Health policy makers in Newfoundland and Labrador are seeking the best available research-based evidence on the clinical and cost-effectiveness of approaches that aim to reduce the incidence of Type II Diabetes (T2D) in NL to help inform diabetes resource allocation. The Contextualized Health Research Synthesis Program worked with the NL health system, with academics and with and subject expert, Dr. Laura Rosella, to synthesize the best available research evidence that would answer the research question: " What interventions are likely to be effective in reducing the incidence of Type 2 Diabetes and its medical complications in the adult population of Newfoundland and Labrador?"
The results of our synthesis indicated the following:
-There is an insufficient amount of high-quality evidence on the long-term clinical benefits and potential harms of screening for T2D at this time. More robust evidence is also needed to confidently evaluate the cost-effectiveness of screening interventions for T2D.
-The effectiveness of drug interventions depends on the risk profile of individuals. In specific at-risk populations, some oral anti-diabetic drug classes and some other drug classes effectively prevent the onset of T2D; other drug classes have no significant preventive effect and some drug classes are more effective for promoting regression to normoglycemic than for reducing T2D incidence.
-Good quality evidence shows that many interventions that promote modest weight loss through improved diet and/or increased physical activity can decrease the incidence of T2D. A key factor in the success of these interventions is adherence to lifestyle changes
-A number of mixed interventions involving, alone or in combination, diet, exercise, drug interventions and/or other interventions, can prevent T2D. The effectiveness of these interventions appears to depend on age, weight loss, and an individual’s risk profile, among other factors.
-Most preventive interventions (non-screening interventions) are considered cost-effective, with an incremental cost-effectiveness ratio of less than $20,000 USD per quality adjusted life year.
View the full report here.