The Cost-Effectiveness of Lifestyle Interventions for Preventing Diabetes in a Health Resource-Limited Setting

Table 1

Key model inputs.

Parameters	Expected values	Ranges	Source
Clinical data
Weibull function parameters
No prevention	,	NA	[9]
Life interventions	,	NA	[9]
RR of diabetes of life interventions vs. no prevention	0.55	0.4-0.76	[9]
RR of MI of T2DM vs. no diabetes	2	1.83-2.19	[17]
RR of stroke of T2DM vs. no diabetes	2.27	1.95-2.65	[17]
RR of CVD death of T2DM vs. no diabetes	2.38	1.45-3.92	[17]
RR of CHF of T2DM vs. no diabetes	2.5	2.3-2.7	[18, 19]
RR of blindness of T2DM vs. no diabetes	1.43	1.04-2.32	[21, 22]
RR of clinical neuropathy of T2DM vs. no diabetes	4.60	3.18-6.02	[23, 24]
RR of chronic kidney disease of T2DM vs. no diabetes	2.38	1.45-3.92	[20]
Costs (US $)^#
Life interventions	134.0	43.8-611.6	[26]
Antidiabetic therapy per day ()	0.5	0.1-1.2	[27]
Antidiabetic therapy per day ()	0.8	0.1-1.6	[27]
Antidiabetic therapy per day ()	1.2	0.3-2.3	[27]
Antidiabetic therapy per day ( duration≥10 years)	1.8	0.7-3	[27]
MI hospitalization per event	6955.0	6128-7782	[4, 28–30]
Care after MI per year	429.0	271.9-586.1	[4, 28–30]
Stroke hospitalization per event	2708.6	2058-4463.6	[4, 28–30]
Care after stroke per year	477.5	420.1-780	[4, 28–30]
CHF per year	1420.3	1181.9-2479.7	[4, 28–30]
ESRD per year	13,003.0	12,391.3-13,724.6	[31]
Blindness per year	1546.8	1347.5-1746	[4, 28–30]
Clinical neuropathy per month	57.4	24.7-95.5	[32]
Uncomplicated DFU per event	71.7	0-213	[32]
Complicated DFU per event	2160.3	1157.2-2713.8	[32]
Minor amputation per event	3124.6	2039.7-4746.8	[32]
Major amputation per event	4728.3	2808.3-7289.6	[32]
Care after major amputation per month	318.5	0-565.9	[32]
Severe hypoglycemia per event	534.4	400.8-667.9	[33]
Utility values
T2DM without complications	0.876	0.736-1	[34]
Utility decrements
MI hospitalization for one month	1.000	0.236-1	[34]
MI after discharge	0.236	0.026-0.446	[34]
Stroke hospitalization for one month	1.000	0.326-1	[34]
Stroke after discharge	0.326	0.036-0.616	[34]
CHF	0.236	0.026-0.446	[34]
ESRD	0.400	0.19-0.61	[4, 28–32]
Blindness	0.157	0.007-0.307	[4, 28–32]
Clinical neuropathy	0.185	0.015-0.355	[34]
Uncomplicated DFU	0.250	0.213-0.287	[4, 28–32]
Complicated DFU	0.300	0.165-0.435	[4, 28–32]
Minor amputation	0.320	0.204-0.436	[4, 28–32]
Major amputation	0.380	0.264-0.496	[4, 28–32]

Abbreviations: NA: not applicable; RR: relative risk; T2DM: type 2 diabetes mellitus; DFU: diabetic foot ulcers; MI: myocardial infarction; CHF: congestive heart failure; CVD: cardiovascular disease; ESRD: end-stage renal disease. ^#All cost data were shown in the 2019 US dollar ().