Screening Those At Risk Of Developing Diabetes - Cost Effective

In a presentation last week, Dr Clare Gillies of the Department of Health Sciences will shared the results of her simulation study investigating the clinical and cost implications of screening people 'at risk' for impaired glucose intolerance and type 2 diabetes mellitus.

An important outcome of the work by Dr Gillies shows that early treatment and intervention resulting from this screening is potentially a cost-effective health policy.

Her research involved comparing the cost and health implications of four different approaches to screening for impaired glucose tolerance and type 2 diabetes. These were:

i) no screening
ii) screening for type 2 diabetes alone resulting in health benefits from early diagnosis and treatment of the disease
iii) screening for impaired glucose tolerance and type 2 diabetes, allowing for both early treatment of diabetes and for lifestyle interventions to be applied to individuals with impaired glucose tolerance to reduce their risk of developing diabetes
iv) as for iii) but with pharmacological rather than lifestyle interventions

Dr Gillies developed a computer decision model using data from a number of sources to evaluate the cost and health implications of these four policies.

She said: "The model simulated a population with an increased risk of developing type 2 diabetes, who were aged 45 at the start of the model and thus time of screening. The model was run to estimate the cost and health implications over a 50 year time horizon, and the four different screening policies were then compared.

"Conclusions drawn from the work were that screening for type 2 diabetes and impaired glucose tolerance, with appropriate interventions for the latter, in an above average risk population at age 45, appears to be cost effective.

"The cost effectiveness of a policy of screening for diabetes alone, which offered no intervention to those with impaired glucose tolerance, is still uncertain and more information is needed on the long term health implications of early diagnosis and treatment of this disease."

The work was funded jointly by the Economic and Social Research Council (ESRC) and the Medical Research Council (MRC) as part of an interdisciplinary research initiative in the social and medical sciences.