Introduction: Lifestyle intervention is a cost-effective approach for preventing type 2 diabetes among adults with prediabetes. Little is known about the cost effectiveness of lifestyle programs for children with prediabetes. The purpose of this study was to examine the cost and incremental cost effectiveness of an adapted diabetes prevention intervention compared to usual care among Latino youth with prediabetes.

Methods: Latino youth (age 13.5±1.4 years, mean±SD) with obesity and prediabetes were randomized to a community-based lifestyle intervention (INT, N=79) or usual care (UC, N=38) . The 6-month INT was delivered at a YMCA and included 1 d/wk of lifestyle education for families and 3 d/wk of physical activity. UC included 2 visits with a pediatric endocrinologist and registered dietician to discuss diabetes risks and healthy lifestyle changes. Data on health care costs and resource utilization were collected prospectively. Efficacy was examined as changes in 2-hr glucose concentrations during an OGTT. Cost analyses were performed from health care sector and societal perspectives.

Results: The INT led to decreases in 2-hr glucose (144.5±3.4 to 132.2±3.4 mg/dL, p=0.002) but these changes were not significantly different from changes in 2-hr glucose observed in UC participants (144.1±4.6 to 139.0±4.6; interaction p=0.260) . The average health care costs per participant were $1,032 for the INT and $1,251 for the UC. Total societal costs (health care plus patient and family opportunity costs) per participant were $3,641 for the INT and $1,331 for the UC. For health care costs alone, the incremental cost-effectiveness ratio (ICER) for 2-hr glucose was -$30.3 per mg/dL. When taking total costs into account, the ICER for 2-hr glucose was $320.8 per mg/dL.

Conclusion: From a health care sector perspective, INT led to greater reductions in 2-hr glucose at a lower cost compared to UC among Latino youth with prediabetes. The cost-effectiveness of INT decreases when total societal costs are included.


M.Olson: None. A.Pena: None. M.E.Putz: None. S.Ayers: None. W.C.Knowler: None. M.Mccullough: None. G.Q.Shaibi: None.


National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Disease (R01DK10757901)

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