Stepwise Approach to Identifying and Preventing Diabetes Cost Effective, Even in Low- and Middle-Income Countries

Recent research led by the Emory Global Diabetes Research Center suggests that a stepwise approach to identifying adults at risk of and preventing diabetes is cost effectivein India. Findings were published in JAMA Network Open. Led by Duygu Islek, MD, MPHin the Department of Epidemiology, additional Rollins co-authors on the study include Mary Beth Weber, PhD; Lisa R. Staimez, PhD; K.M. Venkat Narayan, MD; and Mohammed K. Ali, MD, MSc, MBA. 

The diabetes epidemic is global in scale and is escalating rapidly, which has taken both a humanitarian and economic toll. While past economic evaluations have shown that lifestyle modification programs can be cost-effective, few evaluations have been conducted on their impact in low- and middle-income countries and none thus far have analyzed the cost-effectiveness of stepwise approaches to diabetes prevention and care.

The researchers centered their study in India, a country that ranks second in the total number affected by diabetes globally and whose numbers are expected to continue to increase. Using data collected from 578 participants enrolled in a randomized clinical trial conducted in Chennai, India, the researchers conducted an economic evaluation comparing lifestyle management practices plus metformin use with routine care from multipayer and societal perspectives. Findings showed that it would cost approximately $145 international dollars to screen for and reduce diabetes incidence by 1 percentage point, $14,539 international dollars per diabetes case prevented and/or delayed, and $14, 986 international dollars per quality-adjusted life-year gained.