Drug Used With Diet to Delay Diabetes Lowers Medical Costs

Adults with pre-diabetes conditions of impaired glucose tolerance and elevated blood-sugar levels can save more than $4,400 in medical costs over 10 years by taking medication or changing their habits, a study shows.

Taking metformin, a drug used to regulate blood sugar, before diabetes develops can reduce medical costs related to the disease by $4,412 over a decade, according to the summary of results presented today at the American Diabetes Association’s meeting in San Diego. Dietary changes and regular physical activity can save $2,667 over 10 years, the report said.

The number of diabetics in the U.S. has more than tripled to 26 million since 1980, and 27 percent are undiagnosed, according to the Centers for Disease Control and Prevention in Atlanta. An estimated 79 million U.S. adults have pre-diabetes and, without timely treatment, complications from the illness rise exponentially, according to the World Diabetes Foundation. Diabetics spend an average of $6,649 per year treating the disease, according to a 2008 report by the diabetes association.

“This is a no-brainer,” the study’s lead author, William H. Herman of the University of Michigan Medical Center, said today at the report’s presentation in San Diego. “It represents an intervention that should be adopted and widely implemented.”

The trial by the Diabetes Prevention Program of the National Institutes of Health in Bethesda, Maryland, randomly assigned adults with pre-diabetic symptoms to intensive lifestyle counseling, metformin or placebo for an average of three years. The total medical cost per person after 10 years was $29,585 for lifestyle management, $27,840 for metformin and $32,252 for placebo treatment.

Quality of Life

Researchers also found that patients who exercised and ate healthy diets had the highest scores on quality of life measures. Participants undergoing the intensive lifestyle program lost 7 percent of their body weight and exercised for 150 minutes each week.

Quality of life for each treatment was measured using a ratio known as quality-adjusted life year, or QALY, which estimates how medical intervention helps patients live longer or improve their quality of life. This figure was highest for those who underwent lifestyle management, with 6.81 QALYs. Metformin use and the placebo group accrued 6.69 and 6.67 QALYs, respectively.

“Over 10 years, from a payer perspective, intensive lifestyle and metformin were less expensive and more effective than placebo,” the report said. “Both health policy and social policy should support the funding of intensive lifestyle and metformin for diabetes prevention in high-risk adults.”

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