title: Value of lifestyle intervention to prevent diabetes and sequelae.
abstract: BACKGROUND
  The Community Preventive Services Task Force recommends combined diet and physical activity promotion programs for people at increased risk of type 2 diabetes, as evidence continues to show that intensive lifestyle interventions are effective for overweight individuals with prediabetes.
  
  
  OBJECTIVE
  To illustrate the potential clinical and economic benefits of treating prediabetes with lifestyle intervention to prevent or delay onset of type 2 diabetes and sequelae.
  
  
  METHODS
  This 2014 analysis used a Markov model to simulate disease onset, medical expenditures, economic outcomes, mortality, and quality of life for a nationally representative sample with prediabetes from the 2003-2010 National Health and Nutrition Examination Survey. Modeled scenarios used 10-year follow-up results from the lifestyle arm of the Diabetes Prevention Program and Outcomes Study versus simulated natural history of disease.
  
  
  RESULTS
  Over 10 years, estimated average cumulative gross economic benefits of treating patients who met diabetes screening criteria recommended by the ADA ($26,800) or USPSTF ($24,700) exceeded average benefits from treating the entire prediabetes population ($17,800). Estimated cumulative, gross medical savings for these three populations averaged $10,400, $11,200, and $6,300, respectively. Published estimates suggest that opportunistic screening for prediabetes is inexpensive, and lifestyle intervention similar to the Diabetes Prevention Program can be achieved for ≤$2,300 over 10 years.
  
  
  CONCLUSIONS
  Lifestyle intervention among people with prediabetes produces long-term societal benefits that exceed anticipated intervention costs, especially among prediabetes patients that meet the ADA and USPSTF screening guidelines.
authors.affiliation: IHS Life Sciences, Washington, District of Columbia. Electronic address: tim.dall@ihs.com.
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Dall
authors.affiliation: IHS Life Sciences, Washington, District of Columbia.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Storm
authors.affiliation: IHS Life Sciences, Washington, District of Columbia.
authors.forename: April P
authors.initials: AP
authors.lastname: Semilla
authors.affiliation: Novo Nordisk Inc. Plainsboro, New Jersey.
authors.forename: Neil
authors.initials: N
authors.lastname: Wintfeld
authors.affiliation: NORC at the University of Chicago, Illinois.
authors.forename: Michael
authors.initials: M
authors.lastname: O'Grady
authors.affiliation: Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: K M Venkat
authors.initials: KM
authors.lastname: Narayan
mesh_terms: D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D004032:Diet; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin; D015438:Health Behavior; D005102:Health Expenditures; D006801:Humans; D008019:Life Style; D008297:Male; D008390:Markov Chains; D008403:Mass Screening; D008875:Middle Aged; D009749:Nutrition Surveys; D011236:Prediabetic State / Q000628:therapy*; D011788:Quality of Life; D012307:Risk Factors
chemical_list: D002784:Cholesterol; D006442:Glycated Hemoglobin