title: Lifestyle Interventions to Prevent Type 2 Diabetes: A Systematic Review of Economic Evaluation Studies.
abstract: Objective. To summarize key findings of economic evaluations of lifestyle interventions for the primary prevention of type 2 diabetes (T2D) in high-risk subjects. Methods. We conducted a systematic review of peer-reviewed original studies published since January 2009 in English, French, and Spanish. Eligible studies were identified through relevant databases including PubMed, Medline, National Health Services Economic Evaluation, CINHAL, EconLit, Web of sciences, EMBASE, and the Latin American and Caribbean Health Sciences Literature. Studies targeting obesity were also included. Data were extracted using a standardized method. The BMJ checklist was used to assess study quality. The heterogeneity of lifestyle interventions precluded a meta-analysis. Results. Overall, 20 studies were retained, including six focusing on obesity control. Seven were conducted within trials and 13 using modeling techniques. T2D prevention by physical activity or diet or both proved cost-effective according to accepted thresholds, except for five inconclusive studies, three on diabetes prevention and two on obesity control. Most studies exhibited limitations in reporting results, primarily with regard to generalizability and justification of selected sensitivity parameters. Conclusion. This confirms that lifestyle interventions for the primary prevention of diabetes are cost-effective. Such interventions should be further promoted as sound investment in the fight against diabetes.
authors.affiliation: TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, 2405 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada H3T 1A8.
authors.forename: Koffi
authors.initials: K
authors.lastname: Alouki
authors.affiliation: TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, 2405 Chemin de la Côte Sainte-Catherine, Montreal, QC, Canada H3T 1A8.
authors.forename: Hélène
authors.initials: H
authors.lastname: Delisle
authors.affiliation: Institut de Recherche en Santé Publique de l'Université de Montréal (IRSPUM), University of Montreal, 7101 Avenue du Parc, 3e Étage, Montréal, QC, Canada H3N 1X9.
authors.forename: Clara
authors.initials: C
authors.lastname: Bermúdez-Tamayo
authors.affiliation: Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Tour Saint-Antoine, 850 Rue Saint-Denis, Montréal, QC, Canada H2X 0A9; Department of Health Administration, School of Public Health (ESPUM), Faculty of Medicine, University of Montreal, 7101 Avenue du Parc, 3e Étage, Montréal, QC, Canada H3N 1X9.
authors.forename: Mira
authors.identifier: 0000-0001-5642-787X
authors.initials: M
authors.lastname: Johri
mesh_terms: D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D006801:Humans; D008019:Life Style