
meeting.
Herman said that his group expected that the costs of lifestyle
intervention would come down, probably through group interventions
instead of one-on-one training.
"Doing lifestyle interventions as a group intervention may be less expensive, and may be more effective because of the social bonding aspect," he said.
More information
Visit the American Diabetes Association to learn
your risk of type 2 diabetes.