A ten year study in America shows that, whilst costly, intensive lifestyle interventions were able to reduce the incidence of type 2 diabetes by 58 percent.
The research followed over 3,000 people at high risk of developing type 2 diabetes. Participants included in the study had prediabetes, being overweight and either having impaired glucose tolerance or fasting hyperglycemia. The aim of the study was to review cost effectiveness of intensive lifestyle intervention compared with use of metformin in preventing type 2 diabetes. To measure success, a control group took a placebo.
Lifestyle interventions included a reduced fat and reduced calorie diet supported by 150 minutes of physical activity per week. Participants in the lifestyle intervention group aimed to achieve weight loss of 7 percent of their body weight. Participants in the metformin and placebo groups received less intensive lifestyle recommendations. Over the study, incidence of type 2 diabetes was reduced 58 percent by lifestyle interventions and 31 percent by metformin, compared with a placebo treatment.
In terms of cost effectiveness, lifestyle intervention was the more costly diabetes prevention treatment over the course of the study. However, the costs of medical care for hospitalisation and outpatient care were lowest in the lifestyle group. Whilst in total, lifestyle interventions was the more costly treatment, quality of life indicators, such as mobility, level of pain and emotional outlook scored consistently better for those following the intensive lifestyle treatment.

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