|Funding:||NIHR Programme Grants for Applied Research scheme (RP-PG-0606-1272|
|Collaborators:||Diabetes Research Centre, University of Leicester, Leicester;, Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit, Leicester; Department of Health Sciences, University of Leicester, Leicester.|
Type 2 diabetes mellitus (T2DM) is a major public health problem in terms of patient morbidity, mortality and costs to the healthcare system. Individuals with T2DM experience reduced quality of life, increased healthcare costs and higher risk of long-term complications such as cardiovascular disease, stroke, heart failure, renal failure, amputation and blindness.
Let’s Prevent is the first randomised controlled study looking at whether an educational lifestyle programme (of diet and exercise) can prevent those with a condition called pre-diabetes going on to develop diabetes. Diabetes and impaired glucose tolerance are increasingly appearing in younger people and, before the onset of diabetes, most people will have some degree of abnormal glucose tolerance, as has been found in previous screening studies such as STAR & ADDITION.
The most efficient way to address the problem of diabetes and its complications is to prevent diabetes from developing. Research on patients with impaired glucose tolerance has shown that prevention is possible, particularly using lifestyle modification interventions.
The aim of the study is to establish whether the use of a structured lifestyle modification programme (based on the DESMOND programme) prevents those with pre-diabetes going on to develop diabetes.
We conducted an economic evaluation alongside the clinical trial and showed that the education programme had higher costs and higher quality of life compared with the standard care group. The Let's Prevent programme is very likely to be cost-effective at a willingness to pay threshold of £20 000/QALY gained. The pragmatic nature of the study suggests that the intervention could be readily implemented in the real-world setting.
Cost-effectiveness of a pragmatic structured education intervention for the prevention of type 2 diabetes: economic evaluation of data from the Let's Prevent Diabetes cluster-randomised controlled trial.
J, Leal et al, (2017), BMJ Open