Preventing type 2 diabetes (T2D) involves reducing T2D risk factors at the population level (PL) and lowering the risk of developing T2D in groups at higher risk (GHR). We used the 2013-2018 National Health and Nutrition Examination Survey data to generate a nationally representative population of adults without diabetes. Using the CDC-RTI T2D Cost-Effectiveness simulation model, we estimated the number of T2D cases and their complications prevented by two hypothetical combined PL and high-risk strategies compared with no intervention over 10 years: a moderate strategy (MS) consisting of an annual T2D risk reduction (RR) of 4% at the PL and a RR of 35%, 17.5%, and 10.5% in years 1, 2, and 3 in GHR using a moderate lifestyle intervention program (LIP); an intensive strategy (IS) consisting of an annual RR of 6% at the PL and a RR of 40%, 20%, and 12% over 3 years in GHR using an intensive LIP. We assumed a 50% LIP participation rate. We also assessed % of T2D prevented by the PL strategy alone under MS or IS. The MS and IS would prevent 667,317 and 926,265 T2D cases over 10 years. Of the total cases prevented, 68.3% and 73.9% were due to PL strategy with MS and IS. The prevented complication cases increased with the number of prevented T2D cases. Curbing the national T2D epidemic, implementing both the cost-effective LIP in GHR and PL strategies is needed.

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Disclosure

Y.Shao: Employee; Biogen. H.Shao: Consultant; Lilly Diabetes. G.Imperatore: None. C.S.Holliday: None. P.Zhang: None.

© 2023 by the American Diabetes Association
2023
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