Non-pharmacological interventions for adults with impaired glucose tolerance
Literature review and economic modelling was used to assess the effectiveness and cost-effectiveness of the following interventions for preventing diabetes in people with IGT/IFG:
- Weight loss in those who were overweight (BMI 26-29) or obese (BMI 30 and over), by calorie restriction alone or combined with exercise;
- Exercise therapies – i.e. exercise alone, without weight loss; and
- Qualitative changes in diet without calorie restriction and weight loss.
The above interventions were compared to standard practice which is taken as no organised screening; the usual lifestyle advice given opportunistically; and care of diabetes when it becomes symptomatic. However a survey of primary care using the GPRD database was also undertaken to assess recent practice.
Outcome and Translation
Individuals with impaired glucose tolerance or impaired fasting glucose are at increased risk of developing type 2 diabetes. This report, submitted to the NHS HTA programme, will be used to inform NHS policy surrounding the treatment of individuals identified as having IGT and/or IFG.
External Collaborators: N Waugh (Department of Population Health, University of Aberdeen); Aberdeen HTA Group (University of Aberdeen) and M Gillet (University of Sheffield)
Gillett, M., Royle, P., Snaith, A., Scotland, G., Poobalan, A., Imamura, M., Black, C., Boroujerdi, M., Jick, S., Wyness, L., McNamee, P., Brennan, A. and Waugh, N. (2012) 'Non-pharmacological interventions to reduce the risk of diabetes in people with impaired glucose regulation: a systematic review and economic evaluation', Health Technology Assessment, 16(33).
Gillett, M., Waugh, N., Brennan, A., Scotland, G. and Royle, P. (2008) 'Cost effectiveness of a 2-step lifestyle or metformin strategy for prevention of type 2 diabetes', Controversies to Consensus in Diabetes, Obesity and Hypertension, Barcelona, Spain, November 2008.