Abstract
Aim: To answer: (1) Do we have effective treatments to improve prognosis for those identified at risk of Type-2 diabetes? (2) Will prevention be cost-effective? Methods: A systematic search was done in PubMed using the following search strategy: "diabetes AND prevention AND (IFG OR IGT)". Restrictions were: "English, Meta-Analysis, Randomized Controlled Trial, Review, Humans". Results: Few randomised controlled preventive trials were found. Almost all were done in research settings in people with high risk of developing Type-2 diabetes. It seems possible to either delay or prevent Type-2 diabetes through lifestyle interventions and medication. Cost-utility analyses are few in number and come to very different conclusions as to whether health policy should promote prevention of Type-2 diabetes. Conclusion: Intervention studies using lifestyle counselling and drug therapy in research settings illustrate promising results with lowering of the incidence of Type-2 diabetes, meaning that Type-2 diabetes can be delayed or prevented. It is, however, questionable whether these interventions are cost-effective. We need studies in routine clinical settings evaluating morbidity, mortality and cost-effectiveness as primary outcomes. While waiting for these studies to prove cost-effective, patients with pre-diabetes should be treated according to their 10-year risk of cardiovascular disease following present guidelines.
| Original language | English |
|---|---|
| Pages (from-to) | 5-11 |
| Number of pages | 7 |
| Journal | Primary Care Diabetes |
| Volume | 1 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Feb 2007 |
Funding
Torsten Lauritzen and Knut Borch-Johnsen have received unrestricted grants for the ADDITION study from: The National Health Services in the counties of Copenhagen, Aarhus, Ringkøbing, Ribe and South Jutland in Denmark, Danish Research Foundation for General Practice, Danish Centre for Evaluation and Health Technology Assessment, The diabetes fund of the National Board of Health, The Danish Medical Research Council, The Aarhus University Research Foundation and Novo Nordisk Foundation. Furthermore the trial has been given unrestricted grants from Novo Nordisk AS, Novo Nordisk Scandinavia AB, ASTRA Denmark, Pfizer Denmark, GlaxoSmithKline Pharma Denmark, SERVIER Denmark A/S and HemoCue Denmark A/S. Torsten Lauritzen has received lecture fees from industry, ∼5000&z.euro; during the past year. Apart from lecture fees, Torsten Lauritzen does not receive any honoraria, nor receive employment or shares in any commercial firms. Knut Borch-Johnsen has received lecture fees from industry, ∼1000&z.euro; during the past year. Knut Borch-Johnsen is Director of the Steno Diabetes Center, a hospital owned by Novo Nordisk, but providing patient care for and partly funded by the National Health Care. Knut Borch-Johnsen holds shares in Novo Nordisk. Annelli Sandbaek has received lecture fees from industry, approximately ∼1000&z.euro; during the past year. Annelli Sandbaek has not received any honorarium, employment or shares from any commercial firms. The authors received no funding for the writing of this paper.
Keywords
- Cost-effectiveness
- IFG
- IGT
- Lifestyle intervention
- Pharmacological intervention
- Screening
- Type-2 diabetes
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