Screening overweight and obese adults for pre-diabetes is cost-effective

Screening overweight and obese adults for pre-diabetes is cost-effective, according to a study by researchers at RTI International, the Centers for Disease Control and Prevention, University of Michigan, MedStar Research Institute, and Indiana University.

The study, published in the November issue of Diabetes Care , was funded by the CDC. The study found that screening overweight and obese adults aged 45-74 for signs of pre-diabetes and treating those who have the condition with the Diabetes Prevention Program lifestyle intervention would improve quality of life and be cost-effective.

Previously, the results of the Diabetes Prevention Program demonstrated that the lifestyle intervention could delay or prevent the onset of type 2 diabetes.

"The U.S. is currently facing an epidemic of diabetes that is closely related to the country's rising rate of obesity," said Thomas Hoerger, Ph.D., senior fellow and director of the RTI-UNC Center for Excellence in Health Promotion Economics and the paper's lead author. "With nearly two-thirds of adults overweight or obese, many Americans are at risk for developing diabetes. Our results indicate that it would be cost-effective to actively screen overweight and obese adults for pre-diabetes, and provide interventions to those who are found to have pre-diabetes."

The researchers looked at prescreening strategies that provided intervention treatment to people with either impaired glucose tolerance or impaired fasting glucose or people who had both conditions. Impaired glucose tolerance and impaired fasting glucose are warning signs of progression to diabetes.

The results showed that providing screening and the intervention to patients who had both impaired glucose tolerance and impaired fasting glucose had a cost-effectiveness ratio of $8,181 per quality-adjusted life-year. The ratio indicates that it would cost the health care system $8,181 to gain one quality-adjusted life-year among participants in the screening program. Providing the intervention to patients that exhibited either impaired glucose tolerance or impaired fasting glucose had a slightly higher cost-effectiveness ratio of $9,511 per quality-adjusted life-year.

Both cost-effectiveness ratios are attractive relative to a commonly used benchmark for cost-effectiveness studies ($50,000 per quality-adjusted life-year).

Other authors of the study include Katherine Hicks of RTI; Stephen Sorensen, Ping Zhang, and Michael Engelgau from the CDC; William Herman from the University of Michigan; Robert Ratner from the MedStar Research Institute; and Ronald Ackermann from Indiana University.