Evidence map›Paper›PMID 22442395›Full record

ArticleDiabetes care2012

The 10-year cost-effectiveness of lifestyle intervention or metformin for diabetes prevention: an intent-to-treat analysis of the DPP/DPPOS.

Diabetes Prevention Program Research Group

Erratum issued 2 registry-linked trialsOpen access · hybridAbstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Diabetes care, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 215 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
215citing papers in PubMed, 8 pooled it
113.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01741467 nacompletednot on this map

The Effect of Real Time Continuous Glucose Monitoring in Subjects With Pre-diabetes

TypeinterventionalSponsorWalter Reed National Military Medical CenterRan2012 to 2016Enrolled110ConditionsPre-diabetes, Impaired Glucose ToleranceArmsRT-CGM
NCT03249077 completednot on this mapstarted 2017, after this paper: background citation

Evaluating the Implementation of the Diabetes Prevention Program in an Integrated Health System

TypeobservationalSponsorKaiser PermanenteRan2017 to 2021Enrolled8,198ConditionsDiabetesArmsDigital DPP, In-person DPP, DPP not enrolled
3 · Its place in the literature

Who cites it

215 citing papers in PubMed, 8 syntheses or guidelines pooled it, 427 citations in OpenAlex.

  1. Perspectives into the experience of successful, substantial long-term weight-loss maintenance: a systematic review.International journal of qualitative studies on health and well-being · 2021
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155 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

1 author at 1 institution in 2 countries.

Diabetes Prevention Program Research GroupDiabetes Prevention Program Coordinating Center. dppmail@biostat.bsc.gwu.edu
University of Michigan · US

Funding

Vector and Transgenic Mouse CoreP30DK017047 · NIDDK · UNIVERSITY OF WASHINGTON · PI Julie Mathieu · 1986 to 2026
$41.4M
Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
Primary and Tertiary Prevention of type 2 diabetesZIADK075078 · NIDDK · NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES · PI HANSON, ROBERT · 2012 to 2025
$4.6M
Intramural NIH HHSNIDDK NIH HHS P30 DK017047NIDDK NIH HHS P30 DK092926
6 · The paper itself

Abstract

objectiveThe Diabetes Prevention Program (DPP) and its Outcomes Study (DPPOS) demonstrated that either intensive lifestyle intervention or metformin could prevent type 2 diabetes in high-risk adults for at least 10 years after randomization. We report the 10-year within-trial cost-effectiveness of the interventions. RESEARCH DESIGN AND

methodsData on resource utilization, cost, and quality of life were collected prospectively. Economic analyses were performed from health system and societal perspectives.

resultsOver 10 years, the cumulative, undiscounted per capita direct medical costs of the interventions, as implemented during the DPP, were greater for lifestyle ($4,601) than metformin ($2,300) or placebo ($769). The cumulative direct medical costs of care outside the DPP/DPPOS were least for lifestyle ($24,563 lifestyle vs. $25,616 metformin vs. $27,468 placebo). The cumulative, combined total direct medical costs were greatest for lifestyle and least for metformin ($29,164 lifestyle vs. $27,915 metformin vs. $28,236 placebo). The cumulative quality-adjusted life-years (QALYs) accrued over 10 years were greater for lifestyle (6.81) than metformin (6.69) or placebo (6.67). When costs and outcomes were discounted at 3%, lifestyle cost $10,037 per QALY, and metformin had slightly lower costs and nearly the same QALYs as placebo.

conclusionsOver 10 years, from a payer perspective, lifestyle was cost-effective and metformin was marginally cost-saving compared with placebo. Investment in lifestyle and metformin interventions for diabetes prevention in high-risk adults provides good value for the money spent.

Indexed as

Intention to Treat AnalysisRisk Reduction BehaviorAdultCombined Modality TherapyCost-Benefit AnalysisDiabetes Mellitus, Type 2FemaleFollow-Up StudiesHumansHypoglycemic AgentsMaleMetforminMiddle AgedPrediabetic StatePrognosisRandomized Controlled Trials as TopicHypoglycemic AgentsMetformin

Identifiers

PMID22442395
PMCPMC3308273
OpenAlexW1896651021

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.