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Kosteneffektivität der Primärprävention des Typ-2-Diabetes

Ein systematischer Review

Cost-effectiveness of primary prevention of type 2 diabetes

A systematic review

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Zusammenfassung

Hintergrund

Die Prävalenz des Typ-2-Diabetes mellitus (T2DM) nimmt weltweit zu. Die Erkrankung hat wegen ihrer individuellen und sozialen Belastungen hohe gesundheitswissenschaftliche Relevanz. Es konnte gezeigt werden, dass bei Patienten mit einer prädiabetischen Situation die Manifestation des T2DM durch geeignete Präventionsmaßnahmen (medikamentöse Interventionen, Lebensstiländerung) verhindert bzw. verzögert werden kann. Neben der Frage der Effektivität verschiedener Maßnahmen stellt sich auch die Frage der Kosteneffektivität dieser Interventionen.

Ziel

Im vorliegenden Beitrag werden die Ergebnisse einer systematischen Literaturrecherche zur Kosteneffektivität von Maßnahmen zur Primärprävention des T2DM dargestellt.

Ergebnis

Es konnten 11 relevante Publikationen identifiziert werden. In allen Studien wurde berichtet, dass die Primärprävention des T2DM kosteneffektiv sein kann. Hierbei zeigten sich Unterschiede bezüglich der Kosteneffektivität der Interventionen, die v. a. auf die verschiedenen Studiendesigns und Studienpopulationen zurückzuführen sind.

Abstract

Background

Worldwide the number of adults suffering from type 2 diabetes mellitus (T2DM) is increasing. Since the disease represents a large burden for patients and society, its primary prevention is a major issue of public health. There is strong evidence that T2DM can be delayed or prevented by adequate interventions (pharmacological and lifestyle interventions) in individuals with pre-diabetes. However, the question emerges whether the implementation of these interventions is cost-effective or not.

Objective

This work presents the results of a systematic review of studies concerning the cost-effectiveness of interventions targeting primary prevention of T2DM.

Results

Eleven cost-effectiveness analyses were identified and included in this review. In all of them primary prevention of T2DM was shown to be potentially cost-effective. Differences in reported cost-effectiveness ratios could be explained by varying study design and target population.

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Abbreviations

BMI:

„Body Mass Index“

KI:

Konfidenzintervall

DALY:

„disability adjusted life year“

DPP:

„Diabetes Prevention Program“

DPS:

„Diabetes Prevention Study“

IFG:

„impaired fasting glucose“

IGT:

„impaired glucose tolerance“

KORA:

kooperative Gesundheitsforschung in der Region Augsburg

LC:

Lebenskosten

LE:

Lebenserwartung

LYG:

„life years gained“

OGTT:

oraler Glukosetoleranztest

QALY:

„quality adjusted life year“

STOP-NIDDM:

„Study to prevent non insulin dependent diabetes mellitus“

T2DM:

Typ-2-Diabetes mellitus

Literatur

  1. Bertram MY, Lim SS, Barendregt JJ, Vos T (2010) Assessing the cost-effectiveness of drug and lifestyle intervention following opportunistic screening for pre-diabetes in primary care. Diabetologia 53:875–881

    Article  PubMed  CAS  Google Scholar 

  2. Caro JJ, Getsios D, Caro I et al (2004) Economic evaluation of therapeutic interventions to prevent Type 2 diabetes in Canada. Diabet Med 21:1229–1236

    Article  PubMed  CAS  Google Scholar 

  3. Chiasson JL, Josse RG, Gomis R et al (2002) Acarbose for prevention of type 2 diabetes mellitus: the STOP-NIDDM randomised trial. Lancet 359:2072–2077

    Article  PubMed  CAS  Google Scholar 

  4. Diabetes Prevention Program Research Group, Knowler WC, Fowler SE et al (2009) 10-year follow-up of diabetes incidence and weight loss in the diabetes prevention program outcomes study. Lancet 374:1677–1686

    Article  Google Scholar 

  5. Diabetes Prevention Program Research Group (2003) Within-trial cost-effectiveness of lifestyle intervention or metformin for the primary prevention of type 2 diabetes. Diabetes Care 26:2518–2523

