ALEXANDRIA, VA, Mar 22, 2012 (MARKETWIRE via COMTEX) —
Lifestyle intervention and treatment with metformin provide safe,
long-term, cost-effective means of preventing type 2 diabetes and
should be incorporated into prevention strategies for reducing the
dramatic rise in incidence of type 2 diabetes in the U.S., according
to two new analyses and an editorial published in the April issue of
Diabetes Care.
The two reports provide further analyses and follow-up to the
landmark Diabetes Prevention Program research first funded a decade
ago primarily by the National Institutes of Health’s National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The
studies are accompanied by an editorial highlighting the American
Diabetes Association’s recently revised Strategic Plan, which calls
for an increased focus on translating the growing body of research on
prevention into primary care and community treatment strategies.
“With the current economic realities facing our nation and with the
ever-changing health care delivery landscape, the financial costs of
such an initiative will indeed drive the discussion,” concluded
Diabetes Care Editor William Cefalu, MD. “On one hand, one can argue
that we cannot afford to implement prevention on a national level. On
the other hand, we could also argue that we cannot afford not to!”
Currently, the Centers for Disease Control and Prevention estimates
that 35 percent of U.S. adults aged 20 years or older (roughly 79
million Americans) may have prediabetes, a condition in which blood
glucose levels are higher than normal, but not yet high enough for a
type 2 diabetes diagnosis. People with prediabetes are usually not
aware of their condition, which generally occurs without symptoms but
is easily detectable through testing. Cefalu’s editorial notes that
because the “major factors contributing to the development of
diabetes consist of lifestyle habits (i.e., physical inactivity and
dietary intake) and obesity” and because research has shown the
effectiveness of preventing or delaying type 2 diabetes through
lifestyle intervention and medication, those numbers could be
drastically reduced.
One analysis by the Diabetes Prevention Program Research Group found
that, over 10 years, investing in lifestyle intervention or treatment
with metformin for adults at high risk for type 2 diabetes provided
“good value for the money.” Over the first three years of the
clinical trial, lifestyle interventions (losing 5-8 percent of body
weight, or 10-16 pounds for a 200-pound person, plus increasing
physical activity to at least 150 minutes per week) reduced the
incidence of type 2 diabetes by 58 percent and significantly improved
quality of life. Metformin reduced diabetes by 31 percent. This
follow-up analysis found that lifestyle intervention came at a
cost-effectiveness of about $10,000 per cumulative-quality-adjusted
life-year (QALY) gained. Cost-effectiveness of commonly used
interventions such as mammography or blood pressure generally range
from $10,000 to $50,000 per QALY.
“This new analysis of costs and outcomes in the DPP and its follow-up
study shows both metformin and lifestyle change were very
cost-effective for prevention or delay of type 2 diabetes when
analyzed from the perspective of health care payers,” said Griffin P.
Rodgers, MD, director of the NIH’s National Institute of Diabetes and
Digestive and Kidney Diseases (NIDDK). “Metformin treatment led to a
small savings in health care costs over 10 years. The individual
training in lifestyle change, as delivered in the study, was
cost-effective and could become cost saving if offered to groups in
community settings.”
The second analysis found that long-term treatment with metformin
safely produced sustained weight loss at 10 years and prevented or
delayed the onset of type 2 diabetes.
The Association’s Strategic Plan calls for doubling the percentage of
Americans with prediabetes who are aware of their condition (from 7.3
to 15 percent) so that they may have the opportunity to prevent
progression to type 2 diabetes. It also calls for a 10 percent
increase in people who report engaging in specific preventive
behaviors, such as weight control and weight loss, physical activity
and healthy eating.
“We now know how to prevent type 2 diabetes and have the data to show
that doing so is not only safe, it is cost-effective,” said Vivian
Fonseca, MD, President, Medicine and Science, of the American
Diabetes Association. “We should be taking much greater steps on a
broad scale to reduce this serious health epidemic in our country.
There are nearly 26 million children and adults currently living with
this debilitating disease, with 90 to 95 percent having type 2
diabetes. Another 79 million are at high risk for developing it.
Those are staggering numbers, and we have the knowledge and ability
to reduce them. I would encourage every American to estimate their
own risk using simple tools (for example see diabetes.org/risktest)
and then, if at risk, take simple measures to prevent the disease.”
Diabetes Care, published by the American Diabetes Association, is the
leading peer-reviewed journal of clinical research into one of the
nation’s leading causes of death by disease. Diabetes also is a
leading cause of heart disease and stroke, as well as the leading
cause of adult blindness, kidney failure, and non-traumatic
amputations.
The American Diabetes Association is leading the fight to Stop
Diabetes and its deadly consequences and fighting for those affected
by diabetes. The Association funds research to prevent, cure and
manage diabetes; delivers services to hundreds of communities;
provides objective and credible information; and gives voice to those
denied their rights because of diabetes. Founded in 1940, our mission
is to prevent and cure diabetes and to improve the lives of all
people affected by diabetes. For more information please call the
American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or
visit
www.diabetes.org . Information from both these sources is
available in English and Spanish.
Contact:
Colleen Fogarty
American Diabetes Association
(703) 549-1500 ext. 2146
SOURCE: American Diabetes Association
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