The initial phase of the study lasted three years, and found that lifestyle interventions reduced the rate of diabetes by 58 percent, while metformin dropped the incidence of diabetes by 31 percent, according to Herman.
The researchers continued to follow the study participants for the next seven years so they could assess economic costs. Herman said the current study doesn't take into account whether or not people continued on their prescribed regimens, just at the groups they had initially been in.
When the researchers reviewed the data to assess what the cost was per quality of life-adjusted year, they found that metformin was still cost saving, while lifestyle interventions required an investment.
Herman said the costs put metformin in the same category of interventions that you "broadly apply without question," such as prenatal care, childhood immunizations and flu shots for people over 65 years old. Lifestyle interventions, on the other hand, were in the same cost category per quality of life-adjusted year as high blood pressure medications for those with high diastolic (the bottom number) blood pressure, cholesterol-lowering medications for people who've already had a heart attack, and the use of heart medications known as beta blockers.
"Both of these are effective interventions, and both should be made available to at-risk individuals," said Herman.
"With pre-diabetes, the sooner we intervene, the better," said Dr. Joel Zonszein, director of the clinical diabetes program at Montefiore Medical Center in New York City. "If we wait until someone has type 2, it may be too long. In general, it's cost effective. Treating complications is more costly."
Because one-on-one lifestyle intervention training can be quite costly, and may not be paid for by insurance companies
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