    Article  Google Scholar 

  6. Eddy DM, Schlessinger L, Kahn R (2005) Clinical outcomes and cost-effectiveness of strategies for managing people at high risk for diabetes. Ann Intern Med 143:251–264

    PubMed  Google Scholar 

  7. Heidemann C, Kroll L, Icks A et al (2009) Prevalence of known diabetes in German adults aged 25–69 years: results from national health surveys over 15 years. Diabet Med 26:655–658

    Article  PubMed  CAS  Google Scholar 

  8. Herman WH, Hoerger TJ, Brandle M et al (2005) The cost-effectiveness of lifestyle modification or metformin in preventing type 2 diabetes in adults with impaired glucose tolerance. Ann Intern Med 142:323–332

    PubMed  Google Scholar 

  9. Hoerger TJ, Hicks KA, Sorensen SW et al (2007) Cost-effectiveness of screening for pre-diabetes among overweight and obese U.S. adults. Diabet Care 30:2874–2879

    Article  Google Scholar 

  10. Icks A, Rathmann W, Haastert B et al (2007) Clinical and cost-effectiveness of primary prevention of Type 2 diabetes in a ‚real world‘ routine healthcare setting: model based on the KORA Survey 2000. Diabet Med 24:473–480

    Article  PubMed  CAS  Google Scholar 

  11. Knowler WC, Barrett-Connor E, Fowler SE et al (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403

    Article  PubMed  CAS  Google Scholar 

  12. Li G, Zhang P, Wang J et al (2008) The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabetes Prevention Study: a 20-year follow-up study. Lancet 371:1783–1789

    Article  PubMed  Google Scholar 

  13. Lindgren P, Lindström J, Tuomilehto J et al (2007) Lifestyle intervention to prevent diabetes in men and women with impaired glucose tolerance is cost-effective. Int J Technol Assess Health Care 23:177–183

    Article  PubMed  Google Scholar 

  14. Lindström J, Ilanne-Parikka P, Peltonen M et al (2006) Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet 368:1673–1679

    Article  PubMed  Google Scholar 

  15. Palmer AJ, Roze S, Valentine WJ et al (2004) Intensive lifestyle changes or metformin in patients with impaired glucose tolerance: modeling the long-term health economic implications of the diabetes prevention program in Australia, France, Germany, Switzerland, and the United Kingdom. Clin Ther 26:304–321

    Article  PubMed  Google Scholar 

  16. Quilici S, Chancellor J, Maclaine G et al (2005) Cost-effectiveness of acarbose for the management of impaired glucose tolerance in Sweden. Int J Clin Pract 59:1143–1152

    Article  PubMed  CAS  Google Scholar 

  17. Ramachandran A, Snehalatha C, Yamuna A et al (2007) Cost-effectiveness of the interventions in the primary prevention of diabetes among Asian Indians: within-trial results of the Indian Diabetes Prevention Programme (IDPP). Diabet Care 30:2548–2552

    Article  Google Scholar 

  18. Ramachandran A, Snehalatha C, Mary S et al (2006) The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 49:289–297

    Article  PubMed  CAS  Google Scholar 

  19. Shemilt I, Mugford M, Byford S et al (2008) Chapter 15: incorporating economics evidence. In: Higgins J, Green S (Hrsg) Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.0. The Cochrane Collaboration. (Available from: http://www.cochrane-handbook.org, updated February 2008.)

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Authors and Affiliations

  1. Institut für Biometrie und Epidemiologie, Deutsches Diabetes Zentrum, Auf’m Hennekamp 65, 40225, Düsseldorf, Deutschland

    A. Klein MPH, N. Chernyak, R. Brinks, J. Genz & A. Icks

  2. Funktionsbereich Public Health, Center for Health and Society, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland

    N. Chernyak & A. Icks

Authors
  1. A. Klein MPH
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  2. N. Chernyak
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  3. R. Brinks
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  4. J. Genz
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  5. A. Icks
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Correspondence to A. Klein MPH.

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Klein, A., Chernyak, N., Brinks, R. et al. Kosteneffektivität der Primärprävention des Typ-2-Diabetes. Praev Gesundheitsf 6, 102–110 (2011). https://doi.org/10.1007/s11553-010-0273-y

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