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.

/pdf/lifestyle-interventions-to-prevent-type-2-diabetes-a-28fw32tl6r.pdf

Lifestyle Interventions to Prevent Type 2 Diabetes: A Systematic Review of Economic Evaluation Studies

AIM: To design a medical cost calculator and show that diabetes care is beyond reach of the majority particularly patients with complications.

METHODS: Out-of-pocket expenditures of patients for medical treatment of type-2 diabetes were estimated based on price data collected in Benin, Burkina Faso, Guinea and Mali. A detailed protocol for realistic medical care of diabetes and its complications in the African context was defined. Care components were based on existing guidelines, published data and clinical experience. Prices were obtained in public and private health facilities. The cost calculator used Excel. The cost for basic management of uncomplicated diabetes was calculated per person and per year. Incremental costs were also computed per annum for chronic complications and per episode for acute complications.

RESULTS: Wide variations of estimated care costs were observed among countries and between the public and private healthcare system. The minimum estimated cost for the treatment of uncomplicated diabetes (in the public sector) would amount to 21%-34% of the country’s gross national income per capita, 26%-47% in the presence of retinopathy, and above 70% for nephropathy, the most expensive complication.

CONCLUSION: The study provided objective evidence for the exorbitant medical cost of diabetes considering that no medical insurance is available in the study countries. Although the calculator only estimates the cost of inaction, it is innovative and of interest for several stakeholders.

Simple calculator to estimate the medical cost of diabetes in sub-Saharan Africa.

Spécificités de la prise en charge de l’hypertension artérielle chez le patient diabétique sub-saharien

Transition nutritionnelle et double fardeau de la malnutrition chez des adultes de Ouagadougou au Burkina Faso (Afrique de l’Ouest)

Graves conséquences du coût financier du diabète sur sa prise en charge, en dehors des complications, en Afrique sub-saharienne : l’exemple de la Côte-d’Ivoire

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Graves conséquences du coût financier du diabète sur sa prise en charge, en dehors des complications, en Afrique sub-saharienne : l’exemple de la Côte-d’Ivoire