Prediabetes Interventions Shown Cost Effective

As a practicing primary care physician and a type 2 diabetes researcher, I’m really stunned by these findings. I think they are going to cause a lot of discussion in prevention and policy circles.

There are very few interventions that come along especially pharmaceutical interventions that save money. Metformin is very cheap and it has modest side effects. This could revolutionize the way we approach the management of diabetes prevention.

Many patients prefer lifestyle changes at first as opposed to taking a pill, especially when they consider themselves healthy. The costs of these kinds of efforts already are covered in some ways by some health insurance plans that cover health club memberships.

Getting health insurers to adopt this kind of prevention attitude is a harder sell. Certainly, this kind of evidence has the capacity to shift the way we think about prevention.

The issue for me in trying to incorporate these findings into my practice will be in deciding which patients qualify for the interventions. Some of the eligibility tests performed in the Diabetes Prevention Program are not readily done in the primary care setting. Approximately half of the people in the study had metabolic syndrome, so that might be one way of deciding which individuals to focus on when considering these preventive interventions.

James B. Meigs, M.D., is an associate professor of medicine at Harvard Medical School and Massachusetts General Hospital, Boston. He reported having no relevant conflicts of interest.