The national diabetes prevention goal set by CDC is to reduce new type 2 diabetes cases from 1.4 million in 2018 to 1.1 million in 2025 (a 21% reduction). Policymakers often debate the merits of interventions that focus on high-risk individuals vs. whole population-based interventions that benefit a broader spectrum of the population.

To resolve this debate, we use a simulation modeling approach to optimize resource allocation among a risk-based intervention (the lifestyle change intervention specified in the National Diabetes Prevention Program [National DPP]) and three whole-population interventions (e.g., sugar sweetened beverage taxes, worksite health promotion, and bike lanes or walking paths). We use the simulation model to estimate the cost and number of diabetes cases prevented by combinations of risk-based and whole population-based interventions. We then plot the prevention frontier as the least-cost combination of interventions for each prevention target. The optimal allocation of resources across interventions can be selected by choosing a prevention target or specifying the available prevention budget.

We find that neither the National DPP alone nor three whole population-based interventions combined are likely to meet the 2025 goal for type 2 diabetes prevention (Figure). Instead, a combination of the National DPP and whole population-based interventions will be needed.


S. Neuwahl: None. T.J. Hoerger: Research Support; Self; Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services. M. Laxy: None. H. Shao: None. A.L. Albright: None. P. Zhang: None.


Centers for Disease Control and Prevention

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